Climate Change: Managing theShifting Environmental Health Risks     Changing hazards, changing risks, and     the need for...
Overview• Climate change  – What’s happening and why  – What health impacts we’ll see• Risks from environmental hazards  –...
A brief primerCLIMATE CHANGE
Climate Change         Thanks to Daniel Rochberg for some slides
Increased     Increased                              Increased    Climate   GHG           GHG                             ...
Increased     Increased                              Increased    Climate   GHG           GHG                             ...
Increased     Increased                              Increased                     Climate   GHG           GHG            ...
Increased         Increased                                      Increased           Climate     GHG               GHG    ...
http://ngm.nationalgeographic.com/big-idea/05/carbon-bath
Increased     Increased                              Increased    Climate   GHG           GHG                             ...
Increased            Increased                                             Increased    Climate    GHG                  GH...
Increased     Increased                              Increased    Climate   GHG           GHG                             ...
Increased          Increased                                      Increased     Climate   GHG                GHG          ...
Increased         Increased                                     Increased                     Climate   GHG               ...
Increased     Increased                              Increased    Climate   GHG           GHG                             ...
Increased     Increased                              Increased    Climate   GHG           GHG                             ...
Increased     Increased                              Increased    Climate   GHG           GHG                             ...
Increased                Increased                                                       Increased                        ...
Increased       Increased                                                                                         Increase...
Increased                Increased                                                      Increased                     Clim...
Increased                  Increased                                                          Increased                   ...
Increased                Increased                                                      Increased                     Clim...
The components of risk and how they are shiftingENVIRONMENTAL HAZARD RISK
Basic Risk Formula in CC CommunityEvent           Vulnerability      Loss• Probability   • Exposure         • Damage• Magn...
Some Climate Change Risks                  Lenton, T. M. (2011). Early warning of                  climate tipping points....
Components of RiskEquations                            Considerations• Risk = p(H) x impact or cost       • What is the ha...
How Risk is Changing: Hazards
How Risk is Changing: HazardsIPCC. Managing the Risks of Extreme Events and Disasters to Advance Climate Change Adaptation...
How Risk is Changing: Exposure                   Available: http://www.worldmapper.com
How Risk is Changing: Exposure                          IPCC, SREX, 2012
How Risk is Changing: SusceptibilityGlobal Distribution of Preventable Deaths   Available: http://www.worldmapper.com
Mortality Distribution95% of disaster deaths occur in the developing world                                                ...
Combination, 1975-2010               Disasters
Health Effects of Disasters Pre-event – injuries, road traffic crashes              Event – debris injuries, drowning     ...
Hurricanes Katrina and Rita
NOLA Health Care System Pre and Post                             Rudowitz et                             al., 2006; slide ...
Moving the Coping Range
Approaches to risk and implications for public healthTHE ROLE OF RISK MANAGEMENT
Aspects of Risk Management                             Minimize or Avoid• Multiple components   – Risk recognition        ...
okay, climate change is a problem.       what do we do about it?Increased     Increased                              Incre...
okay, climate change is a problem.         what do we do about it?  Increased      Increased                              ...
Put another way:adapt     mitigate  to      against this       this
Mitigation:“avoiding the unmanageable”                Adaptation: “managing the unavoidable”
All                              affect human                                  healthhttp://www.ipcc.ch/graphics/graphics/...
Potential Co-benefits of GHG             Mitigation Policies• Energy generation –  decreased air pollution• Transportation...
Identifying synergies and opportunities             for co-benefits
Both Are RequiredYohe and Leichenko 2010
Risk Management OptionsIPCC SREX Summary for Policy Makers, available here.
But Where to Start?
BRACE                          1. Forecasted                          Climate Impact                         and Vulnerabi...
“Place Specific and Path Dependent”• At any point in time, health risks associated with  environmental hazards depend mark...
Feedbacks Over Time                      IPCC, SREX, 2012
Changing Risk Over TimeTol R, Ebi K, Yohe G. Infectious disease, development, and climate change: a scenario analysis.Envi...
Awareness of Thresholds                          Lenton, T. M.                          (2011). Early                     ...
The Role of Learning                       IPCC, SREX, 2012
Problem TypesUsed with permission from Hovmand, P. S. Adapted rom Burrell, G., and Morgan,G. (1979). Sociological paradigm...
The Role of Transformation                        IPCC, SREX, 2012
Simulations Can Help
Role of Adaptive Management• Return to the risk  equation                                  Assess   – Reduce hazard probab...
In Summary• Climate change is changing the risk landscape• Several risk management stances are available• Risk can be brok...
Climate Change & Health Webinar
Climate Change & Health Webinar
Climate Change & Health Webinar
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Climate Change & Health Webinar

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The extreme weather events experienced in the US this year will likely be the new normal as global warming affects the earth’s climate. The result will be significant health impacts nationally and around the globe. Dr. Jeremy Hess, a national expert on the topic, describes the major human health consequences of a warming planet including infectious diseases, neurological disorders and heat-related morbidity.

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Climate Change & Health Webinar

  1. 1. Climate Change: Managing theShifting Environmental Health Risks Changing hazards, changing risks, and the need for robust risk management Jeremy Hess, MD, MPH
  2. 2. 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
  3. 3. A brief primerCLIMATE CHANGE
  4. 4. Climate Change Thanks to Daniel Rochberg for some slides
  5. 5. Increased Increased Increased Climate GHG GHG Impacts Temperature ChangeEmissions Concentrations
  6. 6. Increased Increased Increased Climate GHG GHG Impacts Temperature ChangeEmissions Concentrations
  7. 7. Increased Increased Increased Climate GHG GHG Impacts Temperature ChangeEmissions Concentrations http://www.pewclimate.org/facts-and-figures/international/historical
  8. 8. Increased Increased Increased Climate GHG GHG Impacts Temperature Change Emissions ConcentrationsCO2 Concentrations over the past 800,000 years(dark blue line) 2012 Peak Concentration: 396 ppm
  9. 9. http://ngm.nationalgeographic.com/big-idea/05/carbon-bath
  10. 10. Increased Increased Increased Climate GHG GHG Impacts Temperature ChangeEmissions Concentrations
  11. 11. Increased Increased Increased Climate GHG GHG Impacts Temperature Change Emissions ConcentrationsThe Copenhagen Diagnosis, available here.
  12. 12. Increased Increased Increased Climate GHG GHG Impacts Temperature ChangeEmissions Concentrations
  13. 13. Increased Increased Increased Climate GHG GHG Impacts Temperature ChangeEmissions Concentrations Historical and Projected Global Temperatures (degrees C; 2000 = 0) IPCC
  14. 14. Increased Increased Increased Climate GHG GHG Impacts Temperature ChangeEmissions Concentrations“Climate change refersto any distinct change inmeasures of climate lasting for along period of time. In otherwords, ‘climate change’ meansmajor changes intemperature, rainfall, snow, or Climate changewind patterns lasting fordecades 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
  15. 15. Increased Increased Increased Climate GHG GHG Impacts Temperature ChangeEmissions Concentrations
  16. 16. Increased Increased Increased Climate GHG GHG Impacts Temperature ChangeEmissions Concentrations
  17. 17. Increased Increased Increased Climate GHG GHG Impacts Temperature ChangeEmissions Concentrations
  18. 18. Increased Increased Increased Climate GHG GHG Impacts Temperature ChangeEmissions Concentrations “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 Adaptation Summary for Policymakers, p. 11 http://www.cbc.ca/gfx/images/news/photos/2009/07/06/drought-china-cp-w-6244601.jpg
  19. 19. Increased Increased Increased Climate GHG GHG Impacts Temperature Change Emissions Concentrationshttp://earthobservatory.nasa.gov/IOTD/view.php?id=5542 Maldives: 1,192 islands IPCC sea level rise projections 330,000 people by 2100: 18-59 cm average elevation ~1 meter IPCC 4th Assessment Report, Synthesis Report
  20. 20. Increased Increased Increased Climate GHG GHG Impacts Temperature ChangeEmissions Concentrations http://www.history.com/photos/heat-waves/photo2“Frances summer heatwave killed a total of 14,800people, according to official figures released on Thursday.” BBC News, September 25, 2003 “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 Adaptation Summary for Policymakers, p. 11
  21. 21. Increased Increased Increased Climate GHG GHG Impacts Temperature ChangeEmissions Concentrations“It is likely that the frequency of heavyprecipitation or the proportion of total rainfallfrom heavy falls will increase in the 21stcentury 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 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
  22. 22. Increased Increased Increased Climate GHG GHG Impacts Temperature ChangeEmissions ConcentrationsAverage tropical cyclone maximum wind speed is likely toincrease, 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 http://www.nasa.gov/images/content/470571main_isabel_lg.jpg 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
  23. 23. The components of risk and how they are shiftingENVIRONMENTAL HAZARD RISK
  24. 24. Basic Risk Formula in CC CommunityEvent Vulnerability Loss• Probability • Exposure • Damage• Magnitude • Susceptibility • ValuationProbability x Consequence = Risk
  25. 25. Some Climate Change Risks Lenton, T. M. (2011). Early warning of climate tipping points. Nature Climate Change. 1: 201-209.
  26. 26. Components of RiskEquations Considerations• Risk = p(H) x impact or cost • What is the hazard? • Who is most vulnerable?• Risk = p(H) x V/Res, where – Little guidance – pH = Hazard probability – Based on exposure and – V = Vulnerability, where susceptibility: • Elderly • V = p(E) x (S) • Children • pE = Exposure probability • Workers • S = Susceptibility • What drives adaptive capacity – Res = Resilience for vulnerable populations? • How might early warnings• Res ≡ Adaptive Capacity facilitate protective responses and increase resilience?
  27. 27. How Risk is Changing: Hazards
  28. 28. How Risk is Changing: HazardsIPCC. Managing the Risks of Extreme Events and Disasters to Advance Climate Change Adaptation. ASpecial Report of Working Groups I and II of the Intergovernmental Panel on Climate Change.Cambridge, UK: Cambridge University Press; 2012.
  29. 29. How Risk is Changing: Exposure Available: http://www.worldmapper.com
  30. 30. How Risk is Changing: Exposure IPCC, SREX, 2012
  31. 31. How Risk is Changing: SusceptibilityGlobal Distribution of Preventable Deaths Available: http://www.worldmapper.com
  32. 32. Mortality Distribution95% of disaster deaths occur in the developing world IPCC, SREX, 2012
  33. 33. Combination, 1975-2010 Disasters
  34. 34. Health Effects of Disasters Pre-event – injuries, road traffic crashes Event – debris injuries, drowning Post-Event – displacement, chronic dz exacerbation Recovery – depression, violence
  35. 35. Hurricanes Katrina and Rita
  36. 36. NOLA Health Care System Pre and Post Rudowitz et al., 2006; slide courtesy John Balbus
  37. 37. Moving the Coping Range
  38. 38. Approaches to risk and implications for public healthTHE ROLE OF RISK MANAGEMENT
  39. 39. Aspects of Risk Management Minimize or Avoid• Multiple components – Risk recognition Mitigation Avoidance – Risk assessment – Risk engagement• Multiple stances – Risk mitigation Retain or Share – Risk avoidance – Risk retention Retention Sharing – Risk sharing
  40. 40. okay, climate change is a problem. what do we do about it?Increased Increased Increased Climate GHG GHG Impacts Temperature ChangeEmissions Concentrations
  41. 41. okay, climate change is a problem. what do we do about it? Increased Increased Increased Climate GHG GHG Impacts Temperature Change Emissions Concentrations reduce prepare for /emissions respond to the impacts(mitigation) (adaptation)
  42. 42. Put another way:adapt mitigate to against this this
  43. 43. Mitigation:“avoiding the unmanageable” Adaptation: “managing the unavoidable”
  44. 44. All affect human healthhttp://www.ipcc.ch/graphics/graphics/ar4-wg1/ppt/figure02.ppt#278,22,Figure 2.21
  45. 45. 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
  46. 46. Identifying synergies and opportunities for co-benefits
  47. 47. Both Are RequiredYohe and Leichenko 2010
  48. 48. Risk Management OptionsIPCC SREX Summary for Policy Makers, available here.
  49. 49. But Where to Start?
  50. 50. BRACE 1. Forecasted Climate Impact and Vulnerability Assessment 2. Projected5. Evaluation Disease Burden 4. Health Adaptation 3. Intervention Planning and Assessment Implementation
  51. 51. “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
  52. 52. Feedbacks Over Time IPCC, SREX, 2012
  53. 53. Changing Risk Over TimeTol R, Ebi K, Yohe G. Infectious disease, development, and climate change: a scenario analysis.Environment and Development Economics. 2007;12(05):687-706.
  54. 54. Awareness of Thresholds Lenton, T. M. (2011). Early warning of climate tipping points. Nature Climate Change. 1: 201- 209.
  55. 55. The Role of Learning IPCC, SREX, 2012
  56. 56. Problem TypesUsed with permission from Hovmand, P. S. Adapted rom Burrell, G., and Morgan,G. (1979). Sociological paradigmsand 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.
  57. 57. The Role of Transformation IPCC, SREX, 2012
  58. 58. Simulations Can Help
  59. 59. Role of Adaptive Management• Return to the risk equation Assess – Reduce hazard probability – Reduce hazard exposure Adjust Plan – Reduce susceptibility• Requires modeling, learning, and adaptive management Evaluate Implement• Integrated with sustain- able development Monitor
  60. 60. 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

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