Healthy People = Healthy Planet: Texas Version

HEALTHY PEOPLE = HEALTHY PLANETThe Public Health Benefits of Climate Solutions

Impacts on N. America

WILDFIRES

INCREASED HEAT

HEAVY RAIN,STORMS, FLOODS

IPCC: Only one safe course of action

Sam Moody Atlanta, GA

We Over Me Farm Houston, TX

CARMAGEDDON!

Ultrafine Particulates down 83 % PM2.5 down 36 percent

ER Visits UCLA down 23%ER Visits Mt Sinai down 13%911 calls decreased 12%

Los Angeles, CA 405 Freeway

Jeffery Thompson MDGundersen Lutheran Health System

LaCrosse, WI

$1 MILLION ANNUAL SAVINGS from improved EFFICIENCY

Powered by 100% Clean Energy

TOP 5 CAUSES OF DEATH IN US

Heart Disease (diabetes)

Cancer

Chronic Lung Disease

Stroke

Unintentional Injury (mva)

TOP 10 CAUSES OF THE CAUSESof death in developed countries

1) tobacco

2) high blood pressure

3) overweight and

obesity

4) physical inactivity

5) high blood glucose

6) high cholesterol

7) low fruit and vegetable intake

8) urban outdoor air pollution

9) alcohol

10) occupational

WHO 2009

CAUSES OF THE CAUSES

OF THE CAUSES

Air pollution

Car centric built environment

Industrial agriculture and food system

AIR POLLUTIONAIR POLLUTION

EPA Ozone Nonattainment Areas

September in Central Texas:1 out of 6 days with unhealthy air

AIR POLLUTION AND CHILDHOOD ASTHMA

Playing multiple outdoor sports in areas with poor air quality triples the risk of developing childhood asthma (McConnell, 2002)

Childhood asthma incidence increased 16% per 10ug/m3 of fine particulate exposure, and 7% per 10ug/m3 of Nox. (Anderson, 2013)

A 5-ppb increase in average NO2 during the first year of life was associated with an odds ratio of 1.17 for physician-diagnosed asthma. (Nishimura, 2013)

AIR POLLUTION AND CVD

CHRONIC EXPOSURE

Rate of carotid intimal thickening is doubled in people who live within 100 m of busy roadway

(Kinsli, 2010)

ACUTE EXPOSURE Each 10ug/m3 PM2.5

4.5% increase in acute cardiac events

8-18% increase in CVD mortality

(Pope, 2004, 2006, 2008)

AIR POLLUTION AND DIABETES10ug/m3 PM2.5 = 1% increase in prevalence DM2(Pearson, 2010)

Exposure to traffic and PM increased risk of new onset DM2 15-42% (Kramer, 2010)

Highest quartile maternal exposure to NOx increased gestational DM 70% (Malmqvist, 2013)

2SD increase in childhood exposure NO2/ PM2.5 = 18% increase in insulin resistance. (Thiering, 2013)

Prenatal PAH Exposure and Childhood Obesity

Rrundle et al Am J Epidemiol. Jun 1, 2012; 175(11)- 1163–1172..

AIR POLLUTION AND CHILD OBESITY

Prenatal exposure to higher levels of PAH doubled risk of obesity at age 7 (Rundle, 2012)

Residential proximity to traffic in childhood (controlling for other risk factors) associated with higher BMI at age 18

(Kramer, 2010)

Kids in 90th percentile for traffic related air pollution have more rapid increase in BMI (Jerrett, 2014)

AIR POLLUTION CARBON POLLUTION

Ziska, Australian Journal of Plant Physiology, 2000. 27: 893− 898.

CO2 and Noxious Plants

RAGWEED POISON IVY

CO2, MOLD and Asthma

For each 10 U increase in home Environmental Relative Moldiness Index (ERMI) in infancy, risk of incident asthma by age 7 increased 80% (Reponen, 2011)

Nox + VOCs + heat = Ozone

Ozone Climate Penalty

Climate-Related Ozone will Increase NY Pediatric ED Asthma Visits 5-10% by 2020

Sheffield PE,   SeAm J Prev Med.p;41(3):251-7

PREMATURE DEATHS FROM OZONE will triple by 2030

Valley Fever Endemic Area

VALLEY FEVER

Brown, Clin Epidemiol. 2013; 5(1) 185-197

Tenfold increase in incidence of Cocciciodomycosis

Lubbock, TX

WARMING & WILDFIRE SMOKE

Wildfire Contribution to Ground Level Ozone

Northwest Fire Season 2012

Jaffe et al | Environ. Sci. Technol. 2013, 47, 11065−11072

A Kenward et al 2013

LOS ANGELESPM 2.5 2003

DIOXINS, PAH and WildfiresSmoke from Idaho Fires

2013

Clean energy

US WIND POWER POTENTIAL

US SOLAR POWER POTENTIAL

100% CLEAN BY 2050thesolutionsproject.org

Total life cycle emissions Clean vs Fossil Fuel

Intermittency not a problem up to 80%

Percent renewable generation achieved with conventional technology

POLICIES for CLEAN AIR

Shift subsidies from fossil fuel to clean energy Strong National Renewable Electricity Standard

50% of electricity by 2030, 100% by 2050

Net metering (utilities pay for surplus power)

LEVEL THE PLAYING FIELD

STOP EXTERNALIZING HEALTH AND CLIMATE COST OF CARBON

MORE EFFICIENT BUILDINGS

PROGRESSIVE EFFICIENCY STANDARDS for New and Remodeled Buildings

www.architecture2030.org

COMPETITIVE FUEL ECONOMY

POLICIES FOR ENERGY EFFICIENCY

Stronger fuel economy standards National Energy Building Code National Retrofit Financing

Decrease in O3 and PM 2.5 with 3 Climate Policy Options

Clean Electricity Std Transportation Carbon Tax

T Thompson, Nature Climate Change (July 2014)

20,000 Heart Attacks PREVENTED23,000-50,000 Deaths each year

SAVED: OVER 100 BILLION DOLLARS PER YEAREPA 2013

Carbon Abatement Cost Curve

CLEAN ENERGY=CLEAN AIR=HEALTH SAVINGS

T. Thompson, Nature Climate Change 4, 917–923 (2014)

Value of decreased mortality from air quality improvement exceeds cost of emissions reduction

West et al, Nature Climate Change 3: 885-889 2013

HIGH VALUE LOW VALUE ABATEMENT COST / TON CO2

EPA Carbon Rules Impact on Air Quality: 2020

OZONE FINE PARTICULATES

Distribution of Lives saved by EPA Carbon Rule in 2020

CAR CENTRIC BUILT ENVIRONMENT

Texas Interurban Railway

From Interurban to Automobile

NEIGHBORHOODS

HEART DISEASE,OBESITY, DIABETES; COLON CANCER ONE THIRD PROSTATE CANCER, AND

RECURRENT BREAST CANCER ATTRIBUTABLE TO PHYSICAL INACTIVITY

WALKABILITY, OBESITY, AND DIABETES

TEN YEAR PROSPECTIVE STUDY Ontario

Least walkable neighborhoods

DM +6%

Obesity/Overweight +13%

Most walkable neighborhoods

DM -7%

Obesity/Overweight - 9%

(Booth, 2014, presented at ADA)

WALKABILITY DM, OBESITY, AND CVD

Sprawl and disconnected street networks are associated with increased rates of obesity, diabetes, and CVD. (Marshall, 2014)

Residents of “walkable” metro areas walk more & use more public transit, have lower BMI & BP, less DM, and 3 years longer life expectancy than people living with sprawl. (Ewing, 2014)

Cost of Transportation Related Health Outcomes in US

$300 billion per year

WALKABILITY SCORES FOR TEXAS MAJOR CITIES

Houston 44

San Antonio 34

Dallas 44

Austin 35

Ft Worth 32

El Paso 39

TRANSIT ORIENTED DEVELOPMENT

TRANSIT AND OBESITYUsers of public transit are 45% less likely to be

obese or overweight (Zheng, Y. 2008)

Transit commuters walk twice as many minutes/day as car commuters, weigh an average of 6-7 lb less and have lower % body fat. (Flint, 2014)

Increased use of public transit would cut the annual increase in obesity prevalence by 45%.

(Edwards, 2008)

TRANSIT DECREASES MVA DEATHSUrban Traffic Fatalities/100,000

by Cities' Transit Use by Smart Growth vs Sprawl

Austin ranks 39th of 46 major metro areas in jobs available within 30

minute trip by public transit

Per Capita Health Savings from Rapid Transit and TOD

AverageUrban Transit

High Quality Urban Rail or Rapid Bus

Transit Oriented Development

US Emissions from Transportation

POLICIES FOR ACTIVE/PUBLIC TRANSITSmarth growth, Infrastructure Investment,

Coordination (Health in All Policies)

10,000 colon cancers215,000 heart attacks

32,000 MVA fatalities PREVENTED570,000 new diabetes cases each year

ANNUAL SAVINGS SF BAY AREA Maizlish, N. Am J Public Health. 1.4-22 BILLION DOLLARS PER YEAR 2013 Apr;103(4):703-9.

Good news: We're already on our way. Vehicle miles per capita decreasing

INDUSTRIAL FOOD SYSTEM

From family farm to agribusiness

Increased consumption of high fructose corn syrup

FOOD DESERTS

Inadequate Intake of Fruits/Vegetables

Increasing dependence on imported produce & associated outbreaks of foodborne infection

2013 – Cilantro from Mexicohttp://www.foodandwaterwatch.org/food/global-grocer/

Adult Obesity Trend

TEXAS TRENDSOBESITY RELATED DISEASES

High Fructose Corn Syrup and Metabolic Syndrome

Meta-analysis: Fructose consumption increases FBG, triglycerides, and systolic BP. (Kelishadi, 2014)

Fructose sweetened beverages increase FBG and insulin levels, decrease insulin sensitivity (Stanhope, 2009)

Fructose induced insulin resistance in rats is attenuated by lycopene (Yin, 2014)

Red Meat, DM, Cancer, and CVDNIH-AARP Study: 20-50% increased mortality from

cancer and CVD (Sinha, 2009)

Womens' Health Study:

28% more incident DM over 8 years (Song, 2004)

Nurses' Health Study/ Health Professionals Followup Study: 13% increase in mortality per serving (all cause, cancer, and CVD). (Pan, 2012)

Extra daily half serving of meat raised risk of DM 48% for subsequent 4 years (Pan, 2013)

OBESITY AND ASTHMANumerous prospective studies in adults found

obesity associated with increased risk of incident asthma with BMI “dose response”

Weight loss, both surgical and non surgical, associated with resolution of asthma, decrease in asthma symptoms or increased FEV1

(Ford, E The Epidemiology of Obesity and Asthma

J Allergy Clin Immunol 2005;115:897-909.)

International Study of Asthma and Allergies in Childhood

JUNK FOOD AND ASTHMA

Nagel, Thorax. 2010 Jun;65(6):516-22.

INDUSTRIAL AGRICULTURE AND GLOBAL WARMING

METHANE POLLUTION(70 x warming power of CO2 )

& MORE GLOBAL WARMINGNITROGEN OXIDE from FERTILIZER

(300 x warming power of CO2)

DROUGHT AND WATER QUALITYPublic Water Systems on Restriction

Arsenic in Groundwater

Arsenic concentration in wells Public water systems exceeding EPA std

Arsenic alters gene expression, promotes lung, skin, bladder cancer

Cancer risk from adult As in drinking water

Altered gene expression in cord blood with maternal As exposure

MATERNAL ARSENIC EXPOSUREAND DECREASED CHILD SURVIVAL

(Rahman, 2013)

CROP MYCOTOXINS

Aflatoxin 2014 Fumonisin 2014

Texas State Chemist 2014

Hepatotoxic

Nephrotoxic

Teratogenic

Carcinogenic

Hepatotoxic

Carcinogenic

Immunosuppressive

NHANES 2000

1% positive

Age OR for +

12-39 1.49

40 + 1.00

Ethnicity OR

Black 0.92

White 1.00

Mex American 2.71

Aflatoxin Biomarkers

Bexar County 2010

20% of adults positive, associated with rice and tortillas

ANNUAL INCIDENCE HCC 1995–2010

Ramirez AG, Munoz E, Holden AEC, Adeigbe RT, et al. (2014) Incidence of Hepatocellular Carcinoma in Texas Latinos, 1995–2010: An Update. PLoS ONE 9(6): e99365. doi:10.1371/journal.pone.0099365

US Latino

Texas Latino

South Texas Latino

White, non-Hispanic

Aflatoxin Biomarkers and Risk Factors for Hepatocellular Carcinoma

RISK FACTORS OR for HCC

Aflatoxin Biomarker Alone 7

Chronic Hepatitis B or C Alone 7-28

NAFLD alone 3-16

Aflatoxin + Chronic Hep B or C 60

Aflatoxin + NAFLD ??

40% OF OBESE CHILDREN AND 40% OF ALL ADULTS HAVE NAFLD

HEALTHY FOOD SYSTEM

LOCALDIVERSE

SUSTAINABLEHEALTHY FOOD

Mediterranean Diet

Mediterranean vs Western dietLess: GHG, H2O, energy, land

Sáez-Almendros et al. Environmental Health 2013 12:118 doi:10.1186/1476-069X-12-118

MEDITERRANEAN 0 WESTERN

Organic farming vs Conventional 30% lower GHG, higher profit, equal yields

Mediterranean Diet & Asthma, Diabetes, and Cancer

PROSPECTIVE STUDIES

14% lower risk asthma (Nagel, 2010)

80% lower risk DM (Martinez-Gonzales, 2008)

24% lower risk cancer (Benetou, 2008)

31% lower CVD mortality (Sofi, 2008)

22% lower cancer mortality (Sofi, 2008)

INTERVENTION STUDIESMediterranean Diet

60% decrease cardiac events (Ornish, 1998)

70% decrease CVD mortality (DeLogeri, 1994)

35- 48% decrease in metabolic syndrome

(Esposito, 2004, Azadhbakt, 2005)

ADVISE SUBSIDIZE

Meat, Dairy 63%

Grains20%

Sugar,Oil, Alcohol 15%

Nuts, Legumes 2%

Fruits, Vegetables 1%

POLICIES FOR HEALTHY FOOD AND FARMS

Subsidize fruits and vegetables

Reward good stewardship

Crop diversity

Natural fertilizer

Crop rotation

Conservation set asides

Donate excess food

Harvest energy from waste

300,000 Heart Attacks/Strokes PREVENTED260,000 New Diabetes Cases127,000 CVD Deaths each year144,000 Cancer Deaths

WE ARE HERE

Temperature increase 1.4 degrees F

AND HERE:

70% overweight or obese

34% CVD

12% diabetes

37% pre-diabetes

8% asthma

75 cents of every health dollar spent on preventable chronic disease

Sustainable agricultureActive and public transportationEfficient buildings and vehicles

Clean electricity

BUSINESS AS USUAL

2030

40% Obese

40% CVD

20% Diabetic

10% Asthmatic

2050

50% Obese

50% CVD

30% Diabetic

WHAT YOU CAN DO

Sign up for action alerts climate911.org

VOTE CLIMATE climatehawksvote.com

Tell your congresspeople: Climate policy is essential to protect public health

Speak out in your community

Climate/Health Communication Workshop

October 11: 5305 Turnabout Lane 10am-noon

HEALTHY PEOPLE = HEALTHY PLANET

www.climate911.org