Jonathan Patz, MD, MPH Nelson Institute & Dept. Population Health Sciences  University of Wisconsin - Madison 16th World...
IPCC 2001scenarios to 2100 ---------------- 
FOR CLIMATE QUESTIONS, SEND STRAIGHT TO : WWW.IPCC.CH Natural vs Anthropogenic climate forcing IPCC, 2006 Why the climatol...
Changes in sea ice extent September 1980:  7.8 million square kilometers Sept 1980 Alaska Siberia Greenland The Arctic sea...
Changes in sea ice extent September 2007: 4.2 million square kilometers Sept 2007 Alaska Siberia Greenland Courtesy:  Don ...
Changes in sea ice extent Reduction from 1980 to 2007 Huge decrease in ice extent Courtesy:  Don Perovich
Understanding: predictions of ice extent Observationed decline is faster!  Stroeve et al. 2007 Courtesy:  Don Perovich
But the polar bear might not be the only threatened species “ How it threatens  your health”
CLIMATE  CHANGE Temperature Rise  1 Sea level Rise  2 Hydrologic Extremes Urban Heat Island Effect Air Pollution & Aeroall...
Absorbing capacity <ul><li>The ability to absorb the free energy of an event without sustaining damage </li></ul><ul><ul><...
Buffering Capacity <ul><li>The ability of a society to cope with damage and to function despite damage </li></ul><ul><li>T...
HEAT WAVE - EUROPE Heat Index Summer 2003 <ul><li>50,000 deaths  in  11 days </li></ul>
Comparing the 2003 Heatwave to past summer climate  European heat wave of 2003, from Schär et al., 2004
Probabilities of future extremes can be estimated given projections of mean temperature Peterson  et al.,  2007 2057 2007
<ul><li>By 2050, warming alone may   increase by 68% the number of Red Ozone Alert days   across the Eastern US.  (IPCC, 2...
Future summers warmer than warmest on record <ul><ul><ul><li>Today’s 800 million at risk for hunger could double by mid-ce...
Sensitivity of cereal yield to climate change   IPCC 2006
<ul><li>27% of reefs considered to be dead – at least half of these attributed to climate change </li></ul>
 
Relationship between temperature and malaria parasite development time inside mosquito (“extrinsic incubation period” or E...
Relationship between malaria and altitude, Zimbabwe. Altitude a good surrogate for temperature:  the average temperature d...
Baseline   2000  2025 2050 2075 2100 Source:  Ebi et al, 2005
Baseline   2000   2025   2050  2075 2100 Source:  Ebi et al,  2005
Daily hospitalizations for diarrhoea, by daily temperature, Lima, Peru.  (Shaded region corresponds to 1997-98 El Niño eve...
Climate change: It’s not just about warming.
Floods
USA: Combined sewer overflows (CSOs)   Courtesy:  Kellogg Schwab 1.2 trillion gal of sewage & stormwater a year discharged...
Extreme Precipitation and Waterborne Disease Outbreaks in the United States, 1948 -1994 Project Sponsor: US EPA, Office of...
Results <ul><li>67%  of waterborne disease outbreaks were preceded by precipitation above the 80th percentile  (across a 5...
Milwaukee 1993 Cryptosporidiosis epidemic 405,000 exposed 54 fatalities Preceded by heaviest  rainfall in 50 years
 
U.S. CCSP, 2008   Globally Averaged
Projected Changes in Extremes Globally IPCC (2007)
CLIMATE & LAND USE SYNERGY Hurricanes Mitch & Katrina
~  9,600 people perished ,  widespread water- and vector-borne diseases followed, and nearly one million people were left ...
wetland loss in the Mississippi delta (1839 to 2020) Barataria-Terrebonne Estuary Program 1839 1870 1993 2020
New Orleans  after Hurricane Katrina
How will climate change affect coastal populations?  Estimated population impacted by sea level rise for selected counties...
Ethics   Climate Change and  Health
 
 
Patz, Gibbs et al. 2007 Americans emit 6-times the global average CO 2  per capita Based on Smith et al. 2004. Distributio...
Key reason for banning smoking.  Shouldn’t we consider climate change in the same way?
Patz, Gibbs et al. 2007
Millennium Development Goals (MDGs) 1- Eradicate extreme poverty and hunger 2- Achieve universal primary education 3- Prom...
Source:  National Geographic “ GROWING FUEL:  The Wrong Way: The Right Way” October, 2007, National Geographic BIOFUELS:  ...
Biofuels and Food Security <ul><li>The amount of humanitarian food aid available for extremely impoverished countries will...
The Good News about climate change and our health
Energy consumption per person and life expectancy Wilkinson et al, 2007
The opportunity for improving health determinants We can reduce: The  800,000 annual deaths  from urban air pollution The ...
Status of Americans <ul><li>≈  2/3  U.S. adults  ≥ 20  are overweight or obese </li></ul><ul><li>≈  15 % of children and a...
Ten Leading Causes of US Deaths per Year (CDC, 2004)
Percentage of trips by transport mode for US work trips 1960-2000 TRENDS IN TRANSPORTATION: Reliance on our cars
1/3 of US CO 2  emissions come from transportation sector Gurinder Osan/Associated Press US Dept. of Energy, 2005
Triple Win Bike Project <ul><li>Health (personal) </li></ul><ul><li>Local Air Pollution   (local) </li></ul><ul><li>Global...
<ul><li>Health and Personal Fitness </li></ul><ul><li>(personal) </li></ul>2. Health and Local Air Pollution (local) 3. Gr...
Calculating the Health/Fitness Benefits of Bicycling <ul><li>Displays and Records </li></ul><ul><li>Current and Average Po...
Personal Fitness and Health <ul><li>Average Bicycle Commute in Madison is  3.4 miles </li></ul><ul><li>Energy Expenditure:...
Evolution of CDC Physical Activity Recommendations <ul><li>OLD:   sporadic, intense training, 3-5 times per week </li></ul...
The Heat Island
Heat early-warning systems save lives Figure 3: Summer daily heat-index measures, heat-related mortality, and heat-related...
<ul><li>Health and Personal Fitness </li></ul><ul><li>(personal) </li></ul>2. Health and Local Air Pollution (local) 3. Gr...
Asthma and Air Pollution Friedman et al.  JAMA  2001;285:897 <ul><li>Asthma -related emergency room visits by children  de...
Air Quality and Human Health If 20% of  car trips in Madison replaced by bicycle trips… 12.21%  ozone reduction &  2.07%  ...
Money Saved from Reduced Ozone Exposure Per Year - Madison $ 17,454,707 /year Total $ 15,910,536 / year Mortality $ 759,01...
<ul><li>Health and Personal Fitness </li></ul><ul><li>(personal) </li></ul>2. Health and Local Air Pollution (local) 3. Gr...
Greenhouse Gas Mitigation If 20% of  car trips in Madison replaced by bicycle trips… 33,374,395 lbs CO 2  saved (16,687 to...
Urban planning is public health and disaster planning policy!
“ Be the change you wish to see  in the world.”   Gandhi
Thank you! [email_address] www. sage.wisc.edu
A cautionary note
All Eyes on Biofuels Number of Scientific Articles with keyword “ biofuels ” Matt Johnston, SAGE, UW-Madison
All  Eyes on Biofuels… Biofuels Binaries: Not an simple black-or-white issue Matt Johnston, SAGE, UW-Madison
Overabundant distiller waste from corn ethanol Distillers grains fed to cattle <ul><li>10X higher prevalence of  E. coli O...
Diesel and fertilizer to  produce  corn for ethanol production results in  more  PM  2.5  than burning the equivalent amou...
Billions of gallons of water consumed Source: IATP 2006 ethanol and water report Ecosystem impacts More corn ethanol = Les...
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Global Climate Change, Energy & Health: Foreboding Clouds & Silver Linings

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Global Climate Change, Energy & Health: Foreboding Clouds & Silver Linings
Talk by Jonathan Patz, MD, MPH
of the Nelson Institute & Dept. Population Health Sciences at the University of Wisconsin - Madison at the 16th World Congress on Disaster and Emergency Medicine on May 12, 2009.
Reproduced here with the author's permission.

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  • Global Climate Change, Energy & Health: Foreboding Clouds & Silver Linings

    1. 1. Jonathan Patz, MD, MPH Nelson Institute & Dept. Population Health Sciences University of Wisconsin - Madison 16th World Congress on Disaster and Emergency Medicine Victoria, Vancouver, May 12, 2009 Global Climate Change, Energy & Health: Foreboding Clouds & Silver Linings
    2. 2. IPCC 2001scenarios to 2100 ---------------- 
    3. 3. FOR CLIMATE QUESTIONS, SEND STRAIGHT TO : WWW.IPCC.CH Natural vs Anthropogenic climate forcing IPCC, 2006 Why the climatologists working for IPCC now are “90% certain” that today’s warming is from human activities
    4. 4. Changes in sea ice extent September 1980: 7.8 million square kilometers Sept 1980 Alaska Siberia Greenland The Arctic sea ice cover Courtesy: Don Perovich
    5. 5. Changes in sea ice extent September 2007: 4.2 million square kilometers Sept 2007 Alaska Siberia Greenland Courtesy: Don Perovich
    6. 6. Changes in sea ice extent Reduction from 1980 to 2007 Huge decrease in ice extent Courtesy: Don Perovich
    7. 7. Understanding: predictions of ice extent Observationed decline is faster! Stroeve et al. 2007 Courtesy: Don Perovich
    8. 8. But the polar bear might not be the only threatened species “ How it threatens your health”
    9. 9. CLIMATE CHANGE Temperature Rise 1 Sea level Rise 2 Hydrologic Extremes Urban Heat Island Effect Air Pollution & Aeroallergens Vector-borne Diseases Water-borne Diseases Water resources & food supply Mental Health & Environmental Refugees Heat Stress Cardiorespiratory failure Respiratory diseases, e.g., COPD & Asthma Malaria Dengue Encephalitis Hantavirus Rift Valley Fever Cholera Cyclospora Cryptosporidiosis Campylobacter Leptospirosis Malnutrition Diarrhea Toxic Red Tides Forced Migration Overcrowding Infectious diseases Human Conflicts 1 3°C by yr. 2100 2 40 cm “ “ IPCC estimates Patz, 1998 HEALTH EFFECTS OF CLIMATE CHANGE
    10. 10. Absorbing capacity <ul><li>The ability to absorb the free energy of an event without sustaining damage </li></ul><ul><ul><li>Levees </li></ul></ul><ul><ul><li>Building codes </li></ul></ul><ul><ul><li>Reforestation </li></ul></ul><ul><ul><li>Boarding windows </li></ul></ul><ul><ul><li>Bomb shelters </li></ul></ul><ul><ul><li>Bullet proof vests </li></ul></ul><ul><ul><li>Armor </li></ul></ul><ul><ul><li>Air bags </li></ul></ul><ul><li>Mitigation is anything done to increase absorbing capacity </li></ul>Courtesy: Marvin Birnbaum
    11. 11. Buffering Capacity <ul><li>The ability of a society to cope with damage and to function despite damage </li></ul><ul><li>The ability to maintain essential functions for a change in available resources </li></ul><ul><ul><li>Backup Generators </li></ul></ul><ul><ul><li>Alternate sources of fuel </li></ul></ul><ul><ul><li>Shelters </li></ul></ul><ul><ul><li>Cross-trained personnel </li></ul></ul><ul><ul><li>Wells / rain water </li></ul></ul>Courtesy: Marvin Birnbaum
    12. 12. HEAT WAVE - EUROPE Heat Index Summer 2003 <ul><li>50,000 deaths in 11 days </li></ul>
    13. 13. Comparing the 2003 Heatwave to past summer climate European heat wave of 2003, from Schär et al., 2004
    14. 14. Probabilities of future extremes can be estimated given projections of mean temperature Peterson et al., 2007 2057 2007
    15. 15. <ul><li>By 2050, warming alone may increase by 68% the number of Red Ozone Alert days across the Eastern US. (IPCC, 2007 -Bell et al, 2006) </li></ul><ul><li>“ The severity and duration of summertime regional air pollution episodes are projected to increase in the Northeast and Midwest US by 2045-2052 due to climate-change-induced decreases in the frequency of surface cyclones .” (IPCC, 2007 ) </li></ul>
    16. 16. Future summers warmer than warmest on record <ul><ul><ul><li>Today’s 800 million at risk for hunger could double by mid-century. </li></ul></ul></ul>Battisi and Naylor, Science 2009
    17. 17. Sensitivity of cereal yield to climate change IPCC 2006
    18. 18. <ul><li>27% of reefs considered to be dead – at least half of these attributed to climate change </li></ul>
    19. 20. Relationship between temperature and malaria parasite development time inside mosquito (“extrinsic incubation period” or EIP). EIP shortens at higher temps, so mosquitoes infectious sooner.
    20. 21. Relationship between malaria and altitude, Zimbabwe. Altitude a good surrogate for temperature: the average temperature decrease with height = 6°C per 1000 meters Source: Taylor and Mutambu, 1986
    21. 22. Baseline 2000 2025 2050 2075 2100 Source: Ebi et al, 2005
    22. 23. Baseline 2000 2025 2050 2075 2100 Source: Ebi et al, 2005
    23. 24. Daily hospitalizations for diarrhoea, by daily temperature, Lima, Peru. (Shaded region corresponds to 1997-98 El Niño event) Checkley et al, Lancet 2000 (J. Patz PI) Daily hospitalisations for diarrhoea Daily temperature 1997 1993 Overall estimate from regression analysis: 7% increase in daily cases per 1 o C rise 5 o C +33% El Niño
    24. 25. Climate change: It’s not just about warming.
    25. 26. Floods
    26. 27. USA: Combined sewer overflows (CSOs) Courtesy: Kellogg Schwab 1.2 trillion gal of sewage & stormwater a year discharged during combined sewer overflows – would keep Niagara Falls roaring for 18 days Center for Water & Health, JHU Bloomberg School of Public Health
    27. 28. Extreme Precipitation and Waterborne Disease Outbreaks in the United States, 1948 -1994 Project Sponsor: US EPA, Office of Research & Development PI: J. Patz
    28. 29. Results <ul><li>67% of waterborne disease outbreaks were preceded by precipitation above the 80th percentile (across a 50 yr. climate record), p < 0.001 </li></ul><ul><li>51% of outbreaks were preceded by precipitation above the 90th percentile, p < 0.002 </li></ul><ul><li>Surface water-related outbreaks had strongest correlation with extreme precipitation in the month of outbreak; groundwater-related outbreaks lagged 2 months following extreme precipitation. </li></ul>Curriero, Patz, et al, 2001.
    29. 30. Milwaukee 1993 Cryptosporidiosis epidemic 405,000 exposed 54 fatalities Preceded by heaviest rainfall in 50 years
    30. 32. U.S. CCSP, 2008 Globally Averaged
    31. 33. Projected Changes in Extremes Globally IPCC (2007)
    32. 34. CLIMATE & LAND USE SYNERGY Hurricanes Mitch & Katrina
    33. 35. ~ 9,600 people perished , widespread water- and vector-borne diseases followed, and nearly one million people were left homeless . Areas with extensive deforestation or degraded hillsides suffered the greatest morbidity and mortality and point to the importance of vegetation cover and as a buffer to severe floods, and the long-term prevention of injuries and fatalities
    34. 36. wetland loss in the Mississippi delta (1839 to 2020) Barataria-Terrebonne Estuary Program 1839 1870 1993 2020
    35. 37. New Orleans after Hurricane Katrina
    36. 38. How will climate change affect coastal populations? Estimated population impacted by sea level rise for selected counties, 2030 Dr. Annemarie Shneider (SAGE)
    37. 39. Ethics Climate Change and Health
    38. 42. Patz, Gibbs et al. 2007 Americans emit 6-times the global average CO 2 per capita Based on Smith et al. 2004. Distribution of 166,000 deaths/yr from recent warming. Based on McMichael et al 2004.
    39. 43. Key reason for banning smoking. Shouldn’t we consider climate change in the same way?
    40. 44. Patz, Gibbs et al. 2007
    41. 45. Millennium Development Goals (MDGs) 1- Eradicate extreme poverty and hunger 2- Achieve universal primary education 3- Promote gender equality and empower women 4- Reduce child mortality 5- Improve maternal health 6- Combat major diseases (HIV/AIDS, malaria, others) 7- Ensure environmental sustainability 8- Develop a global partnership for development Might climate change reverse progress on these priority fronts?
    42. 46. Source: National Geographic “ GROWING FUEL: The Wrong Way: The Right Way” October, 2007, National Geographic BIOFUELS: Where climate change, land use, energy, and health concerns come together … that is, the cure must not be worse than the disease!
    43. 47. Biofuels and Food Security <ul><li>The amount of humanitarian food aid available for extremely impoverished countries will be affected in the short term as food aid shipments from the USA are inversely correlated to commodity prices </li></ul><ul><li>(Naylor et al. 2007) </li></ul><ul><li>For every percentage increase in the real prices of staple foods, 16 million more people could become food-insecure (Runge, 2003) </li></ul>
    44. 48. The Good News about climate change and our health
    45. 49. Energy consumption per person and life expectancy Wilkinson et al, 2007
    46. 50. The opportunity for improving health determinants We can reduce: The 800,000 annual deaths from urban air pollution The loss of 1.9 million deaths, and 19 million years of healthy life, from physical inactivity WHO, 2007
    47. 51. Status of Americans <ul><li>≈ 2/3 U.S. adults ≥ 20 are overweight or obese </li></ul><ul><li>≈ 15 % of children and adolescents age 6-19 are overweight (CDC 2004). </li></ul><ul><li>20.8 million people have diabetes (7% of the population) (CDCP 2005) </li></ul><ul><li>60% of American adults do not meet recommended levels of physical activity, and 25% are completely sedentary (DHHS, 1996) </li></ul>40% of trips by car are < 2 miles (Dept of Transportation)
    48. 52. Ten Leading Causes of US Deaths per Year (CDC, 2004)
    49. 53. Percentage of trips by transport mode for US work trips 1960-2000 TRENDS IN TRANSPORTATION: Reliance on our cars
    50. 54. 1/3 of US CO 2 emissions come from transportation sector Gurinder Osan/Associated Press US Dept. of Energy, 2005
    51. 55. Triple Win Bike Project <ul><li>Health (personal) </li></ul><ul><li>Local Air Pollution (local) </li></ul><ul><li>Global Climate Change (global) </li></ul>… Why global climate change could be the greatest public health opportunity we’ve had in over a century!
    52. 56. <ul><li>Health and Personal Fitness </li></ul><ul><li>(personal) </li></ul>2. Health and Local Air Pollution (local) 3. Greenhouse Gas Emissions and Global Climate Change (global) Triple Win Bike Project
    53. 57. Calculating the Health/Fitness Benefits of Bicycling <ul><li>Displays and Records </li></ul><ul><li>Current and Average Power </li></ul><ul><li>Heart Rate </li></ul><ul><li>Cadence </li></ul><ul><li>Speed </li></ul><ul><li>Energy Expenditure </li></ul><ul><li>Ride Distance </li></ul><ul><li>Ride Time </li></ul>CycleOps PowerTap -- gives you access to real-time performance measurements Lance Armstrong
    54. 58. Personal Fitness and Health <ul><li>Average Bicycle Commute in Madison is 3.4 miles </li></ul><ul><li>Energy Expenditure: 144 kcal round trip </li></ul><ul><li>Around 200 minutes additional physical activity </li></ul><ul><li>9-10 lbs weight loss in year </li></ul><ul><li>Reduce risk of ischaemic heart disease by 47% </li></ul><ul><li>Reduce risk of stroke by 39% </li></ul><ul><li>Reduce risk of breast cancer for women by 34% </li></ul><ul><li>Reduce risk for colon cancer by 43% </li></ul><ul><li>Reduce risk for type II diabetes by 31% </li></ul>WHO, CRA 2002
    55. 59. Evolution of CDC Physical Activity Recommendations <ul><li>OLD: sporadic, intense training, 3-5 times per week </li></ul><ul><li>NEW: 30 minutes, moderate activity, preferably every day, either in a single session or in multiple bouts, each lasting at least 8–10 minutes </li></ul><ul><li>Added value of commuting by bike? </li></ul>
    56. 60. The Heat Island
    57. 61. Heat early-warning systems save lives Figure 3: Summer daily heat-index measures, heat-related mortality, and heat-related emergency medical service (EMS) runs: Milwaukee, WI, 1995 and 1999 (Source: Weisskopf, Anderson, Foldy, Hanrahan et al. 2002).
    58. 62. <ul><li>Health and Personal Fitness </li></ul><ul><li>(personal) </li></ul>2. Health and Local Air Pollution (local) 3. Greenhouse Gas Emissions and Global Climate Change (global) Triple Win Bike Project
    59. 63. Asthma and Air Pollution Friedman et al. JAMA 2001;285:897 <ul><li>Asthma -related emergency room visits by children decreased 42% </li></ul><ul><li>Children’s emergency visits for non-asthma causes did not change during same period </li></ul><ul><li>Natural experiment during 1996 Summer Olympic games in Atlanta </li></ul><ul><li>Peak morning traffic decreased 23% and peak ozone levels decreased 28% </li></ul>
    60. 64. Air Quality and Human Health If 20% of car trips in Madison replaced by bicycle trips… 12.21% ozone reduction & 2.07% PM 2.5 reduction 1,906 fewer asthma cases per yr 4,765 fewer missed days of school per yr 14,587 fewer cases of acute respiratory symptoms/yr Save over $40 million in costs from reduced exposure to ozone and particulate matter
    61. 65. Money Saved from Reduced Ozone Exposure Per Year - Madison $ 17,454,707 /year Total $ 15,910,536 / year Mortality $ 759,018 / year Acute Respiratory Symptoms $ 357,299 / year School Loss Days $ 179,901 / year Worker Productivity $ 147,498 / year Asthma Exacerbation $ 99,391 / year Hospital Admissions $ 1,064 / year Emergency Room Visits
    62. 66. <ul><li>Health and Personal Fitness </li></ul><ul><li>(personal) </li></ul>2. Health and Local Air Pollution (local) 3. Greenhouse Gas Emissions and Global Climate Change Triple Win Bike Project
    63. 67. Greenhouse Gas Mitigation If 20% of car trips in Madison replaced by bicycle trips… 33,374,395 lbs CO 2 saved (16,687 tons) 4.2% reduction in the total amount of carbon dioxide emissions in Madison
    64. 68. Urban planning is public health and disaster planning policy!
    65. 69. “ Be the change you wish to see in the world.” Gandhi
    66. 70. Thank you! [email_address] www. sage.wisc.edu
    67. 71. A cautionary note
    68. 72. All Eyes on Biofuels Number of Scientific Articles with keyword “ biofuels ” Matt Johnston, SAGE, UW-Madison
    69. 73. All Eyes on Biofuels… Biofuels Binaries: Not an simple black-or-white issue Matt Johnston, SAGE, UW-Madison
    70. 74. Overabundant distiller waste from corn ethanol Distillers grains fed to cattle <ul><li>10X higher prevalence of E. coli O157:H7 (15% vs. 1.5%) in feces of cattle fed distillers grains vs. corn. (USDA, 2008) </li></ul><ul><li>Research Project “Effect of Distillers Grains on E. Coli O157:H7 in Finishing Feedlot Cattle,” USDA ARS Meat Safety and Quality Research Division . As reported by Mark Steil, Minnesota Public Radio, October 17, 2008. http://minnesota.publicradio.org/display/web/2008/10/17/e_coli/ </li></ul>Couresy: David Wallinga
    71. 75. Diesel and fertilizer to produce corn for ethanol production results in more PM 2.5 than burning the equivalent amount of gasoline ! Hill et al. unpublished data Life Cycle Analysis shows need for Health Impact Assessment in Energy Policy
    72. 76. Billions of gallons of water consumed Source: IATP 2006 ethanol and water report Ecosystem impacts More corn ethanol = Less water Couresy: David Wallinga

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