John M. Balbus, MD, MPHNational Institute of Environmental Health Sciences

Captain Edward A. Pfister, RS, MSPHHHS Environmental Program Manager

HHS/OS/ASA/OFMP

USPHS Scientific and Training SymposiumJune 20, 2012

Climate Health Risks and Community Resilience

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The ‘00’s were our hottest decade

FROM: IPCC, 2007 WG1-C1-pg. 115

2011 had a record number of billion dollar disasters

Potential Health Effects of Climate Change

Climate Change:

Temperature rise

Sea level rise

Hydrologic extremes

HEAT Heat stress, cardiovascular failure

SEVERE WEATHER Injuries, fatalities

AIR POLLUTION Asthma, cardiovascular disease

ALLERGIES Respiratory allergies, poison ivy

VECTOR-BORNE DISEASES

Malaria, dengue, encephalitis, hantavirus, Rift Valley fever

WATER-BORNE DISEASES Cholera, cryptosporidiosis, campylobacter, leptospirosis

WATER AND FOOD SUPPLY Malnutrition, diarrhea,

harmful algal blooms

MENTAL HEALTH Anxiety, despair, depression, post-traumatic stress

ENVIRONMENTAL REFUGEES Forced migration, civil

conflictAdapted from J. Patz

How does climate change influence human health?

• Direct impacts of climate change, weather, and sea level rise on humans

– Heat stress– Weather-disease curves– Storms, weather extremes

• Impacts of climate change on physical and chemical agents

– Air pollution effects– Fate and transport of toxic chemicals– Ozone depletion interactions

How does climate change influence human health?

• Impacts of weather and climate change on biological agents– Microbes (including algae)– Plants (pollens, poisons)– Zoonoses, including VBD’s

• Impacts of climate change and sea level rise on fundamental life support– Water availability– Food/crop productivity– Shelter

Climate Change and Health

A Human Health Perspective on Climate Change

• Identifies research needed to better understand the health effects of climate change, and choose the healthiest mitigation and adaptation strategies:– 11 Health Consequences Categories

– Crosscutting issues

www.niehs.nih.gov/climatereport

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Eleven Human Health and Disease Categories

• Asthma, respiratory allergies, and airway diseases

• Cancer

• Cardiovascular disease and stroke

• Foodborne diseases and nutrition

• Heat-related morbidity and mortality

• Human developmental effects

• Mental health and stress-related disorders

• Neurological diseases and disorders

• Vectorborne and zoonotic diseases

• Waterborne diseases

• Weather-related morbidity and mortality

1st set of NIH Population Vulnerability to Climate Change grantees

http://www.ipcc.ch/graphics/graphics/ar4-wg1/ppt/figure02.ppt#278,22,Figure 2.21

Allaffect human health

Climate Change: Adaptation and Mitigation

• Adaptation is a response, the actions necessitated by the actual or anticipated impacts of climate change.

Mitigation is the effort to stop or slow climate change, usually by reducing the GHG emissions driving the problem.

Two prongs used in concert: mitigation reduces impacts, making it adaptation easier .

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 – Livestock has a huge GHG footprint (deforestation, water, transport, refrigeration…)

• Agriculture – improved nutrition

Potential Co-benefits of GHG Mitigation Policies

• For example, transportation policies that augment the use of public transportation or provide safer and more convenient means for individuals to walk or bicycle

Co-benefits:

• reductions in toxic air pollution

• Increases in physical activity

Adaptation principles

• Climate change as stress multiplier• Focus on vulnerability of people (and/or health systems) to climate

change; assure continuity of services

• Impact is proportional to baseline prevalence of climate-sensitive diseases– prepare for future impacts of climate change on health

• Address existing health disparities in cardiovascular disease, diabetes, obesity, asthma

• Address upstream determinants of health• Investigate health implications of major climate change policy decisions

• Importance of urban infrastructure • options/strategies to respond to identified current and future health risks

President’s Climate Adaptation Task Force: Health Recommendation

• Protect human health by addressing climate change in public health activities– Enhance the ability of Federal

decision makers to incorporate health considerations into adaptation planning

– Build integrated public health surveillance and early warning systems to improve detection of climate change health risks

– Promote resilience of individuals and communities to climate‐related health risks 23

Climate-Ready States and Cities Initiative

Category 1: Assessment and Planning to Develop Climate Change Programs

4 States and 1 City HD$80k - $120k / yr / 3 yrs

Activities• Agency needs assessment • Early strategic plan

implementation• Partnership building &

engagement with other initiatives

• Strategic plan development

Climate-Ready States and Cities Initiative

4 States and 1 City HD

$150k - $250k / yr / 3 yrs

Activities• Strategic Plan Implementation• Identification and prediction of health

impacts & population & system vulnerabilities

• Develop & tailor health programs• Identify co-benefits and unintended

consequences of policies, programs and projects in other sectors (HIA)

Category 2: Building Capacity to Implement Climate Change Programs and Adaptations

Climate Change Adaptation: 2012 HHS Environmental Justice Strategy

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HHS can improve the resiliency of vulnerable individuals and marginalized communities, through increased understanding of the human health impacts of climate change and preparedness planning at the state and local levels. Health outcomes that are sensitive to climate change include asthma, cardiovascular disease, stroke, heat-related illnesses and deaths, and mental and stress-related disorders.

Focus: Climate Change intersections with major HHS efforts

HHS Goals Climate Change Impacts

Mitigation/Adaptation Cobenefits

Reduce cardiovascular morbidity and mortality

Impacts of heat stress and milder winters, air pollution

Reduced fossil fuel combustion Increased active transportation

Assure healthy home environments

Moisture and mold Home retrofits; improved insulation, ventilation

Preparedness and response capacity

Increased frequency and severity of extreme weather events

Community resilience to all hazards

Reduce health disparities

Climate impacts on heat stroke, flooding, air pollution

Community engagement and preparedness

Highlights of High-Level Vulnerability Analysis for HHS

• Protecting the most vulnerable: health and human services in the face of weather extremes and climate threats– Office on Disability

– Administration for Children and Families

– Administration on Aging, Center for Medicare Services

– Indian Health Service

– Assistant Secretary for Preparedness and Response

• Incorporating Climate Change Considerations into Regulatory Decisions– FDA

• Incorporating Climate Change Considerations into Public Health Practice and Research– CDC, ATSDR, NIH

Summary

• Climate change is having significant impacts on the health and well-being of vulnerable populations in the United States and around the world

• While health adaptation is essential, it is equally important to highlight the health promotion benefits of climate change mitigation measures ‘

• Necessary to integrate climate change , disparity awareness, and health and environmental impact considerations into internal management functions and policies

• The Commissioned Corps, as a cadre of public health professionals, has a critical role to play in improving community resilience

Thank you!

Questions?