Socioeconomic information in climate impact, vulnerability,
and adaptation assessment for human health
Hans-Martin Füssel
UNFCCC Expert MeetingPort of Spain, Trinidad
10-12 March 2008
“Human health is largely determined by climate”
Source: Henry Chapin & F.G. Walton Smith: The Ocean River, 1952
Very suitableSuitableModerately suitableUnsuitableVery unsuitable
Hans-Martin Füssel 3UNFCCC Expert Meeting, 10-12 March 2008
Climate-health relationship
Source: IPCC WG II
(2007)
Hans-Martin Füssel 4UNFCCC Expert Meeting, 10-12 March 2008
• Diverse range of climate-sensitive health risks(e.g., heat stress, extreme weather events, vector/water-borne diseases, malnutrition, allergies)
• Complex relationships between climate and health
• Strong influence of non-climatic factors(e.g., environmental, socio-economic, behavioural)
• Large uncertainty about future risk levels
• Separation between first-order (biophysical) and second-order (social) impacts not possible
• Health is already strongly managed
• Diverse actors involved in health risk reduction: public & environmental health, natural hazards, urban & spatial planning, housing, agriculture, etc.
Climate change and human health
Hans-Martin Füssel 5UNFCCC Expert Meeting, 10-12 March 2008
Methods to assess future health effects
1. Process-based models• limited consideration of socio-econ. information• less importance compared to other impact
domains (e.g., agriculture, ecosystems, coasts)
2. Empirical-statistical models• based on epidemiological information• distinction between different population groups
3. Geographical or historical analogues• include socio-economic information implicitly
4. Expert judgement• considers broad range of information,
including available socio-economic information
Hans-Martin Füssel 6UNFCCC Expert Meeting, 10-12 March 2008
Guidelines for assessments of climate impacts and adaptation
Evaluation of assessment guidelines
Source: Füssel (2008)
Four stages of climate assessment
Source: Füssel (2003)
Climate
Hans-Martin Füssel 9UNFCCC Expert Meeting, 10-12 March 2008
Model-based climate impact assessment: Changes in climatic suitability for malaria
Source: MIASMA model.
Martens et al. (1999)
Hans-Martin Füssel 10UNFCCC Expert Meeting, 10-12 March 2008
First-generation vulnerability assessment:Expected heat deaths in Europe
Estimated excess mortality for 2030 in 15 European citiesSource: WHO (forthcoming)
Hans-Martin Füssel 11UNFCCC Expert Meeting, 10-12 March 2008
• Environment (air and water quality, land use)• Infrastructure (housing standards, water supply,
sanitation, communication, transport, dams)• Institutions (disaster preparedness, insurance)• Information (radios, telephones, literacy)• Socio-economic (income, poverty, livelihoods)• Social (family types, support networks)• Behaviour (physical activity, clothing, siesta)• Demographic (age structure, gender, ethnicity)• Health status (HIV/AIDS, malnutrition, immunity)• Health services (availability, accessibility, quality)• Disease control (history, effectiveness)
Factors influencing vulnerability (1)
Hans-Martin Füssel 12UNFCCC Expert Meeting, 10-12 March 2008
Factors influencing vulnerability (2)
Source: IPCC (2001)
Hans-Martin Füssel 13UNFCCC Expert Meeting, 10-12 March 2008
Selected international data sources
• WHO databases– World Health Report: http://www.who.int/whr/– Malnutrition: http://www.who.int/nutgrowthdb/– Water and sanitation: http://www.who.int/
water_sanitation_health/database/
• CRED-EMDAT– Data on disasters: http://www.em-dat.net
• Global socio-economic scenarios- IPCC Special Report on Emissions Scenarios- Millennium Ecosystem Assessment- UNEP Global Environmental Outlook- UN World Water Development Report
Hans-Martin Füssel 14UNFCCC Expert Meeting, 10-12 March 2008
Health Effects of Climate Change in the UK
• Health outcomes: - temperature-related morbidity and mortality- food poisoning- vector-borne diseases- water-borne diseases- deaths & injuries due to storms and flooding- respiratory diseases due to air pollution
• Methods: spatial analogues, predictive modelling, and expert judgement
• Use of detailed climate change projections
• Limited use of socio-economic information
Hans-Martin Füssel 15UNFCCC Expert Meeting, 10-12 March 2008
US Human Health Impacts Assessment
• Health outcomes:- temperature-related morbidity and mortality- injuries & illnesses from extreme events- air pollution-related health effects- water- and food-borne diseases- vector- and rodent-borne diseases
• Methods: literature review, expert judgement, some limited impact modelling
• Limited use of climate change projections
• No consideration of socio-economic projections
Hans-Martin Füssel 16UNFCCC Expert Meeting, 10-12 March 2008
Human Health Vulnerability to Climate Variability and Change in Cuba
• Health outcome: dengue
• Method: Epidemiological analysis
• Main climate driver: El Nino/Southern Oscillation
• Use of regional climate projections from one GCM
• Socio-economic information used:- percentage of houses without potable water- percentage of houses with dirt floors- adult illiteracy rate
Hans-Martin Füssel 17UNFCCC Expert Meeting, 10-12 March 2008
Climate Change in Portugal (SIAM)
• Health outcomes:- heat-related mortality- air pollution-related effects- vector-borne diseases
• Methods: epidemiol. modelling, expert judgement
• Use of detailed climate change projections
• Downscaling projections from 4 SRES storylines:- population (urban & rural)- economic activity & distribution of wealth- role of the state & civil society- environmental awareness and policy & values
Hans-Martin Füssel 18UNFCCC Expert Meeting, 10-12 March 2008
Summary• Socio-economic information needs depend on the
purpose, scale, and time horizon of the CCIAV
• Use of socio-economic scenarios to explore climate impacts on population health is currently limited
• Generic socio-economic information typically considered in scenarios for human health CCIAVs:- economic factors (income, income inequality) - demographics (population size, age structure)- internal migration (to urban and coastal areas)- health services (availability, access, prevention)
• Health CCIAVs may additionally consider scenarios of disease-specific socio-economic information
Further information available online• U. Confalonieri & B. Menne (2007): Human health. IPCC WG II AR4.
http://www.ipcc.ch/pdf/assessment-report/ar4/wg2/ar4-wg2-chapter8.pdf
• R.S. Kovats et al. (2003): National assessments of health impacts of climate change: a review.http://www.who.int/globalchange/publications/climatechangechap9.pdf
• J.D. Scheraga et al. (2003): From science to policy: developing responses to climate change.http://www.who.int/globalchange/publications/climatechangechap12.pdf
• P. Barata (2002): Socioeconomic scenarios.http://www.siam.fc.ul.pt/SIAM_Book/3_SocioEconomicScenarios.pdf
• Mini-monograph “Assessing Human Health Vulnerability and Public Health Interventions to Adapt to Climate Change”.Environmental Health Perspectives 114, 12 (2006).http://www.ehponline.org/docs/2006/114-12/toc.html
• K.L. Ebi & J.L. Gamble (2005): Summary of a Workshop on the Dev-elopment of Health Models and Scenarios: Strategies for the Future. Environmental Health Perspectives 113, 3.http://www.ehponline.org/docs/2004/7380/abstract.html
Hans-Martin Füssel 20UNFCCC Expert Meeting, 10-12 March 2008
Backup slides
Hans-Martin Füssel 21UNFCCC Expert Meeting, 10-12 March 2008
Climate-health relationships
Source: Patz et al.
(2000)
Expected climate impacts on health
Source: IPCC WG II, 2007
Hans-Martin Füssel 23UNFCCC Expert Meeting, 10-12 March 2008
• Public health
• Environmental health
• Climate and weather forecast
• Climate impacts and adaptation
• Natural hazards
• Urban and spatial planning
• Settlements and housing
• Livelihoods
• Agriculture
• etc.
Reducing climate-sensitive health risks involves many sectors
Hans-Martin Füssel 24UNFCCC Expert Meeting, 10-12 March 2008
Population health risk management
Source: Sharpe(2005)
Hans-Martin Füssel 25UNFCCC Expert Meeting, 10-12 March 2008
1. Awareness of the problem
2. Availability of effective adaptation measures
3. Information about effective measures
4. Resources available for implementing them
5. Cultural acceptability of effective measures
6. Incentives for actually implementing them
Adaptation (assessment) should focus on those preconditions most in need of improvement.
Preconditions for planned adaptation
Hans-Martin Füssel 26UNFCCC Expert Meeting, 10-12 March 2008
Health impacts of climate change in 2000
Hans-Martin Füssel 27UNFCCC Expert Meeting, 10-12 March 2008
National health impact assessments
Source: Kovats et al. (2003)
National health impact
assessments
Source: IPCC WG II (2007)
Climate Change in Portugal (SIAM)
Hans-Martin Füssel 30UNFCCC Expert Meeting, 10-12 March 2008
Hot weather watch/warning systems
1. City-specific identification of most dangerous weather conditions from past data
2. Identification of vulnerable population groups(age, mobility, living alone, housing type)
3. Continuous monitoring and forecasting of weather conditions
4. Alerting the public about the expected timing and severity of a heatwave
5. Providing targeted advice on adaptive responses to be undertaken by individuals and institutions
Hans-Martin Füssel 31UNFCCC Expert Meeting, 10-12 March 2008
Screening options for malaria control
Theoretical Range of Choice
Technically feasible?
Effective? Environmentally acceptable?
Financially Feasible?
Socially and Legally Acceptable?
Closed/Open (Practical Range of Choice)
Improved public health infrastructure
Yes Low Yes Sometimes Yes Open
Forecasting & early warning systems
Yes Medium Yes Often Yes Open
Public information & education
Yes Low Yes Yes Yes Open
Control of vector breeding sites
Yes Yes Spraying - no Yes Sometimes Open
Impregnated bed nets
Yes Yes Yes Yes Yes Open
Prophylaxis Yes Yes Yes Only for the few
Yes Closed for many
Vaccination No Closed
Source: Ebi and Burton (2005)
Hans-Martin Füssel 32UNFCCC Expert Meeting, 10-12 March 2008
Climate Change and Adaptation Strategies for Human Health in Europe
• Funding:European Union (FP6)
• Duration:2001-2004
• Consortium:8 partners, 6 countries
• Lead agency:WHO Regional Office for Europe
Hans-Martin Füssel 33UNFCCC Expert Meeting, 10-12 March 2008
Key objectives:• to identify vulnerability of population health in
Europe to climate change• to identify the most appropriate measures and
policies to successfully adapt to climate change• to identify barriers to improving adaptive capacity
Health effects considered:• Heat-related mortality and morbidity• River floods• Vector- and rodent-borne diseases• Food-borne diseases
cCASHh project
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Steps in assessing human health vulnerability and adaptation
Source: Kovats et al.
(2003)
Hans-Martin Füssel 35UNFCCC Expert Meeting, 10-12 March 2008
A sequential risk-management strategy for health adaptation assessment
1. Scoping the assessment (regions, resources, criteria)2. Risk screening and final scoping decisions3. Examination of the adaptation baseline4. Analysis of future risks (incl. uncertainties)5. Evaluation of future risks6. Identification and evaluation of adaptation options7. Prioritization of adaptation options8. Decision about adaptation strategy9. Implementation of adaptation strategy10.Monitoring, evaluation, and revision of strategy
Source: Füssel et al. (2005)
Four stages of climate assessment
Source: Füssel & Klein (2006)
Mitigativecapacity
Imple-mentation
Facili-tation
Imple-mentation
Facili-tation
Climatechange
Emissions
Concen-trations
Exposure Sensitivity
Impacts
Impact assessmentVulnerability assessment (1st gener.)Vulnerability assessment (2nd gener.)Adaptation policy assessment
Mitigation
Adaptation
Vulnerability
Non-climatic factors(incl. adaptation baseline)
Climatevariability
Adaptivecapacity
Non-climaticdrivers
Health Adaptation to Climate Change
Mitigativecapacity
Imple-mentation
Facili-tation
Imple-mentation
Facili-tation
Mitigation
AdaptationAdaptivecapacity
Non-climaticdrivers
Climatechange
Emissions
Concen-trations
Population exposureto climatic stimuli
Sensitivityto climatic
stimuli
Climate impacts on human health(morbidity and mortality)
Non-climatic risk factors(environmental; socio-economic;
institutional; demographic; medical; cultural; behavioural)
Climatevariability
Mitigativecapacity
Imple-mentation
Facili-tation
Imple-mentation
Facili-tation
Climatechange
Emissions
Concen-trations
Population exposureto climatic stimuli
Sensitivityto climatic
stimuli
Climate impacts on human health(morbidity and mortality)
Mitigation
Adaptation
Non-climatic risk factors(environmental; socio-economic;
institutional; demographic; medical; cultural; behavioural)
Climatevariability
Adaptivecapacity
Non-climaticdrivers
Adaptation to Heat Stress
Distributionof thermalextremes
Population exposure to thermal extremes („heat
waves“)
Health impacts of thermal extremes(number of premature deaths; DALYs; etc.):
Heat stroke, heat exhaustion, heat syncope, heat cramps
Demographic characteristics;housing conditions; individual behaviour;availability of HWWS; air pollution levels
Demographic trends;econ. development;urban inmigration
Health-relatededucation;
building codesEpidemiolog.
research;establishm. ofbuilding codes
Adapted urban plannin
g
Adviceon
adequate
drinking
Trainingof healthpersonne
l
Implement.
of HWWSDose-response
curve forheat stress
Mitigativecapacity
Imple-mentation
Facili-tation
Imple-mentation
Facili-tation
Climatechange
Emissions
Concen-trations
Population exposureto climatic stimuli
Sensitivityto climatic
stimuli
Climate impacts on human health(morbidity and mortality)
Mitigation
Adaptation
Non-climatic risk factors(environmental; socio-economic;
institutional; demographic; medical; cultural; behavioural)
Climatevariability
Adaptivecapacity
Non-climaticdrivers
Adaptation to Inland Floods
Distributionof heavy
rain events
Population exposureto inland floods
Health impacts of inland floods (casualties; DALYs; etc.):Drowning, injuries, shock, hypothermia, various water-borne infections,mental disorders, effects of chemical pollution, other secondary impacts
Socioeconomic conditions; land topography;drainage systems; building standards;
structural protection; early-warning systems
Land use change;socioeconomicdevelopment
Disasterpreparedness;media access
Vulnerabilitymapping;
zoning lawsAdapted land
use
Educationabout riskavoidance
Psycho-social
assistance
Improveddisasterplanning
Dose-responsecurve for
inland floods
Mitigativecapacity
Imple-mentation
Facili-tation
Imple-mentation
Facili-tation
Climatechange
Emissions
Concen-trations
Population exposureto climatic stimuli
Sensitivityto climatic
stimuli
Climate impacts on human health(morbidity and mortality)
Mitigation
Adaptation
Non-climatic risk factors(environmental; socio-economic;
institutional; demographic; medical; cultural; behavioural)
Climatevariability
Adaptivecapacity
Non-climaticdrivers
Adaptation to Vector-borne Diseases
Health impacts of vector-borne diseases(number of cases; mortality; DALYs):
Tick-borne encephalities, Lyme disease, malaria, dengue, West Nile fever, etc.
Socioeconomic conditions; housing; land use; irrigation systems; host density;
immunity; human behaviour; adaptationbaseline
Land use change;medical advances
Cross-sectoralcooperation;
state of publichealth system Epidemiolog.
research;mapping of
vector distrib.
Vaccination
campaigns
Improvedtreatment of cases
Vector control
Population exposure todisease-specific climatic
stimuli
Mitigativecapacity
Imple-mentation
Facili-tation
Imple-mentation
Facili-tation
Climatechange
Emissions
Concen-trations
Population exposureto climatic stimuli
Sensitivityto climatic
stimuli
Climate impacts on human health(morbidity and mortality)
Mitigation
Adaptation
Non-climatic risk factors(environmental; socio-economic;
institutional; demographic; medical; cultural; behavioural)
Climatevariability
Adaptivecapacity
Non-climaticdrivers
Adaptation to Food-borne Diseases
Population exposure todisease-specific climatic
stimuli
Health impacts of food-borne diseases(number of cases; mortality; DALYs):
Campylobacter, salmonellosis, etc.
Food production conditions; availabilityof clean water; nutritional preferences
Developments in foodproduction & storage;
econ. development
General levelof hygiene;food controlinstitutions Strengthening
of publichealth system
Targeted food
alerts
Early detection of cases
Foodproductio
ncontrol
Legend
Response action
Perception and interpretationof information
Functional relationship:“A is a determinant of B“
Effect of human actions
Physical cause-effect relationship:“A causes (changes in) B“
Key input (Y1) and key output (Y2)of the assessment, respectively
Important concept from the IPCC TARapplicable at the global level (X1),at the regional level (X2),and at diverse levels (X3)
Z
X1 X2 X3
Y1 Y2