the health implications of climate change nancy s. partika, rn, mph, president hawai’i public...
TRANSCRIPT
The Health Implications
of Climate ChangeNancy S. Partika, RN, MPH, President
Hawai’i Public Health Association
Presented to 58th Pacific Island Health Officers Association USAPI Executive
Meeting, August 6,2015
PPT research conducted by Chad K. L. Au, MPH-EPI candidate, University of Hawaiʻi at Mānoa
Definition of Health:
A State of Complete Physical, Social and Mental Well-being, and not merely the absence of disease or
infirmity.
Source: World Health Organization Constitution, 1948
Public Health is…• Population-based• Concerned with Wellness and Disease• Noticed Most when absent• Concerned with Prevention• Multi-disciplinary• Concerned with Quality and Assurance of
health services• Committed to Social Justice
The Connection Between Climate Change and Health
• Until mid-century (2050), projected climate change will impact human health, mainly by exacerbating health problems that already exist (very high confidence).
• Throughout the 21st century, climate change is expected to lead to increases in ill-health in many regions and especially in developing countries with low incomes, as compared to a baseline without climate change (high confidence).
IPCC Predictions-Climate Change 2014• Examples include: greater likelihood of injury, disease, & death
due to more intense heat waves and fires (very high confidence); increased likelihood of under-nutrition resulting from diminished food production in poor regions (high confidence); risks from lost work capacity & reduced labor productivity in vulnerable populations; & increased risks from food- & water-borne diseases (very high confidence) & vector-borne diseases (medium confidence)
• Globally over the 21st century, the magnitude and severity of negative impacts are projected to increasingly outweigh positive impacts (high confidence)
• Island nations are already experiencing impacts due to climate change
Climate Change and Health Implications-CDC
Asthma, Respiratory Allergies and Airway Diseases
Asthma in U.S.•1 in 12 adults•1 in 11 children
• 147,628 (HHS, 2010)• USAPI-???
•Climate change will increase the amounts of pollen, dust and allergens in the air
•VOG (volcanic pollution) affects those with asthma and chronic lung problems
USA. National Governors Association. Health Investments That Pay Off: Strategies for Addressing Asthma in Children. N.p.: n.p., n.d. Print.
Cancer and Climate Change• Higher ambient temperatures may increase the spread
and transfer of carcinogens
• Expected to increase heavy precipitation that may increase the chances of toxic contamination leaking into oceans and water sources
• 2007-11 USAPI Age-Adjusted Cancer Rate for Adults over age 20 years= 206.6/100,000
• Further Cancer & Climate Change research is needed
A Human Health Perspective On Climate Change: A Report Outlining the Research Needs on the Human Health Effects of Climate Change
CVD & Stroke-Climate Change• Cardiovascular disease is the leading cause of death in
the United States, with strokes following as 3rd highest
• In Hawai’i, roughly 1 in 4 of those affected are Native Hawaiian
• In the USAPI, ?? are affected by Cardiovascular Disease & Stroke
• Evidence points to both extreme heat and extreme cold directly affects incidence of CVD & Stroke
Climate Change Key Terms• Adaptation: The adjustment of our built environment,
infrastructure, and social systems in response to actual or expected climatic events or their effects. Adaptation includes responses to reduce harm or capture benefits (Intergovernmental Panel on Climate Change [IPCC], 2007).
• Mitigation: Any sustained action taken to reduce or eliminate long-term risk to life and property from hazard events. This word has two distinct meanings: In the climate change and sustainability context, it means reduction of greenhouse gas emissions and concentrations. In the disaster preparedness and resilience context, it means any type of risk reduction
McMichael, Anthony J., Rosalie E. Woodruff, and Simon Hales. "Climate change and human health: present and future risks." The Lancet 367.9513 (2006): 859-869.
Climate Change:
Mitigation and
Adaptation Connections
toHealth
Health Hazards
of Climate Change
McMichael, Anthony J., Rosalie E. Woodruff, and Simon Hales. "Climate change and human health: present and future risks." The Lancet 367.9513 (2006): 859-869.
Environmental Refugees• Environmental degradation around the world is creating a new category
of people, known as "environmental refugees”
• Populations are being displaced by gradual environmental shifts, many of which linked to climate change (desertification, diminishing water supplies, erosion, rising sea levels)
• Focus has been more on the impact that mass displacement has on the environment rather than on the role environment itself plays in creating refugees
• By 2010 the number of environmental refugees grew to 50 million (UNU-EHS prediction)-There could be as many as 150 million by 2050
• How many of these will be from the USAPI?
Climate Change Impacts on Islands• Water availability is declining, with significant implications for island
communities, economies & resources
• Island communities, infrastructures & ecosystems vulnerable to coastal inundations, due to sea level rise & coastal storms
• Sea level in the western Pacific Ocean has been increasing at a rate 2–3 times the global average, resulting in almost 0.3 meters (1 foot) of net rise since 1990 (4 times higher than global average in Caribbean)
• Effects on coastal & marine ecosystems will have major impacts on tourism & fisheries
Climate change directly exacerbates existing public health problems, including: •The incidence of ciguatera poisoning, diarrheal disease, malnutrition, and vector-borne diseases (dengue fever, due to rise as a result of increased temperatures and changes in rainfall)
The indirect public health effects of climate change could be far-reaching. including:•increases in malnutrition due to losses of subsistence agriculture and fisheries•deterioration in standards of living due to impacts on primary sectors •loss of land and infrastructure, leading to increased crowding and land shortages • immense economic, social, and cultural impacts associated with population relocation, as a result of tidal inundation or water shortages.
Health Impacts of Climate Change Include:
Planning the Public Health Response to Climate Change
and its Impacts on Health
Source: 1 meter contour at High Tide in Honolulu--The Blue Line Project-UH-SOEST-Dr. C. Fletcher
How does climate change affect the health of populations?
• “Climate change, together with other natural and human-made health stressors, influences human health and disease in numerous ways. Some existing health threats will intensify and new health threats will emerge. Not everyone is equally at risk.
• In the U.S., public health can be affected by disruptions of physical, biological, and ecological systems, including disturbances originating here and elsewhere.
• The health effects of these disruptions include increased respiratory and cardiovascular disease, injuries and premature deaths related to extreme weather events, changes in the prevalence and geographical distribution of food- and water-borne illnesses and other infectious diseases, and threats to mental health.”
(Source: Climate Effects on Health: http://www.cdc.gov/climateandhealth/effects/default.htm )
What do you think the Public Health response should be in the current
climate change environment?
•Is it, “Wait and see—we will respond as needed.”
•Or, “We need to be developing & showing leadership in our response now, rather than later.”
•Or, “It is too late anyway—whatever we do will not make a difference.”
Ten Essential Services of Public Health Relating to Climate Change
Climate Change and Health:Hawaii’s Public Policy Discussion 2015
• “House/Senate Concurrent resolution HCR 108, SD1: requesting the convening of a climate change and health working group to assess the scope and risks of climate change on the health of Hawaii’s residents and to develop a strategic plan to address climate change risks to health statewide”
• Passed on May 1, 2015-Directs the Hawaii State Dept. of Health to convene a Climate Change & Health working group and to report its findings and recs to 2016 State Legislature.
• Dialogue needs to broaden and diversify—become more inclusive & community-wide
Hawaii’s Climate Change & Health Working Group-2015-16
• Meeting 1: Aug 20, 2015: Focus: Introductions of WG; overview of HCR108, SD1 and HCCWG purpose; Introduction to climate change and health; Developing, improving, integrating, and maintaining state and regional disease surveillance systems and monitoring capacity to respond to health-related effects of climate change
• Meeting 2: Sept. 17, 2015: Focus: Water security, food safety, and
vector-borne infectious diseases
• Meeting 3: Oct. 15, 2015: Focus: Respiratory and pulmonary effects, including responses to air allergens; the health effects of air pollution, including heightened sensitivity to air pollution
Hawaii’s Climate Change & Health Working Group-2015-16
•Meeting 4: Nov. 19, 2015: Focus: Cardiovascular effects, including impacts of temperature extremes; Mental and behavioral health impacts of climate change in the health of displaced persons and at-risk populations and communities; •Meeting 5: Dec. 17, 2015: Focus: Initial report and recommendations to the 2016 Legislature finalized, reviewed by DOH and sent •Jan-June 2016: WG meeting agendas to focus on working on/refining strategies, tools, needs and resources to address priority challenges to Hawaii’s health from climate change
The CDC has a framework
entitled, Building
Resilience Against Climate Effects
(BRACE)
Focuses on “adaptation”
and “interventions”
Marinucci, Gino D., et al. "Building resilience against climate effects—A novel framework to facilitate climate readiness in public health agencies." International journal of environmental research and public health 11.6 (2014): 6433-6458.
Prioritization of Climate and Health Impacts and Intervention Options
Health and climate effects of carbon pollution-
Unchecked carbon pollution leads to long-lasting changes in our climate, such as:•Rising global temperatures•Rising sea level•Changes in weather and precipitation patterns•Changes in ecosystems, habitats and species diversity•Our most vulnerable citizens, including children, older adults, people with heart or lung disease and people living in poverty may be most at risk from the health impacts of climate change.
The U.S. Clean Power Plan –August 3, 2015
• These changes threaten America's health and welfare for current and future generations. Public health risks include:
• More heat waves and drought• Worsening smog (also called ground-level ozone pollution)• Increasing the intensity of extreme events, like hurricanes,
extreme precipitation and flooding• Increasing the range of ticks and mosquitoes, which can spread
disease such as Dengue Fever, Lyme disease and West Nile virus
source: http://www2.epa.gov/cleanpowerplan
CDC funding helps states address infectious disease threats
• Press Release--For Immediate Release -Monday, August 3, 2015 • Contact: CDC Media Relations (404) 639-3286 • Awards build epidemiology and laboratory capacity for public protection• The Centers for Disease Control and Prevention (CDC) today announced awards of nearly $110
million to help states and communities strengthen their capacity to track and respond to infectious diseases. The awards represent an increase of about $13 million over fiscal year 2014 funding, with increases going to vaccine-preventable-disease surveillance, foodborne-disease prevention and advanced molecular detection, among other projects.
• The funding is allocated through the Epidemiology and Laboratory Capacity for Infectious Diseases Cooperative Agreement (ELC), with a goal of helping states fight infectious disease outbreaks more quickly and develop better interventions to protect the public’s health. Of the nearly $110 million, $51 million is provided through the Affordable Care Act’s Prevention and Public Health Fund. That funding will support:
• Infectious disease surveillance and outbreak response• Public health laboratories• Health information systems• Efforts to combat zoonotic, vector-borne and foodborne diseases; vaccine-preventable infections; influenza; and healthcare-
associated infections.
The Public Health Response to Climate Change Needs to Include:
• A well-prepared line of defense: health providers and systems need to prepare for adverse impacts of climate change & know which populations are most at risk for negative health impacts;
• A reliable tracking system to monitor effects of climate change & identify trends;
• Investigation of disease outbreaks potentially associated with climate change;
• Health care providers well-trained on health aspects of climate change;
• Effective education & communication strategies to inform the public & policy-makers about the health impacts of climate change
