Greenhouse Gas Emissions

1. Warm Climate, Variable Health, Storm Warning Pierre Gosselin, MD, MPHInstitut national de santé publique du Québecand Université LavalCAPE Montreal Conference26 septembre 2009

2. Greenhouse Gas Emissions Density-Equalling Cartogram. Borders have been adjusted according to the countries’ cumulative CO2-equivalent emissions (1970-2000). Source: Gibbs et al. (2007).

3. Mortality caused by Climate Change, 2000 Density-equalling Cartogram – WHO Regions scaled according to estimated mortality (per million people) in the year 2000, attributable to the climate change that occurred from 1970 to 2000. Source: Gibbs et al., 2007.

4. Quebec Data (1960-2003)

5. Projet #4 Source: Ouranos, 2005.

6. Projet #4 RIMOUSKI ? MONTRÉAL ? NASHVILLE ? PITTSBURGH ? Source: Ouranos, 2005.

7. Quebec Data Figure 2 : Nombre de catastrophes naturelles au Canada, de 1900 à 2002 Note : Seules les catastrophes hydrométéorologiques sont associées au climat.Source : D. Etkin et coll., 200417. Figure 2 shows the number of climate-related and other natural disasters recorded in Canada between 1900 and 2002. According to the estimates published in the World Disasters Report, 2004, the total number of Canadians affected by natural disasters has increased from 79,066 between 1984 and 1993, to 578,238 between 1994 and 2003. Note : Only hydrometeorological disasters are associated with the climate. Source : D. Etkin et coll., 2004. In: Évaluation nationale santé et CC 2008

8. Question, 2002-2003: What health impacts were there in Quebec? In: Évaluation nationale santé et CC 2008

9. Several studies conducted in Quebec since 2003 Researchers: • Diane Bélanger PhD (INSPQ, CHUQ) • Bernard Doyon PhD (CHUQ) • Pierre Gosselin MD MPH (INSPQ, CHUQ, U.Laval, Ouranos) Contributors: Belkacem Abdous PhD, Pierre Valois PhD (U.Laval), Philippe Poitras MSc (CHUQ), Mélissa Giguère MSc (INSPQ), Marie-France Sottile MSc (Ouranos), Luc Vescovi PhD (Ouranos), Philippe Gachon PhD (Ouranos), Daniel Martin PhD (CHUQ). Sponsors: Health Canada, Ouranos, MSSS, INSPQ Public Health Agency of Canada, IRSC, GEOIDE, Arcticnet.

10. Several studies conducted in Quebec since 2003 • Other studies: • Kosatsky et al. of the Montreal Public Health Directorate (urban heat islands); • Garneau et al. of UQAM (pollens and asthma); • Nunavuk studies by Furgal et al. (various topics); • Other Canadian studies including Quebec-related data.

11. 2005 Assessment Studies conducted by INSPQ (Quebec’s National Public Health Institute), 2003-2007 • 4 sectoral assessments (water, zoonotic/vectorial diseases, temperature, EMEs) • General population perceptions, behaviour • Public health and municipal managers’ perceptions • Mortality modelling and simulation 14 reports available on-line at: http://www.inspq.qc.ca/publications/liste.asp?E=p&Theme=8

12. 2005 Assessment • Heat wave alert systems (health network) have existed since 2004-2005 for southern Quebec.(93% of the population). Few tests performed. • No systematic review of air conditioning in existing hospitals and shelters, but new standards for new buildings and renovations. • No specific training or recommendations for medical staff regarding health care or medication. • No public awareness/outreach programme. • No real prevention or remediation programme for urban heat islands.

13. 2005 Assessment • Lack of public health emergency training • Very good environmental monitoring system (storms, flooding, dams, rivers, forest fires, etc.) • No follow-up of EME consequences; some short-term psychological follow-up • Some preventive actions regarding flooding and road network, Northern housing and infrastructure.

14. 2005 Assessment • Very good drinking water monitoring system, but infrequent investigation of epidemics • Same for commercial and traditional foodstuffs • Poor beach and swimming pool monitoring – even though Quebec has 50% of Canadian pools! • Preventive watershed-based approach in place but poorly financed.

15. 2005 Assessment • Quantitative water management is poorly implemented (outdated infrastructure, standards, swimming pools…) • No quality control for small water sytems and private wells (20% of population) • Poorly organized public awareness/outreach

16. Public Perceptions and Behaviour • 75% of adults take action to protect themselves from the heat • The proportion of air-conditioned dwellings has doubled since 1997; now at 35,8%. • The most significant factor limiting access to air conditioning is household income.

17. Projet #2 Percentage of households with air conditioning in Quebec, 1972 to 2005 Source: ISQ (2005b) and Bélanger et al. (2006a).

18. Access to air conditioning in 2005, in relation to the mean temperature warming trend (1960-2003) in southern Quebec Source: Bélanger et al. (2006a), Yagouti et al. (2006)

19. Public Perceptions and Behaviour • “Living alone” is an excellent predictor for low income, chronic health problems and “age over 65”; these are the people who are most at risk in case of an Extreme Meteorological Event • Two-thirds of people using walking aids or wheelchairs are unable to go shopping for groceries during a heat wave.

20. Public Perceptions and Behaviour

21. Public Perceptions and Behaviour • Apartment dwellers and low-income people make great use of public parks and beaches during heat waves.

23. Projet #2 Percentage of domestic wood heating, per region Source: Bélanger et al. (2006)

24. Link Between Mortality And Climate

25. Mortality and Climate – Relative to Tº

26. Historical Mortality Rate Modelling and Future Simulations Bonus: Heat Waves Deaths ANNUAL

27. Other questions, 2005:Where does the public stand? What changes are people ready for?

28. Study of Public Health / Municipal Managers • Very high recognition of environmental problems (water, air); some linkage to CC • Same recognition level regarding existing vulnerabilities (poverty, unemployment, aging population) and their link with health conditions • Most managers consider that CC adaptation will be a regional and provincial priority for the next 10 years, with varying importance depending on the region.

29. Results • Both manager categories (public health and municipal) are very aware of the negative impacts on infrastructure and economy, and on physical and mental health. • Collectively, their appreciation of these impacts is clear, detailed and balanced.

30. Results • Most managers believe that their regional institutions, in partnership, share the responsibility for CC adaptation. • However, there is little field work, mostly limited to heat wave emergency plans. • Most managers say they need (in this order): • More practical information; • Regional climate data; • More political and institutional support; and • Financial and human resources to move ahead.

31. Discussion • Municipalities rely more on government information sources, less on scientific sources (Ippersiel & Morissette, 2004) • More municipal (6+) than public health (1+) laws and regulations • Little money tagged for prevention at the municipal level.

32. Discussion • There is no unanimous certainty that a period of climate change has started, notably because of the media-peddled controversy on the causes of the warming trend – natural vs anthropic.

33. Public’s Intentions Regarding Certain Actions (2005)

36. Assessment Summary • Action on housing and infrastructure will be crucial; standards must take CC into account • Availability of shaded and cool areas in cities will have to increase; trees planted today will be useful around 2040…Not cutting them is a lot smarter. • Supporting the poor, handicapped or chronically ill will be decisive to avoid social disasters… Neighbourhood solidarity.

37. Assessment Summary • The ground is fertile but it is necessary to continue tirelessly explaining the links between the actions that need to be taken, their causes and the climate… • Our major information effort: 22 reports, summaries, articles and book chapters (several thousand copies distributed); some 100 conferences and media events; hyperlinks on 6 websites…

38. Assessment Summary Chapter 6 deals with Quebec; it summarizes all studies conducted in Quebec and includes recommendations. See http://www.hc-sc.gc.ca/ahc-asc/media/nr-cp/_2008/2008_122-fra.php and for the online version: http://www.sindark.com/2008/08/03/human-health-in-a-changing-climate/

39. Ouranos Health Research Programme 2006-2009 • Several applied health research projects are being concluded within Ouranos (cyanobacteria, rural gastroenteritis, atlas of vulnerabilities, links between heat and air pollution, historical and future hospitalization modelling) • Advice on guidelines being prepared for doctors and healthcare workers.

40. Ouranos Health Research Programme 2009-2014 • In development • Important support for adaptation work • New issues: urban heat islands and mortality, UV, zoonotic and vectorial diseases, strokes, high risk group characterization, housing, health impacts of Extreme Climatic Events, geosimulation of Lyme’s Disease…

41. Health Action Plan 2007-2013 • Reinforced health monitoring (for ECEs, infectious zoonotic and vectorial diseases, real time mortality) will be in place by 2012 • Platform in development • There will be studies, recommendations and demonstration projects on how to improve climate-related health care and services (institutional and home-delivered) • Adaptation of health care–related buildings and lands (1,700 buildings) according to new standards (demonstration projects)

42. Health Action Plan 2007-2013 • Support demonstration projects for the creation of «cool islands» and for the prevention of EME risks to vulnerable, non-health care clients (schools, day care facilities, low cost housing, etc.) • Training programme planned for network and non-network staff (pending needs identification)

43. Health Action Plan 2007-2013 • First health programme of this kind in Canada – yet incomplete and imperfect • Not much done yet on behaviour and its follow-up (and continuing reinforcement) • Links need to be established with other existing health-related initiatives (UV, physical conditioning, sustainable development, transportation, etc.) • Planned funding: $30 million, including 50% for demonstration projects – initiated last year.

44. LESSONS LEARNED

45. LESSONS LEARNED • Need to start to change our thinking and words on the need for innovation for CC adaptation. The necessary technologies have been around for more than a century: bicycles (1817), railways (1804), tramways (1832), planning (~10,000 years), boats (~10,000 years), tax (~1,600 years) and walking (~2,000,000 years) • What is needed instead is a strenghtening of public institution mandates, infrastructure and legal requirements.

46. LESSONS LEARNED • It took 10 years to get ready to act, so we might as well start now, because… • When the money comes, we’d better be ready to spend it wisely; • It is essential to broadcast, explain and repeat the concepts, solutions, impacts and avoided costs, since human behaviour remains… human.

47. LESSONS LEARNED • What will be lacking is the few billion dollars needed to offset the advertising drive to consume and emit GHGs • Last year, the world automobile industry alone spent $70 billion on advertising and incentives… out of a total world advertising budget of $450 billion • Reducing GHG emissions remains the Number 1 adaptation measure, one which we owe our descendants.

48. Thank you for your attention