View
215
Download
1
Category
Tags:
Preview:
Citation preview
Beating the Heat: Public Health andClimate Change
Southern California Public Health AssociationAnnual Conference, April 18, 2008
Jonathan E. Fielding, M.D., M.P.H., M.B.A
Director of Public Health and Health Officer
L.A. County Department of Public Health
Professor of Health Services and Pediatrics
Schools of Public Health and Medicine, UCLA
Presentation AgendaI. Defining the problem of climate change
I. Why should Public Health care?
II. Discussing the impacts of climate change
I. Global impactsII. Local impactsIII. Health impacts
III. Climate Change and Los AngelesIV. Issuing the challenge
I. Defining the Problem
Defining Climate ChangeUnited Nations Framework Convention on Climate
Change defines it as: “A change of climate which is attributed directly or
indirectly to human activity that alters the composition of the global atmosphere and which is in addition to natural climate variability which is observed over comparable time periods”
Biggest impact of climate change = Global warmingAn increase in average global temperatures
Six gases are considered contributors to global warming
Carbon dioxide Methane Nitrous oxides Three fluorinated industrial gases
Basic Mechanism of Global Warming = Greenhouse Effect
Source: U.S. Environmental Protection Agency
IPCC 2007: Warming is Unequivocal
Source: IPCC 2007 (4th Assessment)
IPCC 2007: Human Impact is Evident
Source: IPCC 2007 (4th Assessment)
Discrepancy Between Emitters and Where Impacts of Climate Change Are Felt
Global Contributors to Greenhouse Gas Emissions
Leading sources of greenhouse gas emissions are combustion of fossil fuels: coal, oil, and natural gas
More than 60% of the annual global industrial carbon dioxide emissions come from industrialized countries, accounting for 20% of the world’s population U.S. per capita emissions of carbon are over 20 times higher than
India, 12 times higher than Brazil, and 7 times higher than China These per capita rates expected to change significantly as China,
India, and other countries continue to develop economically China is now the #1 carbon emitter, surpassing the U.S.
Global carbon dioxide emissions are projected to increase by at least 50% over the next 25 years under current conditions
Annual Carbon Dioxide Emissions - 2005
Total CO2* Contribution
World 27,245,758 100%
U.S. 6,049,435 22.4%
China 5,010,170 18.4%
Russia 3,115,125 11.4%
EU 1,524,993 5.6%
India 1,342,962 4.9%
Japan 1,257,963 4.6%
*(thousands of metric tons)
Source: U.S. Greenhouse Gas Emissions Inventory
The most current estimates state that China is about to surpass the US in emissions and its rate of emissions is accelerating.
Source: U.S. Greenhouse Gas Emissions Inventory
U.S. CO² Emissions from Fossil Fuel
Worldwide Effects of Global WarmingGlobal climate has warmed by about 1° F over the
last 100 yearsWorldwide effects are manifested by the
destabilization of natural systems
•Ice cap & glacier melting•Early arrival of Spring•Oceans warming
•Rising sea levels•Extreme weather patterns•Coral reef disintegration
Why Should Public Health Care?• It is our job to protect the public’s health
– WHO estimates that in the year 2000, there were 150,000 excess deaths per year due to climate change
– Climate change is already affecting health around the world, and its impact on health will continue to grow
• Fighting climate change is aligned with protecting and promoting health– Many of the proposed solutions for climate change are healthy
for everyone
• We have the appropriate skills– Public Health has the skills to effect behavior change, and those
skills can help people adopt greener behaviors too
II. Impacts of Climate Change
Potential Health Effects of Climate Change
Source: Dr. Howard Frumkin
Source: Epstein, Harvard Center for Health & Global Environment
Extreme Weather Events & Disease Clusters
Source: Epstein, Harvard Center for Health & Global Environment
Potential Environmental Impacts inSouthern California of Changing WeatherGlobal warming and increase in variability of weather,
leading to:Change in rain fall patterns
Less rain overall → dry conditions → higher risk of wildfires, loss of flora and fauna, loss of agriculture, increased stress on water supplies
Heavier storms when it does rain → increased risk of floodingIncrease in temperature
Elevated frequency and duration of heat waves → immediate health risks, higher risk of wildfires, energy consumption spikes
Increase in El Niño-type conditions Increased production of ozone and smogIncreased temperature elsewhere → sea level rise everywhereChange in habitat suitability for vectors → shifts in vector-borne
disease distribution
Potential Environmental Impacts in So.Cal. of Climate Change: Rain Fall Patterns
Effects of change in rain pattern Less rain/dry conditions
lead to potential:Loss of agricultureGreater risk of wildfiresAdverse impact on fauna
(disruption of food chains, stress placed on fisheries and endangered species)
Stronger downpours lead to potential:Mudslides/erosionFlash flooding
Potential Environmental Impacts in So.Cal. of Climate Change: Sea Level Rise
Effects of rising sea level• Coastal areas will become
vulnerable to storms and flooding
• Loss of coastal wetlands and erosion of beaches
• Saltwater contamination of drinking water
• Potential damage to roads, highways, and other infrastructures near coastal areas
Potential Environmental Impacts in CA of Climate Change: Floods & Droughts
Warmer temperatures can result in premature and rapid snowmelt in the mountains, which alters the timing of run-off
Severe flooding may occur during winter and spring, with slower water flow during summer seasons
Drought risk may be acutely elevated during the summer months
Potential Environmental Impacts in CA of Climate Change: Floods & Droughts
Sacramento-San Joaquin Delta levees are already vulnerable to storms, significant run-off, and earthquakes
Rising sea level will stress these levees, which may result in unprecedented flooding in California
Potential Environmental Impacts of Climate Change in Los Angeles: Heat Waves
Experts predict that local heat waves will be more frequent and last longer in the futureBy 2020, there will be a twofold increase in the
number of days over 90°F in L.A.By the 2080s, the number of days above 90°F in
L.A. will increase from an average of 4 days a year to 14 to 37 days a year
Potential Health Impacts of Heat Waves
Los Angeles projected to have an increase of 62% - 88% in heat-related mortality by 2080
Health impacts likely to be seen 1 to 3 days after the onset of the heat waves Health effects of extreme and prolonged heat exposure
include: heat cramps, heat exhaustion, heat stroke, heat syncope (fainting)
Devastating heat waves seen elsewhere recently5-day heat wave in Chicago in 1995: 700 excess deaths,
most attributed to the heatAugust 2003 European heat wave: 35,000 excess deaths
Heat Waves: Vulnerable Populations
Greater risk for people who do not have access to air conditioningMay not be able to afford air
conditioningFor populations unaccustomed to heat
waves, people may have air conditioning but chose not to use it, not realizing danger
Two vulnerable populations during heat waves:Elderly: Population of senior citizens (> 60 years old) in Los Angeles
County is expected to increase by 83% by the year 2020Low SES: Over 16% of LA County residents under 100% FPL
Potential Environmental Impacts in So.Cal. of Climate Change: Wildfires
Wildfires are common in Southern California Characteristic of the area since
prehistoric times Santa Ana winds may drive heat waves,
prolong wildfires, and prevent wildfire control in this region
Climate models predict the summer months will be longer, and hotter, due to global warming
Result: dry soil and vegetation become fuel for wildfires
Potential Environmental Impacts in So.Cal. of Climate Change: Air Quality
CA ozone standard
Potential Environmental Impacts in So.Cal. of Climate Change: Air Quality
Increased temperature and increased carbon dioxide in atmosphere leads to Increase in formation of ground-level ozone (and smog) Increased allergen production (e.g. pollen) Longer seasons for allergen producing weeds
Senior citizens, children, and people with respiratory and chronic diseases are most vulnerable to high levels of ozone and increased allergens
Health effects of high levels of ozone exposure include: Reduced lung function Respiratory discomfort Exacerbation of chronic respiratory illnesses (e.g. asthma)
III. Climate Change and Los Angeles
A Public Health Responseto Climate Change
Public health already utilizes a multi-level prevention approach – analogous approach can be taken to respond to climate changePrimary prevention = climate change mitigation
Efforts to slow, stabilize, reverse climate change by reducing GHG emissionsEfforts will occur in sectors other than PH, such as energy and transportation
Secondary/tertiary prevention = climate change adaptationEfforts to prepare for, and minimize health burden of, climate changeSimilar to public health preparedness for other uncertainties (e.g. pandemic
flu, bioterrorist attack), so likely that PH as sector will be involved in adaptation efforts
Source: Frumkin, et al., AJPH 3/08
What Should We Do?1. Mitigation = reduce GHG emissions
1. Reduce energy usage and Reduce, Reuse, Recycle1. As individuals, at home2. As organizations, at work
2. Adaptation = prepare for impact of climate change
1. Emergency preparedness1. As individuals/families2. As local health department
3. Mitigation and adaptation = advocate for healthy policies
1. Support legislation that reduces GHG emissions2. Support sustainable lifestyles & communities
Mitigation: What Can We Do In Our Homes& Workplaces to Combat Global Warming?
Establish recycling programs in the workplace and home Recycling half of your household waste = hundreds of
lbs. of CO2 saved per year
Promote energy efficiency in the home and workplace Changing regular light bulbs to compact fluorescent
bulb throughout your house = hundreds of lbs of CO2/yr
Make “small energy” use changes on a broad scale E.g. replacing all light bulbs with energy efficient light
bulbs in all County buildings
Encourage renewable energy power sources (solar energy and wind energy) and responsible use of energy Turning off your TV, computer, and other electronics =
thousands of lbs. of CO2 saved per year
Mitigation: What Can We Do In Our Homes& Workplaces to Combat Global Warming?
Try to drive less and walk more! You save gas money and keep our air
cleaner for every mile you don’t drive Most car trips taken in your neighborhood
are short enough to walk or bike Encourage carpooling to
work/school Encourage public transportation
use
Provide incentives for employees to purchase fuel-efficient vehicles (e.g. electric, hybrid, CNG vehicles) Every gallon of gas saved = tens of lbs. of CO2 saved
If you do take a car, maintain it Properly inflated tires can improve gas mileage by 3%
Adaptation: Emergency PreparednessWe need to prepare now for the inevitable
effects of climate change, such as heat waves and wildfiresGood news: preparing for one type of
emergency prepares us for all types of emergencies
Preparation minimizes impact of disasters and fear/anxiety
We need to prepare ourselves as individuals and as health agencies
Adaptation: Emergency Preparedness
For individuals and families – “Just Be Ready, Prepare Together.”:Create a family emergency preparedness plan
Practice your and update your plan regularly
Create an emergency supplies kitKnow what to do in specific types of emergencies
Check out www.labt.org for preparedness resources
Adaptation: Emergency Preparedness For local health departments:
Create and practice emergency preparedness and response plans
Ensure that all staff are trained in emergency preparedness and response
Consider how your operations may be impacted by potential emergencies
Heat waves can lead to blackouts Wildfires may impact some sites Are you prepared to have employees
shelter in place at work?
Make sure your residents are prepared
Promoting Healthy Policies –CA’s Global Warming Legislation
AB 1493: California’s Vehicle Global Warming Law – Directs the Air Resources Board to require car makers to reduce greenhouse gas emissions from new passenger vehicles & light trucks starting in 2009Would reduce GHG emissions from cars in CA by 18% (30 m.
tons) by 2020, and by 27% (50 m. tons) by 2030Impact would be much greater, as over a dozen other states have
adopted CA’s proposed standardsBut running into roadblocks with Federal EPA and
current administrationEPA blocked implementation of CA’s proposed standards, now
states are suing the EPA
Promoting Healthy Policies –CA’s Global Warming Legislation
AB 32: Global Warming Solutions Act – Requires California to reduce global warming emissions to 1990 levels by 2020. First comprehensive program of regulatory and market
mechanisms to achieve real, quantifiable, cost-effective reductions of GHG emissions
Directs Air Resources Board to develop regulations and to establish a reporting system to track and monitor levels of global warming emissions.
Gov. Schwarzenegger signed AB 32 in Sept. 2007.
Promote Healthy Policies Support policies related to sustainable
communities Mixed use development, jobs near housing,
transit-oriented design, bike lanes and sidewalks, parks and green
Development and utilization of useful public transportation
Energy efficient "green" buildings and LEED certification
Buildings consume 72% of the nation’s electricity and more GHG than transportation or industry*
Recycling, waste management and pollution control
Securing safe water supplies These policy decisions occur at all levels of
government, so many opportunities for Public Health to give input Health Impact Assessments Surveillance data tracking spread of vectors and
diseasesSource: US Dept of Energy, 2007
Los Angeles County’s Responseto Climate Change
Board of Supervisors approved the Countywide Energy and Environmental Policy in Jan. 2007 Joined the “Cool Counties” initiative, pledging to reduce GHG
emissions and develop a plan to carry out the pledge Created the Energy and Environmental Policy Team – includes
ISD, Public Works, Public Health, Regional Planning, local utility agencies, and others
Energy and Water Efficiency Committee: goal to reduce County’s energy and water consumption 20% by 2015
Green Building Operations Committee: goal to develop a sustainable design program for new and existing buildings
Environmental Stewardship Committee: goal to reduce County’s environmental footprint, including quantifying CO2 emissions from County operations and improving recycling efforts
Los Angeles County operations in 2006 = 700,000 tons of CO2 Passed policy to get discounts on hybrid vehicles for County
employees, contractors, and family of employees
We Can’t Do It AloneSo why should we bother?
Efforts will yield long-term savingsWill make our economy more competitiveThe co-benefits are greatWill improve the sustainability of our
communitiesMoral obligation – if we care about the health
of our communities, then we need to do our part
Realizing the Co-benefits ofReducing GHG Emissions
Important to realize the co-benefits of climate change responses = certain efforts to address climate change often yield other health benefits tooStrategy: reducing vehicle miles traveled
Primary result = lower motor vehicle GHG emissionsCo-benefit = higher physical activity rates
Strategy: promote cleaner energy production and cleaner fuelsPrimary result = reduced GHG emissions from energy productionCo-benefit = less air pollution = less respiratory distress
Source: Frumkin, et. al., AJPH March ‘08
Summary of Health Effects of Air Pollution
• More pre-term babies and birth defects
• Increases in:– abnormal lung development in
children1
– asthma symptoms and other respiratory diseases in children and adults2
– deaths from heart disease and lung cancer3
1 (Gauderman et al. 2007, Lancet)2 (McConnel et al. 2006, Env Health Perspectives; Meng et al. 2006, UCLA CHPR Research Brief)3 (Pope et al. 2002, JAMA)
Lungs of a non-smoker as affected by air pollution (source: AQMD)
Largest Local Contributor to Air Pollution: Los Angeles Ports
More than 40% of all United States imports come through the Ports of Los Angeles and Long Beach
These ports contribute more than 20% of diesel particulate pollution in Southern California, and represent the single largest source of air pollution in the region
Source: South Coast Air Quality Management District & U.S. Department of Transportation
Largest Local Contributor to Air Pollution: Los Angeles Ports
Cargo trucks and rail systems also contribute to diesel emissions originating from the ports
Trade and goods movement are expected to increase, as the ports continue to accommodate the growth of imported goods entering the U.S.
LA Ports are currently examining ways to reduce GHG emissions, such as requiring use of low-sulfur fuels near shore
Ports & Goods Movement: Health Effects
Communities residing near the ports, rail systems, and trucking routes are affected due to the diesel emissions
California has an estimated 2,400 premature heart-related deaths annually due to pollution from the L.A. ports and goods movement
There are approximately 62,000 cases of asthma symptoms in California
More than 1 million respiratory-related school absences in California annually
Source: Environmental Health Perspectives
Summary of Health Effects of Air Pollution
• Amount of goods transported through California projected to nearly quadruple between 2000 and 20201
• Will have significant impact on air quality and health2
• Diesel particulate matter (PM)– concentrated around ports,
railyards, and heavily trafficked roads3
premature deaths cancer respiratory disease lost workdays global warming (2nd to CO2)
Annual Health Impacts in CA from PM and Ozone4
1 (Cal EPA, 2005); 2 (Pacific Institute, 2006)3 (CA/EPA Air Resources Board); 4 (CA/EPA Air Resources Board, 2004)
Health Impacts of PoorAir Quality in Southern CA
6,500 annual premature deaths linked to small particulate matter (PM) are now higher than deaths from second-hand smoke (~5,000/yr); traffic accidents (~3,200/yr); and homicide (~2,000/yr)
Fine particles (PM 2.5) significantly reduce lung function and growth in Los Angeles children (Avol et al., 2001; Gauderman et al., 2002; Peters et al., 1999)
Asthma and air pollution in So Cal:Onset of asthma is linked to exposure to outdoor ozone
(McConnell et al., 2001)Almost 9% of kids up to 17 and 6.5% of adults in LA
County currently have asthma (2005 LAHS)
The Debate Regarding How to Combat Global Warming
What can we safely conclude?Percentage of days that LA County did not meet state
standard for ozone = 20%****Attaining the current California standards for ozone and
particulate matter (PM) would help reduce current health problems related to air pollution:
• 9,000 annual premature deaths• 7,000 annual hospitalizations• 1,258,000 annual respiratory illnesses*
Yearly impact of poor air quality in California from premature deaths and healthcare costs: $48 billion**
Benefits of implementing California’s air quality standards would exceed costs by a 3:1 ratio ***
*Source: California Air Resources Board, 2005; **Source: California Resource Board;
*** Source: US Environmental Protection Agency; ****Source: South Coast AQMD
IV. Issuing the Challenge
National PH Week Pledge Be prepared
Learn more about climate change and health Spread the word
Travel differently Use your car less, walk and bike more Use public transportation
Eat differently Go meatless one day a week
Green your work Use less paper Telecommute and conference call more often
Green your home Reduce, reuse, recycle Heat and cool smartly Use water efficiently Use green power
Reduce your ecological footprint!
Summary
Increase of greenhouse gas emissions likely results in global warming, and the U.S. is the main contributor to greenhouse gas emissions (although developing countries are increasing emissions at alarming rate)
California industry, transportation, and seaports contribute significantly
Global warming has devastating potential effects on human health, the environment, and the economy in Southern California and worldwide
Summary
Utilizing an approach of supporting mitigation efforts and promoting adaptation to the changing climate, Public Health can have a positive impact. The co-benefits of many mitigation efforts will yield benefits for the health of our environment and the public
Two California Assembly Bills have been passed to address global warming in the state of California
Several methods to help combat global warming in the community, workplace, and home
Resources U.S. Environmental Protection Agency
http://www.epa.gov/
Intergovernmental Panel of Climate Change http://www.ipcc.ch/
Energy Information Administration http://www.eia.doe.gov/
South Coast Air Quality Management Districthttp://www.aqmd.gov/
California Air Resource Boardhttp://www.arb.ca.gov/homepage.htm
LA County Public Health – Healthy People Build Healthy Communities
Recommended