FoE nov 2013

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FoE nov 2013

  1. 1. Seeing is believing The transformation of data into understanding through visualisation ! Dr Will Stahl-Timmins Associate Research Fellow: Visualisation EUROPEAN UNION Investing in Your Future European Regional Development Fund 2007-13 EUROPEAN UNION Investing in Your Future European Regional Development Fund 2007-13
  2. 2. ECEHH - European Centre for Environment and Human Health Information graphics - visual presentation of E&HH data and information Seeing is Believing - investigating the effects of visual presentation
  3. 3. ECEHH - European Centre for Environment and Human Health Information graphics Seeing is Believing
  4. 4. ECEHH Information graphics - visual presentation of E&HH data and information Seeing is Believing
  5. 5. Spain South Korea New Zealand Healthy life expectancy in years Palestine Nicaragua Sick 70 Tajikistan Kyrgyzstan Laos Yemen Myanmar Ghana Ethiopia Gambia Niger Mauritania Burundi Mozambique Dem. Rep. Congo Nigeria Cameroon Zambia Sierra Leone 1 000 Afghanistan Angola Lesotho 2 000 100 1000 millions 2011 data for all 193 UN Members and for Hong Kong, Kosovo, Palestine, Puerto Rico and Taiwan. Documentation and pdf version for print at: gapminder.org/downloads/world-pdf Free to copy, share and remix, but attribute to Gapminder Foundation. Botswana Equatorial Guinea If you want to see more data visit: www.gapminder.org Chad Central African Rep. Guinea-Bissau 500 South Africa Mali Colour by region 3 or 10 less Uganda Guinea Somalia Zimbabwe Congo, Rep. Burkina Benin Faso Cote d'Ivoire Rwanda Malawi Kuwait Size by population Gabon Namibia South Sudan Senegal Qatar Brunei United Arab Emirates Kazakhstan Kiribati Djibouti 55 USA Taiwan Denmark Liechtenstein Luxembourg Turkmenistan India Timor-Leste Kenya Togo Liberia Bhutan Sudan Tanzania Singapore Nauru Papua New Guinea Haiti Russia Ukraine Bolivia Tuvalu Comoros 60 Philippines Sao Tome and Principe Cambodia Grenada Serbia Indonesia Fiji Mongolia Pakistan 65 Eritrea Iraq Moldova Uzbekistan Solomon Islands Madagascar Norway Sweden Canada Netherlands Austria Germany Finland Belgium Bosnia and H. Belize Australia Ireland UK China Bangladesh North Korea Nepal Puerto Rico Mexico Slovenia Iceland San Marino Hong Andorra Switzerland Kong France Brazil Micronesia Life Expectancy of the World Malta Cyprus Uruguay Barbados Czech Rep. Poland DominicaCroatia Slovak Rep. Panama Antigua Ecuador Montenegro Argentina&Barbuda Bahamas St.Lucia Bahrain Cape St. Kitts Sri Lanka Thailand Macedonia Libya Estonia Venezuela Verde & Nevis Tunisia Armenia Seychelles Malaysia Hungary Peru Romania Mauritius Egypt Dom.R. Georgia Jordan Saudi Colombia Turkey Latvia Honduras Oman Iran Paraguay Samoa Jamaica Arabia Lebanon Algeria Lithuania Palau Bulgaria Morocco Tonga El Salvador St.Vincent and G. Vanuatu Guatemala Suriname Belarus Azerbaijan Guyana Trinidad and Tobago Kosovo Syria Vietnam Rich Greece Income per Person of the World Poor 75 Chile Portugal Cuba Costa Rica Maldives Albania 50 Italy map layout by Paolo Fausone Israel Mapping the Wealth and Health of Nations 80 Monaco Japan GAPMINDER WORLD 2012 Swaziland 5 000 Version 11 September 2012 10 000 20 000 income per person in US Dollars (GDP/capita, PPP$ inflation adjusted, log scale) 50 000
  6. 6. Charles Joseph Minard: 1869
  7. 7. ISOTYPE: Otto and Marie Neurath, Gerd Artz
  8. 8. 0% + 0.5% (baseline) + 0.6% +1.0% + 1.1% Regression coefficient % Change in population ‘good health’ (+95% CI) 1.5 1.5 1.0 1.0 0.5 0.5 0.0 0.0 -0.5 -0.5 Urban Town/Fringe Rural Q1 Q2 Q3 Q4 Income deprivation quintiles (Q1=most deprived) Q5
  9. 9. > 50km Change in no. of people with ‘good health’ 20–50km 0% (baseline) 0–1km 1–5km distance from sea 5–20km + 0.5% + 0.6% +1.0% + 1.1% Regression coefficient % Change in population ‘good health’ (+ 95% CI) 1.5 1.5 1.0 0.5 0.0 -0.5 1.0 0.5 Urban Town/Fringe Rural 0.0 -0.5 Q1 Q2 Q3 Q4 Income deprivation quintiles (Q1=most deprived) Q5
  10. 10. 0–1km Distance of dwelling from sea > 50km 20–50km 5–20km 1–5km Coast 1.5 1.0 0.5 0.0 1.5 Health (Regression coefficient – % Change in population with ‘good health’ + 95% CI) Income deprivation quintiles: 1.0 0.5 0.0 -0.5 Q1 most deprived Q2 Q3 Q4 Q5 least deprived
  11. 11. 0–1km Distance of dwelling from sea > 50km 20–50km 5–20km 1–5km Coast Health 1.5 1.5 % Change in population with ‘good health’ + 95% CI 1.0 0.5 0.0 -0.5 1.0 0.5 0.0 -0.5 Q1 Q2 Q3 most deprived Q4 Q5 least deprived Income deprivation quintiles
  12. 12. 0–1km Distance of dwelling from sea > 50km 20–50km 5–20km 1–5km (baseline) Health 1.5 1.5 % Change in population with ‘good health’ + 95% CI 1.0 0.5 0.0 -0.5 1.0 0.5 0.0 -0.5 Coast Q1 Q2 Q3 most deprived Q4 Q5 least deprived Income deprivation quintiles
  13. 13. 0–1km Distance of dwelling from sea > 50 km 20–50 km 5–20km 1–5km (baseline) Health % Change in population with ‘good health’ + 95% CI Coast 1.5 1.5 1.0 0.5 0.0 -0.5 1.0 0.5 0.0 -0.5 All urban areas Q1 most deprived Q2 Q3 Q4 All urban areas by income deprivation quintile Q5 least deprived
  14. 14. ECEHH Information graphics Seeing is Believing - investigating the effects of visual presentation
  15. 15. Working Group II Report impacts, Adaptation and Vulnerability ! Chapter 8 Human Health
  16. 16. FLOODS AND STORMS GLOBAL TRENDS Floods are low-probability, high-impact events that can overwhelm physical infrastructure, human resilience and social organisation. Floods are the most frequent natural weather disaster. This information graphic shows some of the causes and health impacts of floods, and shows how the number and severity of floods may increase in the future. CLIMATE CHANGE URBANISATION The majority of climate scientists agree that human activity is causing temperatures to rise around the world. As these higher temperatures free water that is usually frozen at the poles, sea levels are rising. Increased temeratures also lead to more evaporation of water from seas and lakes. This can lead to increased rainfall and greater numbers of storms, cyclones and extreme weather events. The number of people living in cities is growing, particularly in low income countries. 1900 1950 2005 FLOOD CAUSES = 100m people in towns or cities SEA LEVEL RAINFALL STORMS EVAPORATION Coastal regions are more vulnerable to flooding as sea levels rise. Extreme rainfall can overwhelm rivers and lakes, causing them to flood. Drowning by storm surge is the major killer in coastal storms. Global warming and changes in land use (like urbanisation) affect how much water is carried in the air. VULNERABLE PLACES THE NORTH SEA COAST THE NILE DELTA FLOODS SOUTH ASIA MICRONESIA THE GULF COAST LATIN AMERICA LOCAL TOPOGRAPHY Urbanisation can affect how much excess water can be absorbed into the ground. Sometimes, the shape of the land can make areas vulnerable to flooding. One-quarter of the world’s population resides within 100 km distance and 100 m elevation of the coastline. VULNERABLE PEOPLE Those living in Low lying places (especially those with high density) In the USA, lower-income groups were most affected by Hurricane Katrina in 2005. Poorer communities BAY OF BENGAL (particularly at risk from storm GULF OF GUINEA SEYCHELLES surges) DEATH & INJURY HEALTH IMPACTS SURFACE RUN-OFF Those with limited ability to escape Such as children, the infirm, or those living in sub-standard housing. INFECTIOUS DISEASES Deaths recorded in disaster databases are from drowning and severe injuries. VENEZUELA 1999 30,000 DEAD MOZAMBIQUE 2000/2001 1,813 DEAD CHINA 2003 130m AFFECTED Improved warnings have decreased mortality from floods and storm surges in the last 30 years; however, the impact of weather disasters in terms of social and health effects is still considerable and is unequally distributed, particularly affecting women. TOXIC CONTAMINATION MENTAL HEALTH Particularly in places with poor sanitation: Diarrhoeal diseases Cholera Cryptosporidiosis Typhoid fever From storage or from chemicals already in the environment: Oil Pesticides Heavy metals Hazardous waste Insufficiently investigated, but may include: Post-traumatic stress Behavioural disorders in children Anxiety? Depression? FUTURE CHANGES CASE STUDY 1: BANGLADESH CASE STUDY 2: USA If human activity continues to warm global temperatures, countries like Bangladesh are likely to see more flooding. Studies in industrialised countries indicate that densely populated urban areas are at risk from sea-level rise. ASSUMPTIONS Global temperature rise Global Sea level rise Increase in monsoon rains Increase in monsoon discharge into rivers NEW ORLEANS (USA) 2°c 4°c 30cm 100cm 18% 33% 5% 10% LIKELY EFFECTS People affected 4.8% 57% Flooding depth 30–90cm 90–180cm 1.5–3m below sea level now Mid-range estimate of 48 cm sea level rise by 2100 plus subsidence 2.5–4m below This would mean that sea level by 2100 a storm surge from a Category 3 hurricane (estimated at 3 to 4 m without waves) could be 6 to 7 m above areas that were heavily populated in 2004.
  17. 17. GLOBA FLOODS AND STORMS CLIMATE CHANGE The number of people living in cities is growing, particularly in low income countries. 1900 1950 2005 FLOOD CAUSES = 100m people in towns or cities SEA LEVEL RAINFALL STORMS EVAPORATION Coastal regions are more vulnerable to flooding as sea levels rise. Extreme rainfall can overwhelm rivers and lakes, causing them to flood. Drowning by storm surge is the major killer in coastal storms. Global warming and changes in land use (like urbanisation) affect how much water is carried in the air. VULNERABLE PLACES THE NORTH SEA COAST THE NILE DELTA FLOODS SOUTH ASIA MICRONESIA THE GULF COAST LATIN AMERICA SURFACE RUN-OFF LOCAL TOPOGRAPHY Urbanisation can affect how much excess water can be absorbed into the ground. Sometimes, the shape of the land can make areas vulnerable to flooding. One-quarter of the world’s population resides within 100 km distance and 100 m elevation of the coastline. VULNERABLE PEOPLE Those living in Low lying places (especially those with high density) Those with limited ability to escape RAINFALL STORMS EVAPORATION Coastal regions are more vulnerable to flooding as sea levels rise. Extreme rainfall can overwhelm rivers and lakes, causing them to flood. Drowning by storm surge is the major killer in coastal storms. Global warming and changes in land use (like urbanisation) affect how much water is carried in the air. VULNERABLE PLACES In the USA, lower-income groups were most affected by Hurricane Katrina in 2005. Poorer communities BAY OF BENGAL (particularly at risk from storm GULF OF GUINEA SEYCHELLES surges) SEA LEVEL THE NORTH SEA COAST Such as children, the infirm, or those living in sub-standard housing. THE NILE DELTA FLOODS SOUTH ASIA INFECTIOUS DISEASES Deaths recorded in disaster databases are from drowning and severe injuries. VENEZUELA 1999 30,000 DEAD MOZAMBIQUE 2000/2001 1,813 DEAD CHINA 2003 130m AFFECTED Improved warnings have decreased mortality from floods and storm surges in the last 30 years; however, the impact of weather disasters in terms of social and health effects is still considerable and is unequally distributed, particularly affecting women. TOXIC CONTAMINATION MENTAL HEALTH Particularly in places with poor sanitation: Diarrhoeal diseases Cholera Cryptosporidiosis Typhoid fever From storage or from chemicals already in the environment: Oil Pesticides Heavy metals Hazardous waste Insufficiently investigated, but may include: Post-traumatic stress Behavioural disorders in children Anxiety? Depression? CASE STUDY 1: BANGLADESH LATIN AMERICA VULNERABLE PEOPLE Those living in Low lying places (especially those with high density) Poorer communities BAY OF BENGAL (particularly at risk from storm GULF OF GUINEA SEYCHELLES surges) Those with limited ability to escape SURFACE RUN-OFF Urbanisation can affect how much excess water can be absorbed into the ground. One-qu world’s resides distanc elevatio coastlin In the U groups affected Katrina Such as infirm, o in sub-s CASE STUDY 2: USA If human activity continues to warm global temperatures, countries like Bangladesh are likely to see more flooding. MICRONESIA THE GULF COAST Studies in industrialised countries indicate that densely populated urban areas are at risk from sea-level rise. ASSUMPTIONS Global temperature rise Global Sea level rise Increase in monsoon rains Increase in monsoon discharge into rivers NEW ORLEANS (USA) 2°c 4°c 30cm 100cm 18% 33% 5% 10% LIKELY EFFECTS People affected 4.8% 57% Flooding depth 30–90cm 90–180cm 1.5–3m below sea level now Mid-range estimate of 48 cm sea level rise by 2100 plus subsidence 2.5–4m below This would mean that sea level by 2100 a storm surge from a Category 3 hurricane (estimated at 3 to 4 m without waves) could be 6 to 7 m above areas that were heavily populated in 2004. DEATH & INJURY H IMPACTS HEALTH IMPACTS DEATH & INJURY FUTURE CHANGES 1900 1950 2005 URBANISATION The majority of climate scientists agree that human activity is causing temperatures to rise around the world. As these higher temperatures free water that is usually frozen at the poles, sea levels are rising. Increased temeratures also lead to more evaporation of water from seas and lakes. This can lead to increased rainfall and greater numbers of storms, cyclones and extreme weather events. FLOOD CAUSES GLOBAL TRENDS Floods are low-probability, high-impact events that can overwhelm physical infrastructure, human resilience and social organisation. Floods are the most frequent natural weather disaster. This information graphic shows some of the causes and health impacts of floods, and shows how the number and severity of floods may increase in the future. This can lead to increased rainfall and greater numbers of storms, cyclones and extreme weather events. Deaths recorded in disaster databases are from drowning and severe injuries. VENEZUELA 1999 30,000 DEAD MOZAMBIQUE 2000/2001 1,813 DEAD CHINA 2003 130m AFFECTED INFECTIOUS DISEASES TOXIC CONTAMINATION Particularly in places with poor sanitation: Diarrhoeal diseases From storage or from chemicals already in the environment: Oil
  18. 18. FLOODS AND STORMS AIR QUALITY AND DISEASE Weather at all time scales determines the development, transport, dispersion and deposition of air pollutants, with the passage of fronts, cyclonic and anticyclonic systems and their associated air masses being of particular importance. This information graphic shows some of the causes and health impacts of air pollution, and shows how both the amount of air pollution, and our exposure to it, may increase in the future. Floods are low-probability, high-impact events that can overwhelm physical infrastructure, human resilience and social organisation. Floods are the most frequent natural weather disaster. This information graphic shows some of the causes and health impacts of floods, and shows how the number and severity of floods may increase in the future. CLIMATE CHANGE CLIMATE CHANGE URBANISATION The majority of climate scientists agree that human activity is causing temperatures to rise around the world. As these higher temperatures free water that is usually frozen at the poles, sea levels are rising. Increased temeratures also lead to more evaporation of water from seas and lakes. This can lead to increased rainfall and greater numbers of storms, cyclones and extreme weather events. The number of people living in cities is growing, particularly in low income countries. The majority of climate scientists agree that human activity is causing temperatures to rise around the world. These higher temperatures can affect weather systems, causing extremely high or extremely low winds. Rising temperatures also affect the amount of water in the atmosphere. 1900 1950 2005 POLLUTION SOURCES GLOBAL TRENDS Investigating the use of information graphics to explain the effects of climate change on health, compared to textual presentation. FLOODS AND STORMS There is increasing evidence of the importance of mental disorders as an impact of disasters. Prolonged impairment resulting from common mental disorders (anxiety and depression) may be considerable. Studies in both low- and high-income countries indicate that the mental-health aspect of flood-related impacts has been insufficiently investigated. A systematic review of post-traumatic stress disorder in high income countries found a small but significant effect following disasters. There is also evidence of medium- to long-term impacts on behavioural disorders in young children. Vulnerability to weather disasters depends on the attributes of the person at risk (including where they live, age, income, education and disability) and on broader social and environmental factors (level of disaster preparedness, health sector responses and environmental degradation). Poorer communities, particularly slum dwellers, are more likely to live in flood-prone areas. In the USA, lower-income groups were most affected by Hurricane Katrina, and low-income schools had twice the risk of being flooded compared with the reference group. High-density populations in low-lying coastal regions experience a high health burden from weather disasters, such as settlements along the North Sea coast in north-west Europe, the Seychelles, parts of Micronesia, the Gulf Coast of the USA and Mexico, the Nile Delta, the Gulf of Guinea, and the Bay of Bengal. Environmentally degraded areas are particularly vulnerable to tropical cyclones and coastal flooding under current climate conditions. Future vulnerability to climate change EVAPORATION Drowning by storm surge is the major killer in coastal storms. Global warming and changes in land use (like urbanisation) affect how much water is carried in the air. THE NILE DELTA FLOODS SOUTH ASIA MICRONESIA THE GULF COAST LATIN AMERICA HEALTH IMPACTS SURFACE RUN-OFF LOCAL TOPOGRAPHY Urbanisation can affect how much excess water can be absorbed into the ground. Sometimes, the shape of the land can make areas vulnerable to flooding. Those living in Low lying places (especially those with high density) In the USA, lower-income groups were most affected by Hurricane Katrina in 2005. BAY OF BENGAL (particularly at risk from storm GULF OF GUINEA SEYCHELLES surges) Those with limited ability to escape Such as children, the infirm, or those living in sub-standard housing. INFECTIOUS DISEASES Deaths recorded in disaster databases are from drowning and severe injuries. VENEZUELA 1999 30,000 DEAD MOZAMBIQUE 2000/2001 1,813 DEAD CHINA 2003 130m AFFECTED Improved warnings have decreased mortality from floods and storm surges in the last 30 years; however, the impact of weather disasters in terms of social and health effects is still considerable and is unequally distributed, particularly affecting women. TOXIC CONTAMINATION From storage or from chemicals already in the environment: Oil FOREST FIRES As well as producing greenhouse gasses such as carbon dioxide, that lead to global warming, the burning of fossil fuels for energy releases small particles into the air, called particulate matter (PM). The amount of air pollution breathed in by people depends on: — Wind / circulation of air — Topography — Housing characteristics — Activity patterns In urban areas, transport vehicles are the key sources of nitrogen oxides and volatile organic compounds (VOCs) that lead to ground-level ozone. Burning fossil fuels for transport also releases other gasses and particles. Naturally-occuring forest fires mean that toxic gaseous and particulate air pollutants are released into the atmosphere. ALLERGIC RHINITIS Hazardous waste The number of forest fires is affected by: — Raised temperatures — Atmospheric moisture PARTICULATE MATTER (PM) OTHER TOXIC GASSES Many different kinds of combustion, both artificial and natural, can cause particles of solid matter can become suspended in the air. PM is known to affect morbidity and mortality. Ozone is a secondary pollutant formed through photochemical reactions involving nitrogen oxides and volatile organic compounds (VOCs) in the presence of bright sunshine with high temperatures. As well as ozone, other toxic gasses such as carbon monoxide can have effects on human health. PNEUMONIA Insufficiently investigated, but may include: Post-traumatic stress Behavioural disorders in children Anxiety? Pesticides Heavy metals PM generation is affected by: — Raised temperatures — Atmospheric moisture OZONE Severe allergies can limit quality of life. MENTAL HEALTH Particularly in places with poor sanitation: Diarrhoeal diseases Cholera Cryptosporidiosis Typhoid fever URBAN TRANSPORT Ozone generation is affected by: — Bright sunlight — Raised temperatures — Low winds — Atmospheric moisture One-quarter of the world’s population resides within 100 km distance and 100 m elevation of the coastline. VULNERABLE PEOPLE Poorer communities DEATH & INJURY COPD ASTHMA Particularly affects children. Chronic obstructive pulmonary disease. Can affect quality of life, and is increasingly common, particularly in children. OTHER DISEASE Other Cardiovascular and respiratory diseases are also caused by air pollution. BURNS & SMOKE INHALATION forest fires can have direct effects on health. MORTALITY AND MORBIDITY Depression? OZONE MODELS FUTURE CHANGES CASE STUDY 1: BANGLADESH CASE STUDY 2: USA If human activity continues to warm global temperatures, countries like Bangladesh are likely to see more flooding. Studies in industrialised countries indicate that densely populated urban areas are at risk from sea-level rise. ASSUMPTIONS Global temperature rise Global Sea level rise Increase in monsoon rains Increase in monsoon discharge into rivers NEW ORLEANS (USA) 2°c 4°c 30cm 100cm 18% 33% 5% 10% LIKELY EFFECTS People affected 4.8% 57% Flooding depth 30–90cm 90–180cm 1.5–3m below sea level now Mid-range estimate of 48 cm sea level rise by 2100 plus subsidence 2.5–4m below This would mean that sea level by 2100 a storm surge from a Category 3 hurricane (estimated at 3 to 4 m without waves) could be 6 to 7 m above areas that were heavily populated in 2004. PM MODELS Future emissions are, of course, uncertain, and depend on assumptions of population growth, economic development, regulatory actions and energy use. Changes in concentrations of ground-level ozone driven by scenarios of future emissions and/or weather patterns have been projected for Europe and North America: FUTURE CHANGES The risk of infectious disease following flooding in high income countries is generally low, although increases in respiratory and diarrhoeal diseases have been reported after floods. An important exception was the impact of Hurricanes Katrina and Rita in the USA in 2005, where contamination of water supplies with faecal bacteria led to many cases of diarrhoeal illness and some deaths. Flooding may lead to contamination of waters with dangerous chemicals, heavy metals or other hazardous substances, from storage or from chemicals already in the environment (e.g., pesticides). Chemical contamination following Hurricane Katrina in the USA included oil spills from refineries and storage tanks, pesticides, metals and hazardous waste. Concentrations of most contaminants were within acceptable short-term levels, except for lead and volatile organic compounds (VOCs) in some areas. There are also health risks associated with long-term contamination of soil and sediment; however, there is little published evidence demonstrating a causal effect of chemical contamination on the pattern of morbidity and mortality following flooding events. Increases in population density and accelerating industrial development in areas subject to natural disasters increase the probability of future disasters and the potential for mass human exposure to hazardous materials released during disasters. STORMS Extreme rainfall can overwhelm rivers and lakes, causing them to flood. THE NORTH SEA COAST Major storm and flood disasters have occurred in the last two decades. In 2003, 130 million people were affected by floods in China. In 1999, 30,000 died from storms followed by floods and landslides in Venezuela. In 2000/2001, 1,813 died in floods in Mozambique. Improved structural and non-structural measures, particularly improved warnings, have decreased mortality from floods and storm surges in the last 30 years; however, the impact of weather disasters in terms of social and health effects is still considerable and is unequally distributed, particularly affecting women. Flood health impacts range from deaths, injuries, infectious diseases and toxic contamination, to mental health problems. Populations with poor sanitation infrastructure and high burdens of infectious disease often experience increased rates of diarrhoeal diseases after flood events. Increases in cholera, cryptosporidiosis and typhoid fever have been reported in low- and middle-income countries. Flood related increases in diarrhoeal disease have also been reported in India, Brazil and Bangladesh. The floods in Mozambique in 2001 were estimated to have caused over 8,000 additional cases and 447 deaths from diarrhoeal disease in the following months. RAINFALL Coastal regions are more vulnerable to flooding as sea levels rise. VULNERABLE PLACES Floods are low-probability, high-impact events that can overwhelm physical infrastructure, human resilience and social organisation. Floods are the most frequent natural weather disaster. Floods result from the interaction of rainfall, surface runoff, evaporation, wind, sea level and local topography. In inland areas, flood regimes vary substantially depending on catchment size, topography and climate. Water management practices, urbanisation, intensified land use and forestry can substantially alter the risks of floods. Windstorms are often associated with floods. In terms of deaths and populations affected, floods and tropical cyclones have the greatest impact in South Asia and Latin America. Deaths recorded in disaster databases are from drowning and severe injuries. Deaths from unsafe or unhealthy conditions following the extreme event are also a health consequence, but such information is rarely included in disaster statistics. Drowning by storm surge is the major killer in coastal storms where there are large numbers of deaths. An assessment of surges in the past 100 years found that major events were confined to a limited number of regions, with many events occurring in the Bay of Bengal, particularly Bangladesh. SEA LEVEL ENERGY PRODUCTION AIR POLLUTION (AP) FLOOD CAUSES = 100m people in towns or cities These changes may affect air pollution in two main ways. First, it may mean that the atmospheric conditions are right for more air pollution to form. Secondly, it may change the patterns of air flow, meaning that more people are exposed to this pollution. Evidence for the health impacts of particulate matter is stronger than that for ozone. However, there are few models of the impact of climate change on pollutants other than ozone. These tend to emphasise the role of local abatement strategies in determining the future levels of, primarily, particulate matter, and tend to project the probability of air-quality standards being exceeded instead of absolute concentrations; the results vary by region. REFERENCE AREA assumed changes by 2050s TEMP. INCREASE EMISSIONS EFFECTS Knowlton New York et al., 2004 area, USA 1.6 – 3.2°C medium increase 4.5% more deaths Bell et al., 2007 1.6 – 3.2°C medium increase 0.6% more deaths 0.9 – 2.4°C no increase ozone + other AP - 50 cities, East USA Anderson England et al., 2001 & Wales (all models assume population constant at year 2000 level) There are no projections for cities in low- or middleincome countries, despite the heavier pollution burdens in these populations. Because transboundary transport of pollutants plays a significant role in determining local to regional air quality, changing patterns of atmospheric circulation at the hemispheric to global level are likely to be just as important as regional patterns for future local air quality.
  19. 19. Approval View Time 8 mins 6 5 4 3 mins KEY 3 157 157 129 129 160 160 149 177 MEAN & 95% CI SIG. (P < 0.05) N.S. (P > 0.05) TEXT A GRAPHIC A RISK GROUP A: STORMS & FLOODS 179 179 142 142 166 166 163 185 TEXT B GRAPHIC B RISK GROUP B: AIR QUALITY
  20. 20. View Time View Time (log10) 8 mins 6 mins* 3 3 mins mins KEY 157 157 129 129 160 160 149 177 MEAN & 95% CI SIG. (P < 0.05) N.S. (P > 0.05) TEXT A GRAPHIC A RISK GROUP A: STORMS & FLOODS 179 179 142 142 166 166 163 185 TEXT B GRAPHIC B RISK GROUP B: AIR QUALITY
  21. 21. Knowledge Memory 100% 80% 60% 0% KEY MEAN & 95% CI SIG. (P < 0.05) N.S. (P > 0.05) 159 157 130 129 CONTROL A CONTROL A TEXT A TEXT A 164 160 GRAPHIC A GRAPHIC A RISK GROUP A: RISK GROUP A: STORMS & FLOODS STORMS & FLOODS 179 179 142 142 CONTROL B TEXT B CONTROL B TEXT B 166 166 RISK GROUP B: RISK QUALITY AIR GROUP B: AIR QUALITY GRAPHIC B GRAPHIC B
  22. 22. Risk perception (severity) 7 28 1 14 KEY MEAN & 95% CI SIG. (P < 0.05) N.S. (P > 0.05) 158 157 129 129 CONTROL A CONTROL A TEXT A TEXT A 160 160 GRAPHIC A GRAPHIC A RISK GROUP A: RISK GROUP A: STORMS & FLOODS STORMS & FLOODS 176 179 142 142 CONTROL B TEXT B CONTROL B TEXT B 161 166 RISK GROUP B: RISK QUALITY AIR GROUP B: AIR QUALITY GRAPHIC B GRAPHIC B
  23. 23. 50% Age group: control text graphic 68-77 58-67 48-57 38-47 28-37 18-27 68-77 58-67 48-57 38-47 28-37 18-27 68-77 58-67 48-57 38-47 28-37 18-27 Mean knowledge Error Bars: 95% CI 80% 70% 60%
  24. 24. Conclusions ! - This type of box / arrow diagram can be used to communicate information on climate change health impacts in less time and more effectively than using text, for this audience. ! - The technique might be used to effectively present other non-linear narratives. ! - The study suggests that understanding the mechanisms for climate change health impacts, even in the short term, could increase risk awareness.
  25. 25. Limitations ! - Questions asked only test limited knowledge. - Captive audience - doesn’t show attracting attention.
  26. 26. FLOODS AND STORMS AIR QUALITY AND DISEASE Weather at all time scales determines the development, transport, dispersion and deposition of air pollutants, with the passage of fronts, cyclonic and anticyclonic systems and their associated air masses being of particular importance. This information graphic shows some of the causes and health impacts of air pollution, and shows how both the amount of air pollution, and our exposure to it, may increase in the future. Floods are low-probability, high-impact events that can overwhelm physical infrastructure, human resilience and social organisation. Floods are the most frequent natural weather disaster. This information graphic shows some of the causes and health impacts of floods, and shows how the number and severity of floods may increase in the future. CLIMATE CHANGE CLIMATE CHANGE URBANISATION The majority of climate scientists agree that human activity is causing temperatures to rise around the world. As these higher temperatures free water that is usually frozen at the poles, sea levels are rising. Increased temeratures also lead to more evaporation of water from seas and lakes. This can lead to increased rainfall and greater numbers of storms, cyclones and extreme weather events. The number of people living in cities is growing, particularly in low income countries. The majority of climate scientists agree that human activity is causing temperatures to rise around the world. These higher temperatures can affect weather systems, causing extremely high or extremely low winds. Rising temperatures also affect the amount of water in the atmosphere. 1900 1950 2005 POLLUTION SOURCES GLOBAL TRENDS Investigating the use of information graphics to explain the effects of climate change on health, compared to textual presentation. FLOODS AND STORMS There is increasing evidence of the importance of mental disorders as an impact of disasters. Prolonged impairment resulting from common mental disorders (anxiety and depression) may be considerable. Studies in both low- and high-income countries indicate that the mental-health aspect of flood-related impacts has been insufficiently investigated. A systematic review of post-traumatic stress disorder in high income countries found a small but significant effect following disasters. There is also evidence of medium- to long-term impacts on behavioural disorders in young children. Vulnerability to weather disasters depends on the attributes of the person at risk (including where they live, age, income, education and disability) and on broader social and environmental factors (level of disaster preparedness, health sector responses and environmental degradation). Poorer communities, particularly slum dwellers, are more likely to live in flood-prone areas. In the USA, lower-income groups were most affected by Hurricane Katrina, and low-income schools had twice the risk of being flooded compared with the reference group. High-density populations in low-lying coastal regions experience a high health burden from weather disasters, such as settlements along the North Sea coast in north-west Europe, the Seychelles, parts of Micronesia, the Gulf Coast of the USA and Mexico, the Nile Delta, the Gulf of Guinea, and the Bay of Bengal. Environmentally degraded areas are particularly vulnerable to tropical cyclones and coastal flooding under current climate conditions. Future vulnerability to climate change EVAPORATION Drowning by storm surge is the major killer in coastal storms. Global warming and changes in land use (like urbanisation) affect how much water is carried in the air. THE NILE DELTA FLOODS SOUTH ASIA MICRONESIA THE GULF COAST LATIN AMERICA HEALTH IMPACTS SURFACE RUN-OFF LOCAL TOPOGRAPHY Urbanisation can affect how much excess water can be absorbed into the ground. Sometimes, the shape of the land can make areas vulnerable to flooding. Those living in Low lying places (especially those with high density) In the USA, lower-income groups were most affected by Hurricane Katrina in 2005. BAY OF BENGAL (particularly at risk from storm GULF OF GUINEA SEYCHELLES surges) Those with limited ability to escape Such as children, the infirm, or those living in sub-standard housing. INFECTIOUS DISEASES Deaths recorded in disaster databases are from drowning and severe injuries. VENEZUELA 1999 30,000 DEAD MOZAMBIQUE 2000/2001 1,813 DEAD CHINA 2003 130m AFFECTED Improved warnings have decreased mortality from floods and storm surges in the last 30 years; however, the impact of weather disasters in terms of social and health effects is still considerable and is unequally distributed, particularly affecting women. TOXIC CONTAMINATION From storage or from chemicals already in the environment: Oil FOREST FIRES As well as producing greenhouse gasses such as carbon dioxide, that lead to global warming, the burning of fossil fuels for energy releases small particles into the air, called particulate matter (PM). The amount of air pollution breathed in by people depends on: — Wind / circulation of air — Topography — Housing characteristics — Activity patterns In urban areas, transport vehicles are the key sources of nitrogen oxides and volatile organic compounds (VOCs) that lead to ground-level ozone. Burning fossil fuels for transport also releases other gasses and particles. Naturally-occuring forest fires mean that toxic gaseous and particulate air pollutants are released into the atmosphere. ALLERGIC RHINITIS Hazardous waste The number of forest fires is affected by: — Raised temperatures — Atmospheric moisture PARTICULATE MATTER (PM) OTHER TOXIC GASSES Many different kinds of combustion, both artificial and natural, can cause particles of solid matter can become suspended in the air. PM is known to affect morbidity and mortality. Ozone is a secondary pollutant formed through photochemical reactions involving nitrogen oxides and volatile organic compounds (VOCs) in the presence of bright sunshine with high temperatures. As well as ozone, other toxic gasses such as carbon monoxide can have effects on human health. PNEUMONIA Insufficiently investigated, but may include: Post-traumatic stress Behavioural disorders in children Anxiety? Pesticides Heavy metals PM generation is affected by: — Raised temperatures — Atmospheric moisture OZONE Severe allergies can limit quality of life. MENTAL HEALTH Particularly in places with poor sanitation: Diarrhoeal diseases Cholera Cryptosporidiosis Typhoid fever URBAN TRANSPORT Ozone generation is affected by: — Bright sunlight — Raised temperatures — Low winds — Atmospheric moisture One-quarter of the world’s population resides within 100 km distance and 100 m elevation of the coastline. VULNERABLE PEOPLE Poorer communities DEATH & INJURY COPD ASTHMA Particularly affects children. Chronic obstructive pulmonary disease. Can affect quality of life, and is increasingly common, particularly in children. OTHER DISEASE Other Cardiovascular and respiratory diseases are also caused by air pollution. BURNS & SMOKE INHALATION forest fires can have direct effects on health. MORTALITY AND MORBIDITY Depression? OZONE MODELS FUTURE CHANGES CASE STUDY 1: BANGLADESH CASE STUDY 2: USA If human activity continues to warm global temperatures, countries like Bangladesh are likely to see more flooding. Studies in industrialised countries indicate that densely populated urban areas are at risk from sea-level rise. ASSUMPTIONS Global temperature rise Global Sea level rise Increase in monsoon rains Increase in monsoon discharge into rivers NEW ORLEANS (USA) 2°c 4°c 30cm 100cm 18% 33% 5% 10% LIKELY EFFECTS People affected 4.8% 57% Flooding depth 30–90cm 90–180cm 1.5–3m below sea level now Mid-range estimate of 48 cm sea level rise by 2100 plus subsidence 2.5–4m below This would mean that sea level by 2100 a storm surge from a Category 3 hurricane (estimated at 3 to 4 m without waves) could be 6 to 7 m above areas that were heavily populated in 2004. PM MODELS Future emissions are, of course, uncertain, and depend on assumptions of population growth, economic development, regulatory actions and energy use. Changes in concentrations of ground-level ozone driven by scenarios of future emissions and/or weather patterns have been projected for Europe and North America: FUTURE CHANGES The risk of infectious disease following flooding in high income countries is generally low, although increases in respiratory and diarrhoeal diseases have been reported after floods. An important exception was the impact of Hurricanes Katrina and Rita in the USA in 2005, where contamination of water supplies with faecal bacteria led to many cases of diarrhoeal illness and some deaths. Flooding may lead to contamination of waters with dangerous chemicals, heavy metals or other hazardous substances, from storage or from chemicals already in the environment (e.g., pesticides). Chemical contamination following Hurricane Katrina in the USA included oil spills from refineries and storage tanks, pesticides, metals and hazardous waste. Concentrations of most contaminants were within acceptable short-term levels, except for lead and volatile organic compounds (VOCs) in some areas. There are also health risks associated with long-term contamination of soil and sediment; however, there is little published evidence demonstrating a causal effect of chemical contamination on the pattern of morbidity and mortality following flooding events. Increases in population density and accelerating industrial development in areas subject to natural disasters increase the probability of future disasters and the potential for mass human exposure to hazardous materials released during disasters. STORMS Extreme rainfall can overwhelm rivers and lakes, causing them to flood. THE NORTH SEA COAST Major storm and flood disasters have occurred in the last two decades. In 2003, 130 million people were affected by floods in China. In 1999, 30,000 died from storms followed by floods and landslides in Venezuela. In 2000/2001, 1,813 died in floods in Mozambique. Improved structural and non-structural measures, particularly improved warnings, have decreased mortality from floods and storm surges in the last 30 years; however, the impact of weather disasters in terms of social and health effects is still considerable and is unequally distributed, particularly affecting women. Flood health impacts range from deaths, injuries, infectious diseases and toxic contamination, to mental health problems. Populations with poor sanitation infrastructure and high burdens of infectious disease often experience increased rates of diarrhoeal diseases after flood events. Increases in cholera, cryptosporidiosis and typhoid fever have been reported in low- and middle-income countries. Flood related increases in diarrhoeal disease have also been reported in India, Brazil and Bangladesh. The floods in Mozambique in 2001 were estimated to have caused over 8,000 additional cases and 447 deaths from diarrhoeal disease in the following months. RAINFALL Coastal regions are more vulnerable to flooding as sea levels rise. VULNERABLE PLACES Floods are low-probability, high-impact events that can overwhelm physical infrastructure, human resilience and social organisation. Floods are the most frequent natural weather disaster. Floods result from the interaction of rainfall, surface runoff, evaporation, wind, sea level and local topography. In inland areas, flood regimes vary substantially depending on catchment size, topography and climate. Water management practices, urbanisation, intensified land use and forestry can substantially alter the risks of floods. Windstorms are often associated with floods. In terms of deaths and populations affected, floods and tropical cyclones have the greatest impact in South Asia and Latin America. Deaths recorded in disaster databases are from drowning and severe injuries. Deaths from unsafe or unhealthy conditions following the extreme event are also a health consequence, but such information is rarely included in disaster statistics. Drowning by storm surge is the major killer in coastal storms where there are large numbers of deaths. An assessment of surges in the past 100 years found that major events were confined to a limited number of regions, with many events occurring in the Bay of Bengal, particularly Bangladesh. SEA LEVEL ENERGY PRODUCTION AIR POLLUTION (AP) FLOOD CAUSES = 100m people in towns or cities These changes may affect air pollution in two main ways. First, it may mean that the atmospheric conditions are right for more air pollution to form. Secondly, it may change the patterns of air flow, meaning that more people are exposed to this pollution. Evidence for the health impacts of particulate matter is stronger than that for ozone. However, there are few models of the impact of climate change on pollutants other than ozone. These tend to emphasise the role of local abatement strategies in determining the future levels of, primarily, particulate matter, and tend to project the probability of air-quality standards being exceeded instead of absolute concentrations; the results vary by region. REFERENCE AREA assumed changes by 2050s TEMP. INCREASE EMISSIONS EFFECTS Knowlton New York et al., 2004 area, USA 1.6 – 3.2°C medium increase 4.5% more deaths Bell et al., 2007 1.6 – 3.2°C medium increase 0.6% more deaths 0.9 – 2.4°C no increase ozone + other AP - 50 cities, East USA Anderson England et al., 2001 & Wales (all models assume population constant at year 2000 level) There are no projections for cities in low- or middleincome countries, despite the heavier pollution burdens in these populations. Because transboundary transport of pollutants plays a significant role in determining local to regional air quality, changing patterns of atmospheric circulation at the hemispheric to global level are likely to be just as important as regional patterns for future local air quality.
  27. 27. ECEHH - European Centre for Environment and Human Health Information graphics - visual presentation of E&HH data and information Seeing is Believing - investigating the effects of visual presentation
  28. 28. ! w.stahl-timmins@exeter.ac.uk ! www.ecehh.org ! blog.willstahl.com ! Twitter: @will_s_t EUROPEAN UNION Investing in Your Future European Regional Development Fund 2007-13 EUROPEAN UNION Investing in Your Future European Regional Development Fund 2007-13

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