This lecture presented during the CLIM Transition Workshop

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The Relationship Between Extreme
Events and Human Health in a
Changing Climate
Jesse E. Bell, Ph.D.
North Carolina Institute for Climate Studies (NCICS)
Cooperative Institute for Climate and Satellites – NC (CICS-NC)
North Carolina State University
Asheville, NC USA
SAMSI 2018

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• Heat events - Combining daily and annual
mortality data to estimate heatwave risk
• Participants: Brian Reich (NCSU), Veronica
Berrocal (UM), Richard Smith (UNC), Jesse Bell
(NCSU/CICS-NC)
• Student: Munir Winkel (NCSU)
Overview

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Background

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Climate Change and Health

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Climate Change and Health

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Billion-Dollar Disasters are Increasing

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Total Cost = $306 Billion; Deaths = 362

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Increase in Extreme Temperatures
Bell, J.E., et al. 2017. Changes in extreme events and the potential impacts on human health. Journal of the Air & Waste Management Association

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Health

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Long History Between Climate and Health
• Hippocrates wrote about
epidemics in 400 B.C.E. and
noted the change in weather
• 1814 Dr. James Tilton,
Surgeon General of the Army,
directed all hospital surgeons
to keep weather records

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Executive Summary
• Climate change threatens human health and well-being in the
United States. The U.S. Global Change Research Program
(USGCRP) Climate and Health Assessment has been developed to
enhance understanding and inform decisions about this growing
threat. This scientific assessment, called for under the President’s
Climate Action Plan, is a major report of the sustained National
Climate Assessment (NCA) process. The report responds to the
1990 Congressional mandate to assist the Nation in
understanding, assessing, predicting, and responding to human-
induced and natural processes of global change. The agencies of
the USGCRP identified human health impacts as a high-priority
topic for scientific assessment.
• The purpose of this assessment is to provide a comprehensive,
evidence-based, and, where possible, quantitative estimation of
observed and projected climate change related health impacts in
the United States. The USGCRP Climate and Health Assessment
has been developed to inform public health officials, urban and
disaster response planners, decision makers, and other
stakeholders within and outside of government who are
interested in better understanding the risks climate change
presents to human health.
Climate change is a significant threat to
the health of the American people.

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Figure from CDC’s Climate and Health Program

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Costs of Extreme Events

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Heat Waves

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Climate and Environmental Data Pathway
State and Local
Health Departments
Health Studies

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Heat Events
• Algorithm developed to scan
through product to find extreme
temperature events.
– Find the 98th percentile of the time
series.
– Find any days that meet or exceed
that percentile for a period of three
days or more.
• For each event, algorithm
determines severity, comparing to
its period of record (1895-2017).
• Can assess multiple regions.
– NCEI Climate division, state, NCA,
CONUS.

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Number of Heat Events
• 98th Percentile.
• NCEI Climate Division.
• Decadal, 1900s-2010s.
• TMAX top left.
• TMIN bottom left.
• 1930s Dust Bowl
Prevalent.
• Increase in events in
21st Century,
especially in the
southeastern parts of
the US.

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TMAX Heat Events

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TMIN Heat Events

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Duration of TMAX Heat Events

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Duration of TMIN Heat Events

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Intensity of TMAX Heat Events

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Intensity of TMIN Heat Events

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Health Data
• National Vital Statistic System
• Mortality Data
– 1960-2015
– County-level
– Yearly
– Age, race, sex
– All cause and individual
– Below 9 deaths is suppressed

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Health Data
• National Vital Statistic System
• Mortality Data
– 1975-2004
– County level
– Daily
– Age, sex, race, ICD code
– Below population of 100k is suppressed

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Health Data
• 2004-Present
• Working to get the most recent data
• Requires an additional approval process
• Regulations have changed
• Potentially daily, but could be monthly

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Moving Forward
• Combining mortality statistics with heat
analysis
• Obtain more recent mortality data for United
States
• Determine if there is any noticeable change in
mortality with changes in frequency, intensity,
or duration of heat events
• Publish results

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Possible Paths Forward
• Determine if tangible results can be extracted
from lower resolution by using higher
resolution data
• Project analysis forward using climate models
• Use methodology to look at other extreme
events types for better estimate of associated
mortality
– Drought!
• Disseminate this results back to CDC and
NOAA

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health2016.globalchange.gov

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Thank you!
Jesse E. Bell, PhD
jesse@cicsnc.org

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Pathway Between Drought and Health
Drought Drivers:
Decrease in precipitation
Increases in temperature
Decrease in runoff
Decrease in snowpack
Exposure Pathways:
Dust and dust storms
Wildfires
Decrease in water quality and quantity
More Intense Heat Waves
Changes in vector habitat and range
Loss of agriculture and food security
Health Outcomes:
Infectious disease
Mental health consequences
Injuries
Respiratory issues
Hunger/Famine
Heat illness
Gastrointestinal Illness
Environmental&
Institutional Context:
Agricultural management
practices
Preparedness of health
departments
Local environmental conditions
Power, transportation,
communication, and healthcare
infrastructure
Social& Behavioral
Context:
Social determinants of health
Occupation
Rural population
Limited english proficiency
Dependence on caregivers and
medication
Recreational activities
Water supply

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“Floods kill people, but droughts destroy civilizations.”
~U.S. Government Official at a Drought Meeting

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Climate Change and Health
Examples of
Climate Impacts
on Human Health

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• Climate Change is a Significant
Health Threat
• Extreme Events Cause a Variety of
Health Outcomes
– Direct, delayed, etc.
• Costs are Increasing
• Drought and Health
• Information Should Go Both Ways
• Climate Change is Already Causing
Health Outcomes
• Many Opportunities for Research
Conclusions

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Change by State