This document provides an overview of climate change and its effects on healthcare. It defines climate change and outlines key events in the history of climate change study. It then discusses several pressing climate change issues like air pollution and rising temperatures that negatively impact health. The document also examines how climate change leads to deaths directly through extreme weather and indirectly by worsening air quality, heat exposure, and undernutrition. Finally, it discusses strategies for healthcare facilities and professionals to adapt to and mitigate the health effects of climate change through education, facility design, and combating misinformation.

1. Climate Change
&
Its Effects on Healthcare:
An Evidenced-based Overview
Kimberley R. Barker, MLIS
Librarian for Digital Life

2. Note:
This presentation (as with all other presentations created by Claude Moore Health
Sciences librarians), is based on scientific fact. While I acknowledge that the concept of
climate change and its effects on both the environment and people is debated, peer-
reviewed work from credible sources overwhelmingly recognizes climate change, the role
of humans in that change, and its effects on healthcare, as fact.

4. Learning
Objectives
Learn to define
climate change
Learn about the
most pressing
issues
Learn about the
impact of
climate change
on health
Learn about the
strategies for
managing climate
change
Learn about
climate change
indicators
Learn about
important events in
the history of climate
change study

5. What is climate change?
• “Climate change is a long-term change in the average weather patterns that
have come to define Earth’s local, regional and global climates.”- NASA
• “Climate change refers to significant changes in global temperature,
precipitation, wind patterns and other measures of climate that occur over
several decades or longer.”- UC-DAVIS

6. Climate
Attribution
Science
• a scientific process for establishing the principal causes or
physical explanation for observed climate conditions and
phenomena.
• attribution requirements for a detected change are:
• a demonstrated consistency with a combination of
anthropogenic (aka “intentional, non-malicious
behavior by humans that nonetheless harms the
environment”) and natural external forcings
• an inconsistency with "alternative, physically
plausible explanations of recent climate change
that exclude important elements of the given
combination of forcings."

7. A Brief History of Climate Change Events, 1
• Severe droughts precipitated the exodus of early humans from Africa
• Climate observations date back to ancient Greece and Rome
• Aristotle, Hippocrates, and Plato spoke about droughts and subsequent famine due
to extreme weather events
• Scientists theorize that abrupt climate change contributed to the fall of the Maya
civilization

8. A Brief History of Climate Change Events, 2
• The 1800s- beginnings of the Second Industrial Revolution
• 1816- The Year Without a Summer
• Famine: particulates from the explosion of Krakatoa blocked sunlight
• Disease: Drought, then flooding, caused mutation in cholera bacteria in the Bay of Bengal;
spread from Asia because none were resistant to the new strain
• 1824- Joseph Fourier
• Discovered the process whereby gases in the atmosphere trap the sun’s heat and coined
the term “greenhouse gases”
• 1860s- John Tyndall
• Measured the capacity of water vapor and CO2 to trap infrared light
• 1896- Nobel Prize winner Svante Arrhenius was the first to calculate human-driven contributions
(through coal-burning) to the “greenhouse effect”, a term that he coined

9. A Brief History of Climate Change Events, 3
• 1957- Roger Revelle (Scripps Institution of Oceanography) and Hans Suess (U.S. Geological
Survey) discovered the chemical pathways of ocean CO2 uptake. Findings showed they had
limited ability to absorb the CO2 released through burning fossil fuels. Refinement of their
calculations hasn’t changed the basic conclusion.
• 1965 President Johnson said publicly,"[t]his generation has altered the composition of the
atmosphere on a global scale through ... a steady increase in carbon dioxide from the burning
of fossil fuels."
• In 1969 Senator Daniel Patrick Moynihan was warning of a dangerous sea-level rise of 10 feet or
more. "Goodbye New York" he said. "Goodbye Washington.”
• “Over a ten-year horizon, extreme weather and climate-change policy failures are seen as the
gravest threats.”
• from The Global Risks Report (World Economic Forum) 2019

10. Climate
Change
Indicators
• Glacier and sea ice melt
• Increases sea level
• Sea level
• Causes change in precipitation
• Affects the amount of groundwater and surface water
• Causes flooding- threatens coastal communities and
infrastructure
• Determines which plants and animals can live in an
area
• Global temperature
• Surface temperatures have risen at a rate of 0.15 every
decade since 1901
• Rising sea temperatures
• Oceans absorb more than 90% of heat trapped in
atmosphere
• Affects marine ecosystems, breeding, and migration of
marine species.
• Can lead to higher precipitation, tropical cyclones, and
drought

11. How do we
know that
climate
change
negatively
impacts
health?
Research!

12. The Cost of
Climate
Change
• Human
• WHO estimates an 250,000 additional
deaths between 2030-2050 because of
complications caused by climate change.
• Currently, 150,000 deaths annually are
caused by climate change.
• Financial
• By the year 2030 (according to the World
Health Organization) the cost of direct
damage to health is estimated to be
between $2-4 billion/year

13. How Climate Change Leads to Deaths
- Directly
• Extreme heat
• Air pollution
• Flooding
• Storms

14. How Climate Change Leads to Deaths
•Indirectly
•Undernutrition
• Increasing evidence suggests that “rising carbon
dioxide concentrations adversely affect the
nutritional quality of major cereal crops, including
lowering the levels of protein, a range of
micronutrients, and B vitamins” and reduces the
yields of vegetables and legumes, leading to increase
of noncommunicable diseases

15. How Climate Change Leads to Deaths
•Indirectly
• Poverty
• Increased heat exposure leads to less labor
productivity and crop failures
• Without investment in climate-resilient
development, 100 million people may be forced
into extreme poverty (with its attendant health
concerns) by 2030

16. Pressing
Climate
Change
Issues
• Air quality/pollution
• Heat/warming

17. Air Pollution

18. The EPA tracks
air pollutants
in two ways:
• Air concentration
• measuring pollutants in
the ambient air at stations
across the U.S.
• Emissions of air pollutants
• engineering estimates of
the total tons of pollutants
released into the air each
year.

19. Air Pollution:
Six Major
Pollutants
PARTICLE
POLLUTION
GROUND-LEVEL
OZONE
CARBON
MONOXIDE
SULFUR OXIDES NITROGEN
OXIDES
LEAD
Regulation (setting permissible levels) of the six is based on human health and environmental criteria.

20. Air Pollution:
Findings
from
Carnegie
Mellon
University
• “Recent Increases in Air Pollution: Evidence and
Implications for Mortality”
• Between 2009-2016, average fine particulate
matter decreased by 24.2%
• Between 2016 and 2018, average fine
particulate matter increased by 5.5%
• Causes:
• increases in economic activity
• increases in wildfires
• decreases in Clean Air Act enforcement
actions
• Costs of the increase
• 9,700 additional premature deaths in
2018
• damages of $89 billion

21. Air Pollution: Health Impacts
• Respiratory illness and damage
• Fecundity (DNA fragmentation in
sperm; motility)
• Inflammation
• Cardiovascular disease
• Impaired lung function
• Allergies and asthma
• Altered thyroid function
• Malnutrition due to poor crop yield/ food
insecurity
• Cancer
• Heart disease
• Stroke

22. Heat/Warming Temperatures

23. “Temperature data showing rapid warming in the past few decades,
the latest data going up to 2019. According to NASA data, 2016 was the
warmest year since 1880, continuing a long-term trend of rising global
temperatures. The 10 warmest years in the 140-year record all have
occurred since 2005, with the six warmest years being the six most
recent years. Credit: NASA/NOAA.” https://climate.nasa.gov/scientific-
consensus/

24. August 2018 was the 406th straight
month during which global mean
temperatures were above the long-
term mean.

25. Extreme
weather
events
associated
with
heat/warming
• Tornadoes*
• Hurricanes*
• Droughts*
• Heatwaves*
• Heavy rainstorms à flooding*
• Wildfires* à Contribute to climate change
through the release of massive amounts
of carbon dioxide
*event can cause loss of life, property,
livelihood

26. From NASA
• “The planet's average surface temperature has risen
about 2.05 degrees Fahrenheit (1.14 degrees Celsius)
since the late 19th century, a change driven largely by
increased carbon dioxide and other human-made
emissions into the atmosphere.4 Most of the
warming occurred in the past 40 years, with the six
warmest years on record taking place since 2014. Not
only was 2016 the warmest year on record, but eight
months out of that year — from January through
September, with the exception of June — were the
warmest on record for those respective months. 5”
https://climate.nasa.gov/evidence/

27. Rising temps negatively impact crop yields
• For every 1 degree Celsius that the Earth warms:
• corn yields will drop an average of 7.4%
• wheat yields will drop an average of 6%
• rice yields will drop by 3.2%
• soybean yields will drop by 3.1%
“Temperature increase reduces global yields of major crops in four independent estimates”

28. Rising temps cause
drought, which is
more bad news for
crops.
Earth’s temp
rises; water
cycle speeds up
due to
increased
evaporation.
Evaporation
puts more
water in air;
increases
precipitation
increases
storms and
flooding, but
increases
drought in areas
away from
storm paths
Drought impacts
crops through
slowed growth,
decrease of
vitamins and
nutrients in the
plants
Decreased
vitamins and
nutrients leads to
poor nutrition for
affected
populations

29. Rising temps
mean lost
productivity
• “… in the southern US, businesses
lost up to 20 percent of their
potential daylight work hours in
2018’s hottest month. The drop in
productivity translates directly into
economic losses: Across the world
in 2018, 133.6 billion potential work
hours were lost due to heat.”
https://www.wired.com/story/how-the-climate-crisis-
is-killing-us/

30. From the State of Climate Services 2020 Report, from the World Meteorological Organization

31. Health
problems
related to
increased
heat/warming
• Mental health
• According to the CDC, there is a direct
correlation between extreme heat and
suicide completion
• Drought/lack of green space negatively
impacts human mental health
• According to the EPA, more than 9,000
Americans have died of heat-related
illnesses since 1979
• Increased illnesses, including:
• Lyme disease
• West Nile virus
• Ragweed pollen allergies
• Fungi like Candida auris

32. From “Global Risk of Deadly Heat”, 2017
• “Based on the climatic conditions of those lethal heat events, we
identified a global threshold beyond which daily mean surface air
temperature and relative humidity become deadly. Around 30% of
the world’s population is currently exposed to climatic conditions
exceeding this deadly threshold for at least 20 days a year. By
2100, this percentage is projected to increase to ∼48% under a
scenario with drastic reductions of greenhouse gas emissions
and ∼74% under a scenario of growing emissions. An increasing
threat to human life from excess heat now seems almost
inevitable, but will be greatly aggravated if greenhouse gases are
not considerably reduced.”

33. Plastics
• In 2017, China stopped buying U.S. recycling
• Because the U.S. has no real organized recycling program, recycling ended
for the most part
• Used plastics are baled and stored (where they leak into ground water) or
are burned (releasing toxins into the air)
• Chemicals in plastic have been linked to metabolic disorders (including
obesity) and reduced fertility.
• Every human on Earth is ingesting nearly 2,000 particles of plastic a week;
“dosing us with five grams of plastics, many cut with chemicals linked to
cancers, hormone disruption, and developmental delays.”
• “Planet Plastic”- https://www.rollingstone.com/culture/culture-features/plastic-
problem-recycling-myth-big-oil-950957/

34. Climate Change
& Healthcare
Impacts to Health
&
Healthcare Facilities

35. Negative Environmental Effects caused by
Healthcare Facilities
• Emission of greenhouse gases
• Poor management of waste
(biological, chemical, radiological)
• “Our health care facilities are part of the problem in terms of the carbon
emissions that we create that actually does harm to the patients that we
hope to serve…The health care industry is faced with this transition to
producing less carbon, less greenhouse gas emissions in the care we
provide, and I think physicians have an important voice in that discussion as
well.” – Dr. Rebecca Philipsborn

36. The Impact of Climate Change on
Healthcare Facilities
• Facilities must be built in such a way that
they’re able to withstand the climate
change stressors that are specific to their
region
• Sustainable energy source
• Waste disposal
• Architecture appropriate to events in
the areas in which they’re located
(flooding, wildfires, etc)
https://www.who.int/publications/i/item/climate-resilient-and-environmentally-sustainable-health-care-facilities

37. Fundamental
Requirements for
Providing Safe &
Quality Care in the
Context of Climate
Change (according
to the World Health
Organization)
• Health workforce
• Adequate number of trained humans
empowered and informed
• Water, sanitation, hygiene, and health care waste
management
• Safe management of healthcare waste;
sanitation
• Energy
• Sustainable services
• Infrastructure, technologies and products
• Appropriate infrastructure, technologies,
products

38. How is climate
change affecting
health/healthcare?
• Increases in:
• Heat-related illnesses
• Infections
• Asthma
• Mental health disorders
• Poor perinatal outcomes
• Adverse experiences from trauma and
displacement
• Infectious diseases
• Disaster-related disease, injury, and death

39. Two Responses
to
Climate Change
• Adaptation- attempts to manage
the impacts of climate change
• Mitigation- attempts to reduce
the causes of climate change

40. Adaptation
Strategies for
Air, Water,
Land
• Smart growth communities
• Smart building
• Reduce emissions
• Maintain/restore wetlands
• Shoreline maintenance
• Preserve/improve water quality
• Habitat preservation
• Contaminated site management
• Groundwater remediation

41. Adaptation
Strategies
for Public
Health (EPA)
• Extreme heat
• Raise awareness
• Offer incentives for reducing heat
islands
• Establish urban forestry programs
• Retrofit public buildings
• Add heat mitigation into policy,
planning, design, and building standards
and codes
• Water quality
• Understand (and plan for) seasonal and
geographic waterborne illness risks
• Assess vulnerabilities
• Air quality
• Understand health impacts of events
such as wildfires

42. Source: CDC

43. Mitigation Strategies
• Reduction of energy consumption
• Reduction of agricultural emissions
• Alternatives to fossil fuel
• Geoengineering
• Management
• Global
• Local
• Personal

44. Calgary
Canada
Climate
Program

45. How can Healthcare
Professionals Respond to
Climate Change?
Education, Practice, Combating Mis/Disinformation

46. Education in medical and nursing schools
• Adopt educational frameworks such as the one proposed by Phillipsborn,
et, al., which is predicated on three questions:
• What are the harms to health from climate change?
• How does climate change require adaptations in our clinical practice?
• And how does climate change disrupt health care delivery?”
- “Climate Change and the Practice of Medicine”, Academic Medicine: September 8, 2020.
https://journals.lww.com/academicmedicine/Abstract/9000/Climate_Change_and_the_Practice_of_Medicin
e_.97003.aspx

47. Practice
• Prepare for interruptions to healthcare due to climate-related disasters
• Service interruptions
• Supply chain interruptions
• Educate patients about what climate change means
• Talk with patients about the risks that climate change pose in the
environment in which they live
• Health risks
• Natural disaster preparedness

48. Mis/Disinformation
• The Climate Deception Dossiers
• 85 internal memos leaked from the fossil fuel industry
• Forged letters to Congress
• Fake grassroots organizations
• Secret funding of research by a supposedly independent scientist
• Efforts to create uncertainty about climate science
• Industry has known about climate change since at least the 1970s
• 1995- internal memo written by a team headed by a Mobil Corporation scientist
distributed to many fossil fuel companies.
• report warned unequivocally that burning the companies' products was
causing climate change and that the relevant science "is well established
and cannot be denied.”
• Created misinformation campaigns to fool the public about the effect of
fossils fuels on climate change

49. Mis/Disinformation
• Plastics manufacturers have known since the 1970s that plastics couldn’t be
recycled, but spent millions of dollars promoting it to the public
• Since 1950, 6.3 trillion kilo of plastic waste has been produced and not
recycled even once
• Every human on Earth is ingesting nearly 2,000 particles of plastic a week;
“dosing us with five grams of plastics, many cut with chemicals linked to
cancers, hormone disruption, and developmental delays.”
• “Planet Plastic”- https://www.rollingstone.com/culture/culture-features/plastic-
problem-recycling-myth-big-oil-950957/

50. Mis/Disinformation
• American Chemistry Council- trade group that represents plastic
resins-producing oil and petrochemical companies.
• 2016, “the ACC commissioned a study by the consultancy Trucost — ‘the world’s leading
experts in quantifying and valuing the environmental impacts’ from industry. The ACC
paid for the study to demonstrate that plastics are not easily replaceable, and that many
common substitutes — particularly glass — carry higher environmental costs when
factoring in weight for transportation. The Trucost finding that the ACC does not trumpet?
‘The environmental cost to society of consumer plastic products and packaging was over
$139 billion in 2015,’ the report reveals. Without a dramatic change in course, Trucost
predicts, that annual figure will soar to ‘$209 billion by 2025.’”
• “Planet Plastic”- https://www.rollingstone.com/culture/culture-
features/plastic-problem-recycling-myth-big-oil-950957/

51. Thank you!
Both this slide deck and a recording of the class will be made available to you.

52. RESOURCES
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https://www.globalcitizen.org/en/content/climate-change-global-warming-myths
• 10 Climate Change Lies, and How to Catch Them-
https://makechange.aspiration.com/articles/climate-change-lies/
• How Big Oil Misled The Public Into Believing Plastic Would Be Recycled-
https://www.npr.org/2020/09/11/897692090/how-big-oil-misled-the-public-into-believing-plastic-
would-be-recycled
• “Planet Plastic: How Big Oil and Big Soda kept a global environmental calamity a secret for
decades”- https://www.rollingstone.com/culture/culture-features/plastic-problem-recycling-myth-
big-oil-950957/
• “Revealed: plastic ingestion by people could be equating to a credit card a week”-
https://wwf.panda.org/wwf_news/?348337/Revealed-plastic-ingestion-by-people-could-be-
equating-to-a-credit-card-a-week
• “Is plastic a threat to your health?”- https://www.health.harvard.edu/staying-healthy/is-plastic-a-
threat-to-your-health

64. OTHER RESOURCES:
• NCEI tools for tracking extreme events- https://www.Ncdc.Noaa.Gov/climate-
information/extreme-events
• Top climate experts to follow on Twitter-
https://www.Climaterealityproject.Org/blog/top-climate-experts-follow-twitter
• The 2018 report of the Lancet countdown on health and climate change: shaping the
health of nations for centuries to come.
Https://www.Thelancet.Com/journals/lancet/article/PIIS0140-6736(18)32594-7/fulltext
• An Interactive Online Course in Climate and Climate Change: Advancing Climate
Literacy for Non–Atmospheric Science Majors- https://doi.org/10.1175/BAMS-D-19-
0271.1
• AGMIP- https://agmip.org/#
• Feeling discouraged? Google “solar punk” for some inspiring artwork & ideas about
how we can reverse course on climate change.

65. Questions?
Please reach out:
Kimberley@virginia.edu