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Climate Change: Managing the Shifting Environmental Health Risks Changing hazards, changing risks, and the need for robust risk management Jeremy Hess, MD, MPH
Climate Change: Managing the Shifting Environmental Health Risks
Changing hazards, changing risks, and the need for robust risk
management
Jeremy Hess, MD, MPH
Overview
• Climate change – What’s happening and why– What health impacts we’ll see
• Risks from environmental hazards– A conceptual framework for risk– How climate change is changing the risk landscape
• Risk management– Some approaches– Implications for public health
CLIMATE CHANGEA brief primer
Climate Change
Thanks to Daniel Rochberg for some slides
Climate Change
Increased GHG
Emissions
IncreasedGHG
ConcentrationsImpactsIncreased
Temperature
Climate Change
Increased GHG
Emissions
IncreasedGHG
ConcentrationsImpactsIncreased
Temperature
Climate Change
Increased GHG
Emissions
IncreasedGHG
ConcentrationsImpacts
http://www.pewclimate.org/facts-and-figures/international/historical
Increased Temperature
Climate Change
Increased GHG
Emissions
IncreasedGHG
ConcentrationsImpacts
2012 Peak Concentration: 396 ppm
CO2 Concentrations over the past 800,000 years(dark blue line)
Increased Temperature
http://ngm.nationalgeographic.com/big-idea/05/carbon-bath
Climate Change
Increased GHG
Emissions
IncreasedGHG
ConcentrationsImpactsIncreased
Temperature
The Copenhagen Diagnosis, available here.
Climate Change
Increased GHG
Emissions
IncreasedGHG
ConcentrationsImpactsIncreased
Temperature
Climate Change
Increased GHG
Emissions
IncreasedGHG
ConcentrationsImpactsIncreased
Temperature
Historical and Projected Global Temperatures(degrees C; 2000 = 0)
IPCC
Climate Change
Increased GHG
Emissions
IncreasedGHG
ConcentrationsImpactsIncreased
Temperature
Climate change
“Climate change refers to any distinct change in measures of climate lasting for a long period of time. In other words, ‘climate change’ means major changes in temperature, rainfall, snow, or wind patterns lasting for decades or longer.”
U.S. Environmental Protection Agency, Frequently Asked Questions about
Global Warming and Climate Change
http://www.epa.gov/climatechange/downloads/Climate_Basics.pdf
Climate Change
Increased GHG
Emissions
IncreasedGHG
ConcentrationsImpactsIncreased
Temperature
Climate Change
Increased GHG
Emissions
IncreasedGHG
ConcentrationsImpactsIncreased
Temperature
Climate Change
Increased GHG
Emissions
IncreasedGHG
ConcentrationsImpactsIncreased
Temperature
Climate Change
Increased GHG
Emissions
IncreasedGHG
ConcentrationsImpactsIncreased
Temperature
http://www.cbc.ca/gfx/images/news/photos/2009/07/06/drought-china-cp-w-6244601.jpg
“There is medium confidence that droughts will intensify in the 21st century in some seasons and areas, due to reduced precipitation and/or increased evapotranspiration.”
IPCC Special Report on Managing the Risks of Extreme Events and Disasters to Advance Climate Change AdaptationSummary for Policymakers, p. 11
Climate Change
Increased GHG
Emissions
IncreasedGHG
ConcentrationsImpactsIncreased
Temperature
Maldives: 1,192 islands 330,000 peopleaverage elevation ~1 meter
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IPCC sea level rise projections by 2100: 18-59 cm
IPCC 4th Assessment Report, Synthesis Report
Climate Change
Increased GHG
Emissions
IncreasedGHG
ConcentrationsImpactsIncreased
Temperature
http://w
ww
.history.com/photos/heat-w
aves/photo2
“It is very likely that the length, frequency, and/or intensity of warm spells or heat waves will increase over most land areas.”
IPCC Special Report on Managing the Risks of Extreme Events and Disasters to Advance Climate Change AdaptationSummary for Policymakers, p. 11
“France's summer heatwave killed a total of 14,800 people, according to official figures released on Thursday.”
BBC News, September 25, 2003
Climate Change
Increased GHG
Emissions
IncreasedGHG
ConcentrationsImpactsIncreased
Temperature
photo by Paula Bronstein, Getty Images http://news.nationalgeographic.com/news/2010/08/photogalleries/100826-pakistan-flooding-millions-people-pictures/#/pakistan-flooding-man-water_25084_600x450.jpg
“It is likely that the frequency of heavy precipitation or the proportion of total rainfall from heavy falls will increase in the 21st century over many areas of the globe.”IPCC Special Report on Managing the Risks of Extreme Events and Disasters to
Advance Climate Change Adaptation, Summary for Policymakers, p. 11
Climate Change
Increased GHG
Emissions
IncreasedGHG
ConcentrationsImpactsIncreased
Temperature
Average tropical cyclone maximum wind speed is likely to increase, although increases may not occur in all ocean basins.
IPCC Special Report on Managing the Risks of Extreme Events and Disasters to Advance Climate Change Adaptation, Summary for Policymakers, p. 11
It is likely that the global frequency of tropical cyclones will either decrease or remain essentially unchanged.
IPCC Special Report on Managing the Risks of Extreme Events and Disasters to Advance Climate Change Adaptation, Summary for Policymakers, p. 11
http://ww
w.nasa.gov/im
ages/content/470571main_isabel_lg.jpg
Climate Change
Increased GHG
Emissions
IncreasedGHG
ConcentrationsImpactsIncreased
Temperature
ENVIRONMENTAL HAZARD RISKThe components of risk and how they are shifting
Event•Probability•Magnitude
Vulnerability•Exposure•Susceptibility
Loss•Damage •Valuation
Basic Risk Formula in CC Community
Probability x Consequence = Risk
Some Climate Change Risks
Lenton, T. M. (2011). Early warning of climate tipping points. Nature Climate Change. 1: 201-209.
Components of Risk
Equations• Risk = p(H) x impact or cost• Risk = p(H) x V/Res, where
– pH = Hazard probability– V = Vulnerability, where
• V = p(E) x (S)• pE = Exposure probability• S = Susceptibility
– Res = Resilience• Res ≡ Adaptive Capacity
Considerations• What is the hazard?• Who is most vulnerable?
– Little guidance– Based on exposure and susceptibility:
• Elderly • Children• Workers
• What drives adaptive capacity for vulnerable populations?
• How might early warnings facilitate protective responses and increase resilience?
How Risk is Changing: Hazards
How Risk is Changing: Hazards
IPCC. Managing the Risks of Extreme Events and Disasters to Advance Climate Change Adaptation. A Special Report of Working Groups I and II of the Intergovernmental Panel on Climate Change. Cambridge, UK: Cambridge University Press; 2012.
How Risk is Changing: Exposure
Available: http://www.worldmapper.com
How Risk is Changing: Exposure
IPCC, SREX, 2012
How Risk is Changing: Susceptibility
Available: http://www.worldmapper.comGlobal Distribution of Preventable Deaths
Mortality Distribution
95% of disaster deaths occur in the developing worldIPCC, SREX, 2012
Combination, 1975-2010
People Killed
People Affected
Disasters
People Killed
People Affected
Disasters
Health Effects of Disasters
Pre-event – injuries, road traffic crashes
Event – debris injuries, drowning
Post-Event – displacement, chronic dz exacerbation
Recovery – depression, violence
Hurricanes Katrina and Rita
NOLA Health Care System Pre and Post
Rudowitz et al., 2006; slide courtesy John Balbus
Moving the Coping Range
THE ROLE OF RISK MANAGEMENTApproaches to risk and implications for public health
Aspects of Risk Management
• Multiple components– Risk recognition– Risk assessment– Risk engagement
• Multiple stances– Risk mitigation– Risk avoidance– Risk retention– Risk sharing
Minimize or AvoidRetention Sharing
Mitigation AvoidanceRetain or Share
Climate Change
Increased GHG
Emissions
IncreasedGHG
ConcentrationsImpactsIncreased
Temperature
okay, climate change is a problem.what do we do about it?
Climate Change
Increased GHG
Emissions
IncreasedGHG
ConcentrationsImpactsIncreased
Temperature
reduce emissions
(mitigation)
prepare for / respond to the
impacts(adaptation)
okay, climate change is a problem.what do we do about it?
mitigate against
this
adapt to this
Put another way:
Mitigation:“avoiding the unmanageable”
Adaptation:“managing the unavoidable”
http://www.ipcc.ch/graphics/graphics/ar4-wg1/ppt/figure02.ppt#278,22,Figure 2.21
Allaffect human
health
Potential Co-benefits of GHG Mitigation Policies
• Energy generation – decreased air pollution
• Transportation – increased physical activity, decreased air pollution, decreased injuries from collisions
• Agriculture – reduced red meat consumption
• Agriculture – improved nutrition
Identifying synergies and opportunities for co-benefits
Both Are Required
Yohe and Leichenko 2010
Risk Management Options
IPCC SREX Summary for Policy Makers, available here.
But Where to Start?
BRACE1. Forecasted
Climate Impact and Vulnerability
Assessment
2. Projected Disease Burden
3. Intervention Assessment
4. Health Adaptation
Planning and Implementation
5. Evaluation
“Place Specific and Path Dependent”
• At any point in time, health risks associated with environmental hazards depend markedly on interactions between components of risk
• Do we start with hazards or vulnerability?– If vulnerability relatively high, address that preferentially– If vulnerability relatively low, explore thresholds and
implications of shifting hazards• Be mindful of feedbacks over time:
– Exposure over time (or lack thereof) can feed back into vulnerability
– Implications for adaptive capacity, development, and resilience
Feedbacks Over Time
IPCC, SREX, 2012
Changing Risk Over Time
Tol R, Ebi K, Yohe G. Infectious disease, development, and climate change: a scenario analysis. Environment and Development Economics. 2007;12(05):687-706.
Awareness of Thresholds
Lenton, T. M. (2011). Early warning of climate tipping points. Nature Climate Change. 1: 201-209.
The Role of Learning
IPCC, SREX, 2012
Problem Types
Used with permission from Hovmand, P. S. Adapted rom Burrell, G., and Morgan,G. (1979). Sociological paradigms and Organizational analysis: Elements of sociology of corporate life. London, and Heinemann, and Lane, D. C. (1999). Social theory and System dynamics practice. Journal of Operational Research Society, 113, 501-527.
The Role of Transformation
IPCC, SREX, 2012
Simulations Can Help
Role of Adaptive Management
• Return to the risk equation– Reduce hazard probability– Reduce hazard exposure– Reduce susceptibility
• Requires modeling, learning, and adaptive management
• Integrated with sustain-able development
Assess
Plan
Implement
Monitor
Evaluate
Adjust
In Summary• Climate change is changing the risk landscape• Several risk management stances are available• Risk can be broken down into components and
the breakdowns can help guide risk management• Risk assessment, risk management, and risk
communication are increasingly linked• Adaptive management is an important short- to
medium-term tool
