Mitigating Health Consequences of Climate Change

Sten H. Vermund, MD, PhDYale School of Public Health

Global threats to the environment of human origin

• Global climate change (originally known as global warming, but renamed by a political lobbyist)

• Direct human effects

– Hotter and drier summers (heat related deaths)

– Warmer and wetter winters (loss of polar/glacial ice)

– Increased extreme weather (adverse events)*

– Property (especially coastal) and crop loss

– Loss of fish (ocean biodiversity) starting with loss of reef ecosystems

*Net Hurricane Power Dissipation Highly Correlated w/ Tropical Sea Surface Temp. Nature 2015*Increased Sea Surface Temperatures and Greater Hurricane Intensity. Science 2005

16 of the 17th hottest years in the past 137

years have been since 2001 (17th in 1998).

Hottest 3 years were 2016, 2012, and 2017.

3rd

2014 2010

Since 1979, size of summer polar ice cap has shrunk >40%

https://its-interesting.com/2012/10/23/what-will-ice-free-arctic-summers-bring/

Canada

Alaska

Siberia

Spitzbergen/Norway

Debate: Deforestation vs. global warming.

Result in either case, malaria in the foothills

Thermohaline CirculationThe ocean is a vast heat store and North-South, East-West circulator

Atlantic current: Meridional overturning circulation (MOC)

http://www.eoearth.org/view/article/150290/

Evidence for global climate change

• Irrefutable and overwhelming

– Analogous to smoking and lung cancer, HPV and cervical cancer, asbestosis and mesothelioma, HIV and AIDS

– Scientists who disagree are nearly all on the payrolls of interested parties, e.g., fossil fuel industry

– Major climate change denial “experts” are mostly paid lobbyists without any scientific background

Most obviously, direct effects threats

• Heat-related morbidity and mortality well documented, notably in heat waves of defined time period– Elderly, Poor, Homeless, Infants

– Water-shortage areas

• Decreased population adaptability to heat documented over time, but not to cold– Arbuthnott K, et al. Changes in population

susceptibility to heat and cold over time: …. Environ Health 2016; 15 Suppl 1:33.

Some countries and regions are especially

vulnerable to direct climatological events

Alliance of Small Island Statesaosis.org

Members• Antigua and Barbuda• Bahamas• Barbados• Belize• Cape Verde• Comoros• Cook Islands• Cuba• Dominica• Dominican Republic• Fiji• Fed. States of Micronesia• Grenada• Guinea-Bissau• Guyana

• St. Lucia• St. Vincent and the

Grenadines• Suriname• Timor-Leste• Tonga• Trinidad and Tobago• Tuvalu• Vanuatu

Observers• American Samoa• Netherlands Antilles• Guam• U.S. Virgin Islands• Puerto Rico

• Haiti• Jamaica• Kiribati• Maldives• Marshall Islands• Mauritius• Nauru• Niue• Palau• Papua New Guinea• Samoa• Singapore• Seychelles• São Tome and Principe• Solomon Islands• St. Kitts and Nevis

Implications of rising sea levels

• Displacement of coastal communities• Disturbance of agricultural activity• Coastal erosion, beach loss, decline in tourism• Intrusion of sea water into freshwater aquifers• Complete underwater disappearance of islands, many

of them previously occupied– The Bahamas, Kiribati, the Maldives, Tuvalu, Torres Strait

Islands (between Australia and PNG), Solomon Islands– The Marshall Islands (NY Times, Dec.1, 2015)– Micronesia (Nunn PD, et al. Identifying and assessing

evidence for recent shoreline change attributable to uncommonly rapid sea-level rise in Pohnpei, Federated States of Micronesia, Northwest Pacific Ocean. J Coast Conserv 2017;21:719.)

Kennedy Space

Center

Miami

Areas subjected to

inundation w/ 1 m

rise in sea level

Source: Corell RW,

2004: Impacts of a

warming Arctic. Arctic

Climate Impact

Assessment

(www.acia.uaf.edu)

Cambridge University

PressEverglades and

FL Keys

v

Global warming: may affect storm formation and intensity (e.g., hurricanes, cyclones, tornados)

How?As temperatures rise, more and more water vapor evaporates into the atmosphere “fuel” for storms• More heat and water in the atmosphere

combined w/warmer ocean surface temperatures increases the wind speeds of tropical storms

• Analogous phenomena with temperature inversions can drive tornados

• Droughts and floods also facilitated

http://earthobservatory.nasa.gov/Features/RisingCost/rising_cost5.php

Hurricane Sandy: 29-31 Oct. 2012 • Record rain, wind, and storm surges.

– 23,000 homeless and 8.5 M no power in NJ, NY, and 12 states

• Costs incurred within just one year…

– $1.4 B in Individual Assistance provided to >182,000 victims

– $2.4 B in low-interest disaster loans approved by the SBA

– >$7.9 B in National Flood Insurance Program payments made

– FEMA approval for $3.2 B for emergency response and rehab.

Costs of Extreme Weather Events

Spread of vector-borne diseases

• Mosquito-related infections– Malaria– Dengue Fever, Yellow Fever, Zika virus– West Nile, EEE, SLE, Bourbon virus– Chikungunya, other arboviruses

• Other vector-related infections– Filariasis/Onchocerciasis (Blackflies)– Schistosomiasis (Snails)– Hantaviruses (Rodents)– Trypanosomiasis (In Africa, tsetse

fly; In Americas, Reduviid bug)

Malaria in the highlands of Africa

Tick-borne infectious diseases

• Greater distributions and longer tick seasons• Lyme disease

• Rocky Mountain spotted fever

• Babesiosis

• Ehrlichiosis and Anaplasmosis

• Relapsing Fever

• Tularemia

Water-borne diseases

• Cholera

• Typhoid fever

• Diarrheal diseases: bacteria, virus, parasite

• Enteric parasites: warm, moist soil maturation

• Sanitation-related: hookworm

Population Growth Pressure around Lake Victoria

Shrinkage of Lake Chad

Persistent drought

& water diversion

has shrunk the lake

to about a tenth of

its former size

In 1972, a larger

lake surface area is

visible with 2001

lake as indicated on

the next slide

Aral Sea is shrinking, as did Lake Chad & California’s Mono Lake

Education (especially girls/women) Unmet need for family planning (and improved maternal/child survival) Sustainable economic empowerment

Global Climate Change

Loss of Biodiversity

Overpopulation

Research, Policy,

Education, Action

Policy/Action to stabilize CO2

Atmospheric Levels• Efficient Transportation• Energy Conservation• Sustainable Energy Sources • Sustainable Land Use• Population Stabilization• Economic incentives (cap and trade; carbon credits)

• Political change and commitment– Moratorium on fossil fuel exploration– Massive shift to alternative energy sources– Commitment to conservation, e.g., mass transit, LEED buildings,

policy shifts (68⁰F. in winter, 72⁰F. in summer)

Mitigation• Emergency responses and planning

– Heat waves, drought, extreme weather– Flooding refugee relocations

• Anticipatory work– Ocean barriers– Air cooling/hydration planning for vulnerable

populations– Prior relocations– Re-forestation, not de-forestation– Control of air and water pollution

• Vector control; water and hygiene• Family planning to meet unmet needs

Yale Climate Change and Health Initiative

https://publichealth.yale.edu/climate/

Director: Prof. Rob Dubrow

sten.vermund@yale.edu