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Paradigm Change in Drinking Water
Management to Achieve Vision 2030
Content
• Title “Is drinking water the correct term”
• Do we ensure complete health with that?
• Is it to enough to provide water for drinking
  purposes to achieve Vision 2030?
• Should we change the term “Drinking Water”
  for the term “Vitamin G Water”?
• Have we achieved the Millennium
  Development Goals for Water
Vision 2030
To make “Jamaica the place of choice to raise families,
             live, work and do business”
Water Related Expected Results(39) Vision 2030
        National Outcome                                               Outcome
                                                                  Expected Result
1    A Healthy and Stable          Improve the quality of life
     Population                    Increase average life expectancy
                                   Encourage healthy lifestyles
                                   Primary Health Care
2    World-Class Education and     Creative and productive individuals
     Training                      Holistic development of the child
                                   Training of under-trained population
3    Effective Social Protection   Identify and create employment and business opportunities
5    Security and Safety           Reducing the level of crime and violence in our country
                                   Empowering communities to participate fully in mainstream society
6    Effective Governance          Equity, tolerance and respect for human rights and freedoms.
7    A Stable Macroeconomy         Financial system stability
                                   Price stability over the long term.
8    An Enabling Business          Improve labour productivity and worker satisfaction;
     Environment                   Promote and develop entrepreneurship
9    Strong Economic               W&S that contributes competitiveness producers and ↑ quality of life
     Infrastructure                W&S services for economic and social uses.
10   Energy Security and           Reduce dependency on imported petroleum
     Efficiency                    Provide a secure and sustainable energy supply
                                   Diversify energy supply, and increase use of renewable energy
                                   Take advantage of emerging technologies
11   A Technology-Enabled          Deepen application of S&T to benefit all aspects national dev
     Society                       Build our capacity for undertaking research and development,
                                   Applying S&T to practical and productive uses.
12   Internationally Competitive   Environmental sustainability and food security
     Industry Structures           Promote use of clean technology
                                   Adopt and adapt new construction technologies
                                   Compliance relevant environmental standards and reg
                                   Reduce sector’s carbon footprint and waste generation
                                   Increase growth of sport
                                   Increase use of Jamaican inputs in tourism
13   Sustainable Management and    Env considerations integral factors socio-econ decision making
     Use of Environmental and      Green economy
     Natural Resources             Conserve NR; incorporating environ consider dec mak processes;
14   Hazard Risk Reduction and     Haz risk manag activ/progr for reducing vulnerability
     Adaptation Climate Change     Incorporate climate change future economic and land use planning
15   Sustainable Urban and Rural   Rundown town centres, urban sprawl, environmental degradation, unsafe and
     Development                   dilapidated housing, planned and unplanned development in ecologically-sensitive
                                   areas, crime and disorder, rural-urban migration, and poverty
                                   Create framework urb & rur dev that supports econ and soc devpmnt
                                   A spatial arrangement of land use that facilitates social and economic development,
                                   respects the environment and satisfies the need for safety, efficiency, aesthetics and
                                   social justice
Vitamin
               National Outcome                                           Outcome                                 Drinking      G
                                                                                                                   Water      Water
                                               Improve the quality of life
                                               Increase average life expectancy
1    A Healthy and Stable Population
                                              E ncourage healthy   lifestyles
                                               Primary Health Care
                                               Creative and productive individuals
2    World-Class Education and Training        Holistic development of the child
                                               Training of under-trained population
                                               M easures to identify and create employment and business
3    Effective Social Protection
                                             opportunities for the unemployed and underemployed poor


                                                                                                                             Vitamin
               National Outcome                                           Outcome                                 Drinking      G
                                                                                                                   Water      Water
                                               Reducing the level of crime and violence in our country
5    Security and Safety                        Empowering communities to participate fully in mainstream
                                             society
                                                Equity in all spheres of society; and tolerance and respect for
6    Effective Governance
                                             human rights and freedoms.
                                               Financial system stability
7    A Stable M acroeconomy
                                               Price stability over the long term.
                                               Improve labour productivity and worker satisfaction;
8    An Enabling Business Environment
                                               Promote and develop entrepreneurship
                                                Water supply and sanitation infrastructure that contributes to
                                             the competitiveness of our producers and improved quality of life
9    Strong Economic Infrastructure          for our people
                                                Provide adequate and safe water supply and sanitation services
                                             for economic and social uses.
                                                                                                                             Vitamin
               National Outcome                                           Outcome                                 Drinking      G
                                                                                                                   Water      Water
                                                Reduce dependency on imported petroleum as its primary
                                             source of energy
                                               Provide a secure and sustainable energy supply
10 Energy Security and Efficiency
                                                Diversify our energy supply, and increase use of renewable
                                             energy
                                               Take advantage of emerging technologies
                                               Deepen the application of science and technology to benefit all
                                             aspects of national development
11 A Technology-Enabled Society                Build our capacity for undertaking research and development,

                                                Applying science and technology to practical and productive
                                             uses.
                                                                                                                             Vitamin
               National Outcome                                           Outcome                                 Drinking      G
                                                                                                                   Water      Water
                                               Environmental sustainability and food security
                                               Promote the use of clean technology
                                                Adopt and adapt new construction technologies
   Internationally Competitive Industry          Compliance with relevant environmental standards and
12
   Structures                                regulations
                                                Reduce the sector’s carbon footprint and waste generation
                                               Increase the growth of sport
                                               Increase the use of Jamaican inputs in tourism
                                                Environmental considerations become integral factors in socio-
                                             economic decision making
   Sustainable M anagement and Use of           Green economy
13
   Environmental and Natural Resources           Providing an effective regulatory framework for the
                                             conservation of our natural resources; incorporating
                                             environmental considerations into decision making processes;
                                                                                                                             Vitamin
               National Outcome                                           Outcome                                 Drinking      G
                                                                                                                   Water      Water
                                               Hazard risk management activities and programmes for
   Hazard Risk Reduction and Adaptation to reducing our existing and future vulnerability
14
   Climate Change                             Incorporate climate change scenarios in future economic and
                                           land use planning
                                               Rundown town centres, urban sprawl, environmental
                                           degradation, unsafe and dilapidated housing, planned and
                                           unplanned development in ecologically-sensitive areas, crime and
                                           disorder, rural-urban migration, and poverty
15 Sustainable Urban and Rural Development    Create a framework for urban and rural development that
                                           supports the economic and social development
                                              A spatial arrangement of land use that facilitates social and
                                           economic development, respects the environment and satisfies the
                                           need for safety, efficiency, aesthetics and social justice
Comparison
                                                                                                               Vitamin
              National Outcome                                    Expected Result                     Drinking    G
                                                                                                       Water    Water
                                           Improve the quality of life
                                           Increase average life expectancy
1   A Healthy and Stable Population
                                          E ncourage healthy   lifestyles
                                           Primary Health Care
                                           Creative and productive individuals
2   World-Class Education and Training     Holistic development of the child
                                           Training of under-trained population
                                           M easures to identify and create employment and business
3   Effective Social Protection
                                         opportunities for the unemployed and underemployed poor




                                                                                                                10
Vitamin
                National Outcome                             Expected Result                               Drinking       G
                                                                                                            Water      Water
                                        Reducing the level of crime and violence in our country
5   Security and Safety                  Empowering communities to participate fully in mainstream
                                      society
                                         Equity in all spheres of society; and tolerance and respect for
6   Effective Governance
                                      human rights and freedoms.
                                        Financial system stability
7   A Stable Macroeconomy
                                        Price stability over the long term.
                                        Improve labour productivity and worker satisfaction;
8   An EnablingBusiness Environment
                                        Promote and develop entrepreneurship
                                         Water supply and sanitation infrastructure that contributes to
                                      the competitiveness of our producers and improved quality of life
9   StrongEconomic Infrastructure     for our people
                                         Provide adequate and safe water supply and sanitation services
                                      for economic and social uses.




                                                                                                                        11
Vitamin
             National Outcome                             Expected Result                               Drinking    G
                                                                                                         Water    Water
                                       Reduce dependency on imported petroleum as its primary
                                    source of energy
                                      Provide a secure and sustainable energy supply
10 Energy Security and Efficiency
                                       Diversify our energy supply, and increase use of renewable
                                    energy
                                      Take advantage of emerging technologies
                                      Deepen the application of science and technology to benefit all
                                    aspects of national development
11 A Technology-Enabled Society       Build our capacity for undertaking research and development,

                                       Applying science and technology to practical and productive
                                    uses.




                                                                                                                 12
Vitamin
              National Outcome                                    Expected Result                               Drinking    G
                                                                                                                 Water    Water
                                              Environmental sustainability and food security
                                              Promote the use of clean technology
                                              Adopt and adapt new construction technologies
     Internationally Competitive Industry       Compliance with relevant environmental standards and
12
     Structures                             regulations
                                              Reduce the sector’s carbon footprint and waste generation
                                              Increase the growth of sport
                                              Increase the use of Jamaican inputs in tourism
                                               Environmental considerations become integral factors in socio-
                                            economic decision making
     Sustainable M anagement and Use of       Green economy
13
     Environmental and Natural Resources        Providing an effective regulatory framework for the
                                            conservation of our natural resources; incorporating
                                            environmental considerations into decision making processes;




                                                                                                                          13
Vitamin
             National Outcome                                     Expected Result                             Drinking    G
                                                                                                               Water    Water
                                               Hazard risk management activities and programmes for
   Hazard Risk Reduction and Adaptation to reducing our existing and future vulnerability
14
   Climate Change                             Incorporate climate change scenarios in future economic and
                                           land use planning
                                               Rundown town centres, urban sprawl, environmental
                                           degradation, unsafe and dilapidated housing, planned and
                                           unplanned development in ecologically-sensitive areas, crime and
                                           disorder, rural-urban migration, and poverty
15 Sustainable Urban and Rural Development    Create a framework for urban and rural development that
                                           supports the economic and social development
                                              A spatial arrangement of land use that facilitates social and
                                           economic development, respects the environment and satisfies the
                                           need for safety, efficiency, aesthetics and social justice




                                                                                                                        14
Millennium Development Goals
              Table Drinking water coverage estimates

                        Urban (%)      Rural (%)         Total (%)

                       1990 2010      1990    2010      1990   2010

 Piped onto premises    89     91      34      47        61     70

     Other improved      9      7      54      41        32     23
             source
   Other unimproved      2      2       1       8        1       5

       Surface water     0      0      11       4        6       2

    Target 7.C:
    Halve, by 2015, the proportion of the population without
    sustainable access to safe drinking water and basic sanitation.
    Jamaica Goal was to reach 97.5% (in 1990 95%)

                                                                      15
Joint Monitoring Programme UNICEF/WHO

• Improved Water
  – An improved drinking-water source is
    defined as one that, by nature of its
    construction or through active
    intervention, is protected from outside
    contamination, in particular from
    contamination with faecal matter.




                                              16
• "Improved" sources of                 • "Unimproved" sources
  drinking-water:                         of drinking-water:
  •   Piped water into dwelling [ v ]     •   Unprotected spring [ v ]
  •   Piped water to yard/plot [ v ]      •   Unprotected dug well [ v ]
  •   Public tap or standpipe [ v ]       •   Cart with small
  •   Tubewell or borehole [ v ]              tank/drum [ v ]
  •   Protected dug well [ v ]            •   Tanker-truck [ v ]
  •   Protected spring [ v ]              •   Surface water [ v ]
  •   Rainwater [ v ]                     •   Bottled water [ v ]




                                                                           17
Census 2011




              18
Water Supply by Source
                    3.6 2.2

             11.1
5.9


      16.0                        57.3




                                         Piped into Dwelling
                                         Piped into Yard
                                         Standpipe
                                         Catchment
      Protected Source = 94.2%           Spring or River
      Unprotected Source = 5.8%          Trucked Water/Water Truck

                                                               19
Bottled

       Treated
                 7.6



                       23.9




66.8
Census: Water Treatment


                        7.6

                                   23.9



        66.8




                                          Bottled
                                          Treated
% Protected Source = 23.9%? Or 92.4%?     No Treated

                                                       21
% Households with Standpipe (Census 2011)
16.0

       14.5
              14.1
14.0
                     12.8
12.0                        11.5

                                   9.9   9.9
10.0
                                               8.7
 8.0
                                                     7.2

 6.0                                                       5.6   5.4   5.2

 4.0

                                                                             2.5
 2.0
                                                                                   1.8   1.5

 0.0




                                                                                         22
% Households with Water Catchment, Per Parish
                                        Census 2011
40.0
       36.6
35.0
              32.1
                     29.5
30.0                        28.7

25.0



20.0
                                   16.5
15.0                                      13.6

10.0
                                                 9.5   8.9
                                                             6.1
                                                                   5.0   4.4
 5.0                                                                           3.1
                                                                                     1.6   1.3
 0.0




                                                                                           23
% Households Spring/River Water Source
                                      Census 2011
10.0
       9.1
 9.0         8.8

 8.0               7.6
 7.0
                         6.8
                               6.0   5.8
 6.0


 5.0
                                           4.3
 4.0
                                                 3.5
                                                       3.1
 3.0
                                                             2.4
 2.0
                                                                   1.2   1.0
 1.0
                                                                               0.8
                                                                                     0.0
 0.0




                                                                                     24
% Households Receiving Water by Truck by Parish
                                        Census 2011
4.5
      4.1
4.0
            3.7
3.5
                  3.2
3.0
                           2.9   2.9   2.8

2.5


2.0                                          1.8   1.8   1.8
1.5                                                            1.4
                                                                     1.1
                                                                           1.0
1.0

                                                                                 0.5
0.5                                                                                    0.3

0.0




                                                                                       25
Are we meeting the MDGs?

       No, We don’t




                           26
Health Definition
• The World Health Organization (WHO) states
health is
 ‘A state of complete physical, mental, and social
wellbeing, and not merely the absence of disease
                   or infirmity’




                                                28
29
Epidemiological-Demographic and
                        Socio-economic transitions
                           Top five leading causes of death in Jamaica 1945-2004

        1945                          1982                          1996                   2004
  Tuberculosis                Cerebrovascular                  Cerebrovascular        Cerebrovascular
                                  Disease                          Disease                Disease
 Heart Disease                 Heart Disease                   Diabetes Mellitus     Diabetes Mellitus
     Nephritis                    Malignant                    Ischaemic Heart     Ischemic Heart Disease
                                  Neoplasm                         Disease
      Syphilis                  Hypertension                     Hypertensive      Hypertensive Diseases
                                                                   Diseases
   Pneumonia                Diabetes Mellitus Homicide/Assault                      Other Heart Disease
     Influenza                 Gastroenteritis                                     Accidents and Injuries-
                                                                                   (Accidents, poisoning
                                                                                       and violence)*
Source: Chronic Disease in the Caribbean: Jamaica Case Study                                            31
Disability Adjusted Lost Years

            DALYs




                                 32
Perfect Health
        100
Level of Health




                               Healthy from womb to tomb
                  50
                                       A Healthy Death




                   0   1   2   3   4    5     10    20   30   40   60   80
                                            Age, years
Healthy Years Lost (DALYS)
        100
                                                   Non – Healthy time
Level of Health




                  50


                                   Healthy time




                   0
                       1   2   3   4    5     10     20        30       40   60   80
                                            Age, years
Estimated DALY’s per 100,000 population, 2004
                   Jamaica


 Communicable, maternal, perinatal and
 nutritional conditions                  3,893

 NCDs                                    10,250

 Injuries                                2,170

 Total                                   16,314
Country profile of Environmental Burden of
            Disease (Jamaica)
DALys Comparison
• NCDs        10,250
• Diarrheas   280
Burden of Non Communicable
            Diseases (NCD)
• NCDs have resulted in a large direct and indirect
  economic burden for individuals in Jamaica.
• An average individual suffering from an NCD
  spends approximately one-third of household
  income (JM$ 55,503) on healthcare services and
  pharmaceutical purchases.
• Direct healthcare costs associated with NCDs are
  regressive and impose a greater burden on
  poor households than better-off households.
Present Health Conditions and
               Threats
•   Chronic Diseases↑
•   Obesity ↑
•   Mental Health ↑
•   Violence ↑
•   Sedentarism ↑
•   Junk Food ↑
•   Energy Consumption per capita ↑
•   Environmental Pollution ↑
From Homo sapiens to Homo sedens




                                   40
Obesity and overweight
major risk factors for NCDs
        Source: WHO 2012

             DIABETES 44%
             CVD      23% (mainly heart d and stroke)
             CANCER 41% (Breast, endometrial, Colon)
             HYPERTENSION

          Cholesterol, Dyslipidemia, LDL
          Gall stone disease
          Glucose intolerance

          Skin problems
          Respiratory problems
          Sleeping problems-Apnea
          Psychological Problems depression, dementia
          Musculoskeletal disorders:
          Arthritis, Osteoporosis

                                                   41
Obesity Burden and its NCDs cause:
•   Premature death
•   Long term Morbidity
•    S. Disability
•   Loss of Productivity
•   Reduction in quality life
•   High economic Burden-programs-PHC-
• 77% of the cost of illness from obesity C Fray-Aiken-ERU-UWI
• Can occupy an enormous % of MOH budget

                                                             42
Disease Condition Evolution
       (2001 – 2008)
Table 1. Prevalence of selected conditions in Jamaica Health and
  Lifestyle Survey 1 (JHLS–1) compared to Jamaica Health and
                   Lifestyle Survey 2 (JHLS–2).


Disease Condition              JHLS–1               JHLS–2
                               (2001)               (2008)
Diabetes mellitus           7.2 (6.0–8.3)        7.9 (6.7–9.0)

Hypertension*             20.9 (18.4–23.2)     25.2 (23.3–27.2)

Prehypertension           29.9 (27.1–32.7)     35.3 (32.6–37.9)

High cholesterol          14.6 (12.7–16.5)     11.7 (10.2–13.1)

*p < 0.05; JHLS–1 was conducted from 2000–2001 and JHLS–
22007–2008.                                                        43
Prevalence of cardiovascular disease risk factors
      by body mass index (BMI) category.
Twenty Highest Female Obesity Prevalence and Twenty Lowest Female Obesity
                              Prevalence Countries
Ranking   Most Obese             Prevalence   Ranking   Least Obese                 Prevalence
      1   Nauru                     81.9            1   Ethiopia                       0.03
      2   Tonga                     80.8            2   Eritrea                        0.2
      3   Micronesia                78.5            3   Sri Lanka                      0.2
      4   Cook Islands              72.5            4   Bangladesh                     0.3
      5   Samoa                     72.4            5   Nepal                          0.4
      6   Niue                      70.1            6   Cambodia                       0.5
      7   Kuwait                    66.6            7   Viet Nam                       1.1
      8   Barbados                  62.7            8   Dem Republic of the Congo      1.7
      9   Palau                     61.9            9   Japan                          1.7
     10   Trinidad and Tobago       60.7           10   Rwanda                         1.7
     11   Dominica                  60.0           11   Central African Republic       2.1
     12   Egypt                     59.4           12   Zambia                         2.2
     13   United States             54.8           13   Burkina Faso                   2.3
     14   Jamaica                   52.6           14   Uganda                         2.4
     15   United Arab Emirates      52.4           15   Afghanistan                    2.9
     16   Jordan                    52.2           16   India                          3.0
     17   Nicaragua                 51.2           17   Malawi                         3.1
     18   Mexico                    51.1           18   Kenya                          3.1
     19   Malta                     50.6           19   Burundi                        3.2
     20   Seychelles                50.4           20   Papua New Guinea               3.2
Climate Change Impacts
• Higher temperatures
    – 2 oC
• Higher Relative Humidity
    – 2.2% from 1973 to 2003
•   Rising seas
•   Increased risk of drought, fire and floods
•   Stronger storms and increased storm damage
•   Changing landscapes
•   More heat-related illness and disease
•   Economic losses
•   Wildlife at risk
    It is expected an increase of 1.5 to 2.8o Celsius increase in
                  temperature by 2050 and 2080
Infrared Image
Atlanta, Georgia
   Urban Area
Health Impacts
•   Increase on water use: bath and laundry
•   Change on quality
•   Higher groundwater table
•   Increase in chronic diseases
•   Increase in violence
•   Increase in vector borne diseases
•   Impacts on physical activity
•   Impacts on occupational Health
•   Sick Building Syndrome
Hot Temperatures Effects
• Increase aggression by
   – directly increasing feelings of hostility and
   – indirectly increasing aggressive thoughts.
• Body exhibits changes (increased heart rate, blood
  circulation and sweating, and metabolic changes) associated
  with sympathetic nervous system activity, which
  in turn is linked to fight-or-flight responses.
• Increases testosterone production, tilting that
  equation towards fight.
Ranson Study in USA
                      (2012)
• Across a variety of offenses, higher temperatures cause more
  crime.
• For most categories of violent crimes, this relationship appears
  approximately linear through the entire range of temperatures
  experienced in in-sample counties.
• He has estimated that between 2010 and 2099, climate change
  will cause an additional 30,000 murders, 200,000 cases of
  rape, 1.4 million aggravated assaults, 2.2 million simple
  assaults, 400,000 robberies, 3.2 million burglaries, 3.0 million
  cases of larceny, and 1.3 million cases of vehicle theft in the
  United States.
Impact on Physical Activity
Wet Bulb Globe Temperature
• American College of Sports Medicine,
  developed the concept of Wet Bulb Globe
  Temperature (WBGT) from Temperature and
  Relative Humidity;
• MOH Australia using WBGT has estimated the
  Risk of health illness and developed advices
Wet Bulb Globe Temperature (WBGT) from Temperature and
        Relative Humidity and Risk for Heath Illness


Low            Moderate-High       High – Very High   Extreme
WGBT and Risk of Thermal Injury
     Risk of                     Recommendation
     Thermal
WGBT Injury
<18  Minimal       Unlimited Activity
                   Keep Alert for possible increases in the
18 - 23 Moderate Indexand for symptoms of heat stress
                   Active exercise for unacclimatised persons
23 - 28 High       should be restricted
                   Active execise for all should be restricted,
28 - 30 Very High except well acclimatised
> 30    Extreme All training should be stopped
  The higher the reading the greater the risk of thermal injury
Kingston Assessment

• Use Temperature and Relative Humidity to
  calculate WBGT for each month and different
  hours:
  – 4:00
  – 6:00
  – 13:00
  – 18:00
  – 20:00
Table . Climate Change Risk of Thermal Injury during different hours of the year
        Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
 4:00    29 29   30 31   31 33 32 33 32 33 31 30
 6:00    29 28   29 30   31 32 32 32 32 32 31 30
13:00    32 32   33 34   35 35 36 36 36 35 34 33
18:00    31 31   32 32   33 34 34 34 34 34 33 32
20:00    30 29   30 32   33 33 34 34 34 33 32 31
“Impact of Climate Change on Occupational
   Health and Safety: Are we prepared?”
                     Dr. Homero Silva-Serrano
   Professor of Public Health Environment and Climate Change
         School of Public Health and Health Technology
                 University of Technology, Jamaica
Informal Workforce




        63
Informal Workforce




        64
Informal Workforce




        65
Humidex Chart
Preventive Measures
Humidex                           Respone
          Provide 15 minutes relief per hour
           Provide adequate cool (10 - 15 oC) water
  38 - 39
           At leas 1 cup (240 ml.) of water every 20 minutes
           Workers with symptoms should seek medical attention
           Provide 30 minutes relief per hour in addition to the
  40-42
           provisions listed above
           if feasible, provide 45 minutes relief per hour in addition
           to the provisions listed above
  43 - 44
           If a 75% relief period is not feasible then stop working
           until Humidex is 42 or less
45 or over Stop working until Humidex is 44 or less
Table No Working Risk Conditions with Climate Change
                 Working Risk Conditions With Climate Change
               Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
           4:00 35 35 36 38 39 41 40 41 40 40 38 37
           6:00 35 34 35 37 38 40 40 40 40 40 38 36
          10:00 40 39 39 42 43 44 44 45 44 45 43 41
          13:00 40 40 41 42 44 45 45 46 45 44 43 40
          16:00 40 39 40 42 43 44 43 45 45 45 43 42
          18:00 39 39 40 41 41 43 43 44 43 42 41 41
          20:00 37 36 37 40 41 42 43 43 43 42 40 38

           Table . Working Risk Conditions With Climate Change and Urban
                                 Heath Island Effect
                  Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
           4:00    41 41 42 44 45 47 46 47 46 47 44 43
           6:00    41 40 41 43 44 46 46 46 46 46 44 42
          10:00    45 43 45 46 50 51 51 52 50 50 50 46
          13:00    45 45 46 48 49 51 53 53 51 50 50 47
          16:00    45 45 46 47 48 51 53 51 51 50 49 47
          18:00    45 44 46 46 47 49 48 50 49 48 47 47
          20:00    42 42 43 46 47 48 49 49 49 48 46 44
The solution to Reduce Obesity
• Reduce input of calories
  – improving nutrition
  – changes in food availability and variety
  – and providing enough nutritional information on what
    we eat
• Increase output of calories = increasing
  physical activity
  – Providing public parks with facilities
  – providing regulations for infrastructure for physical
    activity and its enforcement;
  – change personal life style behaviors toward physical
    exercise.
The Complexity Eating Healthy
Table 2. Impacts on Health by 10kg weight loss

Health Condition                Impact
                     20-25% fall in total mortality
       Mortality
                     40-50% fall in obesity related
                     cancer deaths
                     Fall of 10mmHG systolic pressure
 Blood Pressure
                     Fall of 20 mmHg diastolic
                     pressure
                     Fall by 10% in total cholesterol
     Lipids
                     Fall by 15% LDL cholesterol
                     Fall by 30% triglycerides
                     Increase by 8% in HDL
                     cholesterol
                     Fall of 30-50% in fasting blood
       Diabetes
                     glucose
                     Fall of 15% in HbA1c


                                                         71
Prevalence of cardiovascular disease risk
 factors by physical activity levels (PAL).
Not much progress has been achieved in
         increasing physical activity




Source: Strategic Plan of Action for the Prevent and Control of NCDs for Countries in the Caribbean
Communities 2011-2015                                                                                 73
Physical Activity level of Jamaicans 15-74 yrs. old



               Men more physically active
                     than women




                                                 74
Some Calculations
              Source: Professor Homero Silva Serrano



       WHO Guideline is 12 m2/person

Kingston has 0.6 m2/person that means about
 5 % of what is required
Montego Bay IDB estimated 0.69 m2/person
USA is 64 m2/person



                                                       76
A Physical Representation of Public Parks




    Area Required = 313 Has

     Available = 32 Has




                                       77
Preliminary Evaluation of Some Kingston Parks




                                                                                                                                                                                                                                                                                                                                                                                     Grade
                                                                                                                                                      shade




                                                                                                                                                                                                                                                                                                                                                                           Safety
                                                                                                                                                              Playground
                                                                                                                          appeal
                                                    Park Size




                                                                                                                                                                           Lighting




                                                                                                                                                                                                                                     Restroom/changing



                                                                                                                                                                                                                                                                           Parking lots
                                                                                         Park features




                                                                                                                                                                                                                                                                                                                               Conditions




                                                                                                                                                                                                                                                                                                                                                                                              Percentage
                                                                                                                                                                                      Irrigation system




                                                                                                                                                                                                                                                            Picnic areas
                               Within park access


                                                                Layout: Activity areas




                                                                                                                                                                                                                                                                                                               Surrounding neighborhood
                                                                                                                                                                                                                                                                                          No Visual cues of




                                                                                                                                                                                                                                                                                                                                            Recreation programs or the
                                                                                                         Landscaping or Aesthetic




                                                                                                                                                                                                                                               facilities
                                                                                                                                    Balance between sun and




                                                                                                                                                                                                                                                                                                                                                    organized activities
                                                                                                                                                                                                          Other aesthetic features




                                                                                                                                                                                                                                                                                                incivilities
No
 1 Hope Gardens                     1                 1               1                     1                     1                          1                  1            0            1                     1                            0                 1              1                  1                       1                             1                    1        15      83.3
 2 Emancipation Park                1                 0               1                     1                     1                          0                  0            1            1                     1                            1                 0              1                  1                       1                             1                    1        13      72.2
 3 Boys Town Park                   1                 1               0                     1                     1                          0                  1            1            0                     0                            1                 0              1                  1                       1                             1                    1        12      66.7
 4 Tony Spaulding Complex           0                 0               0                     0                     1                          0                  0            1            1                     1                            1                 0              1                  1                       1                             0                    1         9      50.0
 5 Police Officers Club             0                 0               1                     0                     0                          0                  1            1            0                     0                            1                 0              1                  1                       1                             1                    1         9      50.0
 6 Barbican Football Field          0                 0               1                     0                     0                          0                  0            1            1                     0                            0                 0              0                  1                       1                             1                    1         7      38.9
 7 Mona Reservoir                   0                 1               0                     0                     1                          0                  0            0            0                     0                            0                 0              1                  1                       1                             0                    1         6      33.3
 8 Baldwin Park ?                   0                 0               0                     1                     0                          0                  0            1            0                     0                            0                 0              1                  1                       1                             0                    1         6      33.3
 9 National Heroes Park             0                 1               0                     0                     0                          0                  1            0            0                     0                            0                 0              1                  1                       1                             0                    0         5      27.8
10 UWI Park                         0                 0               0                     0                     1                          0                  0            0            0                     0                            0                 0              1                  1                       1                             0                    1         5      27.8
11 St. William Grant Park           0                 0               0                     0                     0                          0                  0            1            1                     0                            0                 0              0                  1                       0                             0                    1         4      22.2
12 Emmet Park                       0                 0               1                     0                     0                          0                  0            0            0                     0                            1                 0              0                  0                       1                             0                    1         4      22.2
13   Dunrobin Privare Park          0                 0               0                     0                     0                          0                  0          0              0                     0                            0                 0              1                1                       1                               0                   1          4      22.2
14   Stadium Gardens                0                 0               0                     0                     0                          0                  0          0              0                     0                            0                 0              1                1                       1                               0                   0          3      16.7
15   Mandela Park                   0                 0               0                     0                     1                          0                  0          1              0                     0                            0                 0              0                1                       0                               0                   0          3      16.7
16   Langlard Ave. Park             0                 0               0                     0                     0                          0                  0          1              0                     0                            0                 0              1                1                       0                               0                   0          3      16.7
17   Coorevill Gardens              0                 0               0                     0                     0                          0                  0          1              0                     0                            0                 0              1                0                       1                               0                   0          3      16.7
18   Hope Pastures Park             0                 0               0                     0                     0                          0                  0          0              0                     0                            0                 0                               1                       1                               0                   0          2      11.1
19   Cling Cling Park               0                 0               0                     0                     0                          0                  0          0              0                     0                            0                 0            1                  0                       1                               0                   0          2      11.1
20   Washington Gardens Park        0                 0               0                     0                     0                          0                  0          0              0                     0                            0                 0            0                  1                       1                               0                   0          2      11.1
21   Trench Town Park               0                 0               0                     0                     0                          0                  0          0              0                     0                            0                 0            0                  1                       0                               0                   0          1       5.6
22   Lowell Park ??                 0                 0               0                     0                     0                          0                  0          0              0                     0                            0                 0            0                  0                       1                               0                   0          1       5.6
23   Vint Lawrence Park             0                 0               0                     0                     0                          0                  0          0              0                     0                            0                 0            0                  0                       0                               0                   0          0       0.0
     Total                          3                 4               5                     4                     7                          1                  4          10             5                     3                            5                 1            14                 18                      18                              5                   12
                                                                                                                                                                                                                                                                                                                                                                                       78
                                                                                                                                                                                                                                                                                                                                                                                     119
                                                                                                                                                                                                                                                                                                                                                                                    5.174    28.7
Shading characteristics of
deciduous trees during the summer
Temperature Reduction using Trees

• Shading. by blocking solar radiation, trees
  prevent structures and surfaces from
  heating up beyond the ambient air
  temperature (Direct Effect).
• Evapotranspiration. Summer reduction of
  air temperature by evaporative cooling as
  water passes through plant leaves is
  important for comfort and for reducing air
  conditioning needs (Indirect Effect).
Shading
                 (Direct Effect)

• Shading can reduce summer air
  conditioning costs by 15 to 35 percent,
• As much as 50 percent or more in certain
  specific situations.
• Simply shading the air conditioner – by
  using shrubs or vine-covered trellis – can
  save up to 10 percent in annual cooling
  energy costs
Evapotranspiration
                     (Indirect Effect)

 Trees transpire up to 100 gallons of water            in a day
                              In a hot dry climate, This
                               cooling effect equal that of
                                5 air conditioners running
                                for 20 hours




                              When the effects of evapotranspiration
                               are combined with the effect of
                               strategically placed shade, temperatures
                               can drop by as much as 9 oF in the
                               immediate vicinity of the trees.

                                                                    82
Contribution of Vitamin G to Human Health and Wellbeing
Component of health                  Contribution of parks
Physical                             Provide a variety of settings and infrastructure for
                                     various levels of formal and informal sport and
                                     recreation, for all skill levels and abilities e.g.
                                     picnicking, walking, dog training, running, cycling,
                                     ball     games,     sailing,     surfing,     photography,
                                     birdwatching, bushwalking, rock climbing, camping
Mental                               Make nature available for restoration from mental
                                     fatigue; solitude and quiet; artistic inspiration and
                                     expression; educational development (e.g. natural and
                                     cultural history)
Spiritual                            Preserve the natural environment for contemplation,
                                     reflection and inspiration; invoke a sense of place;
                                     facilitate feeling a connection to something beyond
                                     human concerns
Social                               Provide settings for people to enhance their social
                                     networks and personal relationships from couples and
                                     families, to social clubs and organisations of all sizes,
                                     from casual picnicking to events days and festivals
Environmental                        Preserve ecosystems and biodiversity, provide clean air
                                     and water, maintain ecosystem function, and foster
                                     human involvement in the natural environment
                                     (Friends of Parks groups, etc.)                      83
Is Drinking Water Enough?




                            84
Thanks for Not Snoring

  hsilva10@hotmail.com

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Paradigm change in drinking water management to achieve

  • 1. Paradigm Change in Drinking Water Management to Achieve Vision 2030
  • 2. Content • Title “Is drinking water the correct term” • Do we ensure complete health with that? • Is it to enough to provide water for drinking purposes to achieve Vision 2030? • Should we change the term “Drinking Water” for the term “Vitamin G Water”? • Have we achieved the Millennium Development Goals for Water
  • 3. Vision 2030 To make “Jamaica the place of choice to raise families, live, work and do business”
  • 4.
  • 5.
  • 6.
  • 7.
  • 8. Water Related Expected Results(39) Vision 2030 National Outcome Outcome Expected Result 1 A Healthy and Stable Improve the quality of life Population Increase average life expectancy Encourage healthy lifestyles Primary Health Care 2 World-Class Education and Creative and productive individuals Training Holistic development of the child Training of under-trained population 3 Effective Social Protection Identify and create employment and business opportunities 5 Security and Safety Reducing the level of crime and violence in our country Empowering communities to participate fully in mainstream society 6 Effective Governance Equity, tolerance and respect for human rights and freedoms. 7 A Stable Macroeconomy Financial system stability Price stability over the long term. 8 An Enabling Business Improve labour productivity and worker satisfaction; Environment Promote and develop entrepreneurship 9 Strong Economic W&S that contributes competitiveness producers and ↑ quality of life Infrastructure W&S services for economic and social uses. 10 Energy Security and Reduce dependency on imported petroleum Efficiency Provide a secure and sustainable energy supply Diversify energy supply, and increase use of renewable energy Take advantage of emerging technologies 11 A Technology-Enabled Deepen application of S&T to benefit all aspects national dev Society Build our capacity for undertaking research and development, Applying S&T to practical and productive uses. 12 Internationally Competitive Environmental sustainability and food security Industry Structures Promote use of clean technology Adopt and adapt new construction technologies Compliance relevant environmental standards and reg Reduce sector’s carbon footprint and waste generation Increase growth of sport Increase use of Jamaican inputs in tourism 13 Sustainable Management and Env considerations integral factors socio-econ decision making Use of Environmental and Green economy Natural Resources Conserve NR; incorporating environ consider dec mak processes; 14 Hazard Risk Reduction and Haz risk manag activ/progr for reducing vulnerability Adaptation Climate Change Incorporate climate change future economic and land use planning 15 Sustainable Urban and Rural Rundown town centres, urban sprawl, environmental degradation, unsafe and Development dilapidated housing, planned and unplanned development in ecologically-sensitive areas, crime and disorder, rural-urban migration, and poverty Create framework urb & rur dev that supports econ and soc devpmnt A spatial arrangement of land use that facilitates social and economic development, respects the environment and satisfies the need for safety, efficiency, aesthetics and social justice
  • 9. Vitamin National Outcome Outcome Drinking G Water Water Improve the quality of life Increase average life expectancy 1 A Healthy and Stable Population E ncourage healthy lifestyles Primary Health Care Creative and productive individuals 2 World-Class Education and Training Holistic development of the child Training of under-trained population M easures to identify and create employment and business 3 Effective Social Protection opportunities for the unemployed and underemployed poor Vitamin National Outcome Outcome Drinking G Water Water Reducing the level of crime and violence in our country 5 Security and Safety Empowering communities to participate fully in mainstream society Equity in all spheres of society; and tolerance and respect for 6 Effective Governance human rights and freedoms. Financial system stability 7 A Stable M acroeconomy Price stability over the long term. Improve labour productivity and worker satisfaction; 8 An Enabling Business Environment Promote and develop entrepreneurship Water supply and sanitation infrastructure that contributes to the competitiveness of our producers and improved quality of life 9 Strong Economic Infrastructure for our people Provide adequate and safe water supply and sanitation services for economic and social uses. Vitamin National Outcome Outcome Drinking G Water Water Reduce dependency on imported petroleum as its primary source of energy Provide a secure and sustainable energy supply 10 Energy Security and Efficiency Diversify our energy supply, and increase use of renewable energy Take advantage of emerging technologies Deepen the application of science and technology to benefit all aspects of national development 11 A Technology-Enabled Society Build our capacity for undertaking research and development, Applying science and technology to practical and productive uses. Vitamin National Outcome Outcome Drinking G Water Water Environmental sustainability and food security Promote the use of clean technology Adopt and adapt new construction technologies Internationally Competitive Industry Compliance with relevant environmental standards and 12 Structures regulations Reduce the sector’s carbon footprint and waste generation Increase the growth of sport Increase the use of Jamaican inputs in tourism Environmental considerations become integral factors in socio- economic decision making Sustainable M anagement and Use of Green economy 13 Environmental and Natural Resources Providing an effective regulatory framework for the conservation of our natural resources; incorporating environmental considerations into decision making processes; Vitamin National Outcome Outcome Drinking G Water Water Hazard risk management activities and programmes for Hazard Risk Reduction and Adaptation to reducing our existing and future vulnerability 14 Climate Change Incorporate climate change scenarios in future economic and land use planning Rundown town centres, urban sprawl, environmental degradation, unsafe and dilapidated housing, planned and unplanned development in ecologically-sensitive areas, crime and disorder, rural-urban migration, and poverty 15 Sustainable Urban and Rural Development Create a framework for urban and rural development that supports the economic and social development A spatial arrangement of land use that facilitates social and economic development, respects the environment and satisfies the need for safety, efficiency, aesthetics and social justice
  • 10. Comparison Vitamin National Outcome Expected Result Drinking G Water Water Improve the quality of life Increase average life expectancy 1 A Healthy and Stable Population E ncourage healthy lifestyles Primary Health Care Creative and productive individuals 2 World-Class Education and Training Holistic development of the child Training of under-trained population M easures to identify and create employment and business 3 Effective Social Protection opportunities for the unemployed and underemployed poor 10
  • 11. Vitamin National Outcome Expected Result Drinking G Water Water Reducing the level of crime and violence in our country 5 Security and Safety Empowering communities to participate fully in mainstream society Equity in all spheres of society; and tolerance and respect for 6 Effective Governance human rights and freedoms. Financial system stability 7 A Stable Macroeconomy Price stability over the long term. Improve labour productivity and worker satisfaction; 8 An EnablingBusiness Environment Promote and develop entrepreneurship Water supply and sanitation infrastructure that contributes to the competitiveness of our producers and improved quality of life 9 StrongEconomic Infrastructure for our people Provide adequate and safe water supply and sanitation services for economic and social uses. 11
  • 12. Vitamin National Outcome Expected Result Drinking G Water Water Reduce dependency on imported petroleum as its primary source of energy Provide a secure and sustainable energy supply 10 Energy Security and Efficiency Diversify our energy supply, and increase use of renewable energy Take advantage of emerging technologies Deepen the application of science and technology to benefit all aspects of national development 11 A Technology-Enabled Society Build our capacity for undertaking research and development, Applying science and technology to practical and productive uses. 12
  • 13. Vitamin National Outcome Expected Result Drinking G Water Water Environmental sustainability and food security Promote the use of clean technology Adopt and adapt new construction technologies Internationally Competitive Industry Compliance with relevant environmental standards and 12 Structures regulations Reduce the sector’s carbon footprint and waste generation Increase the growth of sport Increase the use of Jamaican inputs in tourism Environmental considerations become integral factors in socio- economic decision making Sustainable M anagement and Use of Green economy 13 Environmental and Natural Resources Providing an effective regulatory framework for the conservation of our natural resources; incorporating environmental considerations into decision making processes; 13
  • 14. Vitamin National Outcome Expected Result Drinking G Water Water Hazard risk management activities and programmes for Hazard Risk Reduction and Adaptation to reducing our existing and future vulnerability 14 Climate Change Incorporate climate change scenarios in future economic and land use planning Rundown town centres, urban sprawl, environmental degradation, unsafe and dilapidated housing, planned and unplanned development in ecologically-sensitive areas, crime and disorder, rural-urban migration, and poverty 15 Sustainable Urban and Rural Development Create a framework for urban and rural development that supports the economic and social development A spatial arrangement of land use that facilitates social and economic development, respects the environment and satisfies the need for safety, efficiency, aesthetics and social justice 14
  • 15. Millennium Development Goals Table Drinking water coverage estimates Urban (%) Rural (%) Total (%) 1990 2010 1990 2010 1990 2010 Piped onto premises 89 91 34 47 61 70 Other improved 9 7 54 41 32 23 source Other unimproved 2 2 1 8 1 5 Surface water 0 0 11 4 6 2 Target 7.C: Halve, by 2015, the proportion of the population without sustainable access to safe drinking water and basic sanitation. Jamaica Goal was to reach 97.5% (in 1990 95%) 15
  • 16. Joint Monitoring Programme UNICEF/WHO • Improved Water – An improved drinking-water source is defined as one that, by nature of its construction or through active intervention, is protected from outside contamination, in particular from contamination with faecal matter. 16
  • 17. • "Improved" sources of • "Unimproved" sources drinking-water: of drinking-water: • Piped water into dwelling [ v ] • Unprotected spring [ v ] • Piped water to yard/plot [ v ] • Unprotected dug well [ v ] • Public tap or standpipe [ v ] • Cart with small • Tubewell or borehole [ v ] tank/drum [ v ] • Protected dug well [ v ] • Tanker-truck [ v ] • Protected spring [ v ] • Surface water [ v ] • Rainwater [ v ] • Bottled water [ v ] 17
  • 19. Water Supply by Source 3.6 2.2 11.1 5.9 16.0 57.3 Piped into Dwelling Piped into Yard Standpipe Catchment Protected Source = 94.2% Spring or River Unprotected Source = 5.8% Trucked Water/Water Truck 19
  • 20. Bottled Treated 7.6 23.9 66.8
  • 21. Census: Water Treatment 7.6 23.9 66.8 Bottled Treated % Protected Source = 23.9%? Or 92.4%? No Treated 21
  • 22. % Households with Standpipe (Census 2011) 16.0 14.5 14.1 14.0 12.8 12.0 11.5 9.9 9.9 10.0 8.7 8.0 7.2 6.0 5.6 5.4 5.2 4.0 2.5 2.0 1.8 1.5 0.0 22
  • 23. % Households with Water Catchment, Per Parish Census 2011 40.0 36.6 35.0 32.1 29.5 30.0 28.7 25.0 20.0 16.5 15.0 13.6 10.0 9.5 8.9 6.1 5.0 4.4 5.0 3.1 1.6 1.3 0.0 23
  • 24. % Households Spring/River Water Source Census 2011 10.0 9.1 9.0 8.8 8.0 7.6 7.0 6.8 6.0 5.8 6.0 5.0 4.3 4.0 3.5 3.1 3.0 2.4 2.0 1.2 1.0 1.0 0.8 0.0 0.0 24
  • 25. % Households Receiving Water by Truck by Parish Census 2011 4.5 4.1 4.0 3.7 3.5 3.2 3.0 2.9 2.9 2.8 2.5 2.0 1.8 1.8 1.8 1.5 1.4 1.1 1.0 1.0 0.5 0.5 0.3 0.0 25
  • 26. Are we meeting the MDGs? No, We don’t 26
  • 27.
  • 28. Health Definition • The World Health Organization (WHO) states health is ‘A state of complete physical, mental, and social wellbeing, and not merely the absence of disease or infirmity’ 28
  • 29. 29
  • 30.
  • 31. Epidemiological-Demographic and Socio-economic transitions Top five leading causes of death in Jamaica 1945-2004 1945 1982 1996 2004 Tuberculosis Cerebrovascular Cerebrovascular Cerebrovascular Disease Disease Disease Heart Disease Heart Disease Diabetes Mellitus Diabetes Mellitus Nephritis Malignant Ischaemic Heart Ischemic Heart Disease Neoplasm Disease Syphilis Hypertension Hypertensive Hypertensive Diseases Diseases Pneumonia Diabetes Mellitus Homicide/Assault Other Heart Disease Influenza Gastroenteritis Accidents and Injuries- (Accidents, poisoning and violence)* Source: Chronic Disease in the Caribbean: Jamaica Case Study 31
  • 32. Disability Adjusted Lost Years DALYs 32
  • 33. Perfect Health 100 Level of Health Healthy from womb to tomb 50 A Healthy Death 0 1 2 3 4 5 10 20 30 40 60 80 Age, years
  • 34. Healthy Years Lost (DALYS) 100 Non – Healthy time Level of Health 50 Healthy time 0 1 2 3 4 5 10 20 30 40 60 80 Age, years
  • 35. Estimated DALY’s per 100,000 population, 2004 Jamaica Communicable, maternal, perinatal and nutritional conditions 3,893 NCDs 10,250 Injuries 2,170 Total 16,314
  • 36. Country profile of Environmental Burden of Disease (Jamaica)
  • 37. DALys Comparison • NCDs 10,250 • Diarrheas 280
  • 38. Burden of Non Communicable Diseases (NCD) • NCDs have resulted in a large direct and indirect economic burden for individuals in Jamaica. • An average individual suffering from an NCD spends approximately one-third of household income (JM$ 55,503) on healthcare services and pharmaceutical purchases. • Direct healthcare costs associated with NCDs are regressive and impose a greater burden on poor households than better-off households.
  • 39. Present Health Conditions and Threats • Chronic Diseases↑ • Obesity ↑ • Mental Health ↑ • Violence ↑ • Sedentarism ↑ • Junk Food ↑ • Energy Consumption per capita ↑ • Environmental Pollution ↑
  • 40. From Homo sapiens to Homo sedens 40
  • 41. Obesity and overweight major risk factors for NCDs Source: WHO 2012  DIABETES 44%  CVD 23% (mainly heart d and stroke)  CANCER 41% (Breast, endometrial, Colon)  HYPERTENSION Cholesterol, Dyslipidemia, LDL Gall stone disease Glucose intolerance Skin problems Respiratory problems Sleeping problems-Apnea Psychological Problems depression, dementia Musculoskeletal disorders: Arthritis, Osteoporosis 41
  • 42. Obesity Burden and its NCDs cause: • Premature death • Long term Morbidity • S. Disability • Loss of Productivity • Reduction in quality life • High economic Burden-programs-PHC- • 77% of the cost of illness from obesity C Fray-Aiken-ERU-UWI • Can occupy an enormous % of MOH budget 42
  • 43. Disease Condition Evolution (2001 – 2008) Table 1. Prevalence of selected conditions in Jamaica Health and Lifestyle Survey 1 (JHLS–1) compared to Jamaica Health and Lifestyle Survey 2 (JHLS–2). Disease Condition JHLS–1 JHLS–2 (2001) (2008) Diabetes mellitus 7.2 (6.0–8.3) 7.9 (6.7–9.0) Hypertension* 20.9 (18.4–23.2) 25.2 (23.3–27.2) Prehypertension 29.9 (27.1–32.7) 35.3 (32.6–37.9) High cholesterol 14.6 (12.7–16.5) 11.7 (10.2–13.1) *p < 0.05; JHLS–1 was conducted from 2000–2001 and JHLS– 22007–2008. 43
  • 44. Prevalence of cardiovascular disease risk factors by body mass index (BMI) category.
  • 45. Twenty Highest Female Obesity Prevalence and Twenty Lowest Female Obesity Prevalence Countries Ranking Most Obese Prevalence Ranking Least Obese Prevalence 1 Nauru 81.9 1 Ethiopia 0.03 2 Tonga 80.8 2 Eritrea 0.2 3 Micronesia 78.5 3 Sri Lanka 0.2 4 Cook Islands 72.5 4 Bangladesh 0.3 5 Samoa 72.4 5 Nepal 0.4 6 Niue 70.1 6 Cambodia 0.5 7 Kuwait 66.6 7 Viet Nam 1.1 8 Barbados 62.7 8 Dem Republic of the Congo 1.7 9 Palau 61.9 9 Japan 1.7 10 Trinidad and Tobago 60.7 10 Rwanda 1.7 11 Dominica 60.0 11 Central African Republic 2.1 12 Egypt 59.4 12 Zambia 2.2 13 United States 54.8 13 Burkina Faso 2.3 14 Jamaica 52.6 14 Uganda 2.4 15 United Arab Emirates 52.4 15 Afghanistan 2.9 16 Jordan 52.2 16 India 3.0 17 Nicaragua 51.2 17 Malawi 3.1 18 Mexico 51.1 18 Kenya 3.1 19 Malta 50.6 19 Burundi 3.2 20 Seychelles 50.4 20 Papua New Guinea 3.2
  • 46.
  • 47. Climate Change Impacts • Higher temperatures – 2 oC • Higher Relative Humidity – 2.2% from 1973 to 2003 • Rising seas • Increased risk of drought, fire and floods • Stronger storms and increased storm damage • Changing landscapes • More heat-related illness and disease • Economic losses • Wildlife at risk It is expected an increase of 1.5 to 2.8o Celsius increase in temperature by 2050 and 2080
  • 48.
  • 49.
  • 51.
  • 52. Health Impacts • Increase on water use: bath and laundry • Change on quality • Higher groundwater table • Increase in chronic diseases • Increase in violence • Increase in vector borne diseases • Impacts on physical activity • Impacts on occupational Health • Sick Building Syndrome
  • 53. Hot Temperatures Effects • Increase aggression by – directly increasing feelings of hostility and – indirectly increasing aggressive thoughts. • Body exhibits changes (increased heart rate, blood circulation and sweating, and metabolic changes) associated with sympathetic nervous system activity, which in turn is linked to fight-or-flight responses. • Increases testosterone production, tilting that equation towards fight.
  • 54. Ranson Study in USA (2012) • Across a variety of offenses, higher temperatures cause more crime. • For most categories of violent crimes, this relationship appears approximately linear through the entire range of temperatures experienced in in-sample counties. • He has estimated that between 2010 and 2099, climate change will cause an additional 30,000 murders, 200,000 cases of rape, 1.4 million aggravated assaults, 2.2 million simple assaults, 400,000 robberies, 3.2 million burglaries, 3.0 million cases of larceny, and 1.3 million cases of vehicle theft in the United States.
  • 55.
  • 56. Impact on Physical Activity
  • 57. Wet Bulb Globe Temperature • American College of Sports Medicine, developed the concept of Wet Bulb Globe Temperature (WBGT) from Temperature and Relative Humidity; • MOH Australia using WBGT has estimated the Risk of health illness and developed advices
  • 58. Wet Bulb Globe Temperature (WBGT) from Temperature and Relative Humidity and Risk for Heath Illness Low Moderate-High High – Very High Extreme
  • 59. WGBT and Risk of Thermal Injury Risk of Recommendation Thermal WGBT Injury <18 Minimal Unlimited Activity Keep Alert for possible increases in the 18 - 23 Moderate Indexand for symptoms of heat stress Active exercise for unacclimatised persons 23 - 28 High should be restricted Active execise for all should be restricted, 28 - 30 Very High except well acclimatised > 30 Extreme All training should be stopped The higher the reading the greater the risk of thermal injury
  • 60. Kingston Assessment • Use Temperature and Relative Humidity to calculate WBGT for each month and different hours: – 4:00 – 6:00 – 13:00 – 18:00 – 20:00
  • 61. Table . Climate Change Risk of Thermal Injury during different hours of the year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 4:00 29 29 30 31 31 33 32 33 32 33 31 30 6:00 29 28 29 30 31 32 32 32 32 32 31 30 13:00 32 32 33 34 35 35 36 36 36 35 34 33 18:00 31 31 32 32 33 34 34 34 34 34 33 32 20:00 30 29 30 32 33 33 34 34 34 33 32 31
  • 62. “Impact of Climate Change on Occupational Health and Safety: Are we prepared?” Dr. Homero Silva-Serrano Professor of Public Health Environment and Climate Change School of Public Health and Health Technology University of Technology, Jamaica
  • 67. Preventive Measures Humidex Respone Provide 15 minutes relief per hour Provide adequate cool (10 - 15 oC) water 38 - 39 At leas 1 cup (240 ml.) of water every 20 minutes Workers with symptoms should seek medical attention Provide 30 minutes relief per hour in addition to the 40-42 provisions listed above if feasible, provide 45 minutes relief per hour in addition to the provisions listed above 43 - 44 If a 75% relief period is not feasible then stop working until Humidex is 42 or less 45 or over Stop working until Humidex is 44 or less
  • 68. Table No Working Risk Conditions with Climate Change Working Risk Conditions With Climate Change Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 4:00 35 35 36 38 39 41 40 41 40 40 38 37 6:00 35 34 35 37 38 40 40 40 40 40 38 36 10:00 40 39 39 42 43 44 44 45 44 45 43 41 13:00 40 40 41 42 44 45 45 46 45 44 43 40 16:00 40 39 40 42 43 44 43 45 45 45 43 42 18:00 39 39 40 41 41 43 43 44 43 42 41 41 20:00 37 36 37 40 41 42 43 43 43 42 40 38 Table . Working Risk Conditions With Climate Change and Urban Heath Island Effect Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 4:00 41 41 42 44 45 47 46 47 46 47 44 43 6:00 41 40 41 43 44 46 46 46 46 46 44 42 10:00 45 43 45 46 50 51 51 52 50 50 50 46 13:00 45 45 46 48 49 51 53 53 51 50 50 47 16:00 45 45 46 47 48 51 53 51 51 50 49 47 18:00 45 44 46 46 47 49 48 50 49 48 47 47 20:00 42 42 43 46 47 48 49 49 49 48 46 44
  • 69. The solution to Reduce Obesity • Reduce input of calories – improving nutrition – changes in food availability and variety – and providing enough nutritional information on what we eat • Increase output of calories = increasing physical activity – Providing public parks with facilities – providing regulations for infrastructure for physical activity and its enforcement; – change personal life style behaviors toward physical exercise.
  • 71. Table 2. Impacts on Health by 10kg weight loss Health Condition Impact 20-25% fall in total mortality Mortality 40-50% fall in obesity related cancer deaths Fall of 10mmHG systolic pressure Blood Pressure Fall of 20 mmHg diastolic pressure Fall by 10% in total cholesterol Lipids Fall by 15% LDL cholesterol Fall by 30% triglycerides Increase by 8% in HDL cholesterol Fall of 30-50% in fasting blood Diabetes glucose Fall of 15% in HbA1c 71
  • 72. Prevalence of cardiovascular disease risk factors by physical activity levels (PAL).
  • 73. Not much progress has been achieved in increasing physical activity Source: Strategic Plan of Action for the Prevent and Control of NCDs for Countries in the Caribbean Communities 2011-2015 73
  • 74. Physical Activity level of Jamaicans 15-74 yrs. old Men more physically active than women 74
  • 75.
  • 76. Some Calculations Source: Professor Homero Silva Serrano WHO Guideline is 12 m2/person Kingston has 0.6 m2/person that means about 5 % of what is required Montego Bay IDB estimated 0.69 m2/person USA is 64 m2/person 76
  • 77. A Physical Representation of Public Parks Area Required = 313 Has Available = 32 Has 77
  • 78. Preliminary Evaluation of Some Kingston Parks Grade shade Safety Playground appeal Park Size Lighting Restroom/changing Parking lots Park features Conditions Percentage Irrigation system Picnic areas Within park access Layout: Activity areas Surrounding neighborhood No Visual cues of Recreation programs or the Landscaping or Aesthetic facilities Balance between sun and organized activities Other aesthetic features incivilities No 1 Hope Gardens 1 1 1 1 1 1 1 0 1 1 0 1 1 1 1 1 1 15 83.3 2 Emancipation Park 1 0 1 1 1 0 0 1 1 1 1 0 1 1 1 1 1 13 72.2 3 Boys Town Park 1 1 0 1 1 0 1 1 0 0 1 0 1 1 1 1 1 12 66.7 4 Tony Spaulding Complex 0 0 0 0 1 0 0 1 1 1 1 0 1 1 1 0 1 9 50.0 5 Police Officers Club 0 0 1 0 0 0 1 1 0 0 1 0 1 1 1 1 1 9 50.0 6 Barbican Football Field 0 0 1 0 0 0 0 1 1 0 0 0 0 1 1 1 1 7 38.9 7 Mona Reservoir 0 1 0 0 1 0 0 0 0 0 0 0 1 1 1 0 1 6 33.3 8 Baldwin Park ? 0 0 0 1 0 0 0 1 0 0 0 0 1 1 1 0 1 6 33.3 9 National Heroes Park 0 1 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 5 27.8 10 UWI Park 0 0 0 0 1 0 0 0 0 0 0 0 1 1 1 0 1 5 27.8 11 St. William Grant Park 0 0 0 0 0 0 0 1 1 0 0 0 0 1 0 0 1 4 22.2 12 Emmet Park 0 0 1 0 0 0 0 0 0 0 1 0 0 0 1 0 1 4 22.2 13 Dunrobin Privare Park 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 4 22.2 14 Stadium Gardens 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 3 16.7 15 Mandela Park 0 0 0 0 1 0 0 1 0 0 0 0 0 1 0 0 0 3 16.7 16 Langlard Ave. Park 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 3 16.7 17 Coorevill Gardens 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 3 16.7 18 Hope Pastures Park 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 2 11.1 19 Cling Cling Park 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 2 11.1 20 Washington Gardens Park 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 2 11.1 21 Trench Town Park 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 5.6 22 Lowell Park ?? 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 5.6 23 Vint Lawrence Park 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0 Total 3 4 5 4 7 1 4 10 5 3 5 1 14 18 18 5 12 78 119 5.174 28.7
  • 79. Shading characteristics of deciduous trees during the summer
  • 80. Temperature Reduction using Trees • Shading. by blocking solar radiation, trees prevent structures and surfaces from heating up beyond the ambient air temperature (Direct Effect). • Evapotranspiration. Summer reduction of air temperature by evaporative cooling as water passes through plant leaves is important for comfort and for reducing air conditioning needs (Indirect Effect).
  • 81. Shading (Direct Effect) • Shading can reduce summer air conditioning costs by 15 to 35 percent, • As much as 50 percent or more in certain specific situations. • Simply shading the air conditioner – by using shrubs or vine-covered trellis – can save up to 10 percent in annual cooling energy costs
  • 82. Evapotranspiration (Indirect Effect)  Trees transpire up to 100 gallons of water in a day  In a hot dry climate, This cooling effect equal that of 5 air conditioners running for 20 hours  When the effects of evapotranspiration are combined with the effect of strategically placed shade, temperatures can drop by as much as 9 oF in the immediate vicinity of the trees. 82
  • 83. Contribution of Vitamin G to Human Health and Wellbeing Component of health Contribution of parks Physical Provide a variety of settings and infrastructure for various levels of formal and informal sport and recreation, for all skill levels and abilities e.g. picnicking, walking, dog training, running, cycling, ball games, sailing, surfing, photography, birdwatching, bushwalking, rock climbing, camping Mental Make nature available for restoration from mental fatigue; solitude and quiet; artistic inspiration and expression; educational development (e.g. natural and cultural history) Spiritual Preserve the natural environment for contemplation, reflection and inspiration; invoke a sense of place; facilitate feeling a connection to something beyond human concerns Social Provide settings for people to enhance their social networks and personal relationships from couples and families, to social clubs and organisations of all sizes, from casual picnicking to events days and festivals Environmental Preserve ecosystems and biodiversity, provide clean air and water, maintain ecosystem function, and foster human involvement in the natural environment (Friends of Parks groups, etc.) 83
  • 84. Is Drinking Water Enough? 84
  • 85. Thanks for Not Snoring hsilva10@hotmail.com

Editor's Notes

  1. Jamaica have experienced an epidemiological transitions over the past 60 year, this is a illustrative table which show the leading causes of death in jamaica for selected years between 1945 and 2004, the top 5 leading causes of death including . Largely rooted in our lifestyle. CNDs accounted for 56% of death annually.“Urbanization and socioeconomic transition are linked to Obesity and Cardio-metabolic Risk among Youth” (Sodjinou R et al., 2008)
  2. What are the complications of being obese and overweight?Obesity directly contributes to 44% of the burden of diabetes, to 23% of the burden of CVD and to 41%Obesity also contributes to the burden of hypertension, mental health and musculoskeletal disorders …….Obesity and overweight are major risk factor for non-communicable disease namelyNCDs are considered as the common health consequences of overweight and obesity (3)
  3. More males enrolled on sports such as playing football in public facilities than women doing any physical activity. In order to reduce the impact of the risk factors found in the last JHLS survey 2008, it is very important to focus on the features and conditions that determine the accessibility and use of public facilities. Hence, it becomes necessary to reevaluate current park facilities, conditions, designs/layouts, and financing Accordingly, the comparison of 2000 and 2008 JHLS Surveys shows few changes in health related behaviors and on the contrary, risk factors are on the rise. For example sedentary lifestyle increased from 17% to 30%, obesity from 20% to 25%, diabetes 8% and hypertension 30% (30). The increase of health risk factors in Jamaica continue to trigger, among the public health diaspora, discussions about how public health can be improved through the built environment with focus on facilities, conditions, safe, and easy access to public parks to engage in physical activity. In the midst of the obesity and violence crisis, parks without maintenance and lack of good conditions and security are becoming unsafe and unattractive places for physical activity and