Climate Change and Public Health 101

1. Climate Change and Public Health 101 Climate Change 101 Climate Change Training Module MN Climate & Health Program Minnesota Department of Health Environmental Impacts Analysis Unit October 2012 625 Robert Street North PO Box 64975 St. Paul, MN 55164-0975

2. Notice MDH developed this presentation based on scientific research published in peer-reviewed journals. References for information can be found in the relevant slides and/or at the end of the presentation.

3. Outline • Climate Change in Minnesota • Health Impacts of Climate • Extreme Heat Events • Air Quality: Pollutants and Allergens • Flooding and Drought • Other Impacts • The High Cost of Disasters • The Role of Public Health

4. Definitions • Weather – conditions of the atmosphere over a short period of time • Climate – conditions of the atmosphere over long periods of time (30- year standard averaging period)

5. Definitions • Adaptation – efforts to anticipate and prepare for the effects of climate change, and thereby to reduce the associated health burden • Mitigation – efforts to slow, stabilize, or reverse climate change by reducing greenhouse gas emissions

6. Outline • Climate Change in Minnesota • Health Impacts of Climate • Extreme Heat Events • Air Quality: Pollutants and Allergens • Flooding and Drought • Other Impacts • The High Cost of Disasters • The Role of Public Health

7. Observed Climate Changes There have been three recent significant observed climate trends in Minnesota: • The average temperature is increasing • The average number of days with a high dew point may be increasing • The character of precipitation is changing

8. Temperature Changes in Minnesota

9. Temperature Changes in Minnesota Significant observations in warming pattern: • Winter temperatures have been rising about twice as fast as annual average temperatures • Minimum or ‘overnight low’ temperatures have been rising faster than maximum or ‘daytime high’ temperatures

10. Temperature Changes in Minnesota Seasonal Temperature Trends (°F per century) Based on 1895-2010 Data SPRING: + 1.6° SUMMER: + 0.8° AUTUMN: + 0.5° WINTER: + 2.2°

11. Projected Summer Temperatures Current average summer temperature (°C) Average summer temperature change by 2069 (°C)

12. Dew Point Changes • Dew point – a measure of water vapor in the air • A high dew point makes it more difficult for sweat to evaporate off the skin, which is one of the main mechanisms the body uses to cool itself • The number of days with high dew point temperatures (≥ 70°F) may be increasing in Minnesota

13. Dew Point Changes

14. Changes in Precipitation

15. Changes in Precipitation • Precipitation in Minnesota is changing: • More localized, heavy precipitations events • Potential to cause both increased flooding and drought

16. Outline • Climate Change in Minnesota • Health Impacts of Climate • Extreme Heat Events • Air Quality: Pollutants and Allergens • Flooding and Drought • Other Impacts • The High Cost of Disasters • The Role of Public Health

17. Extreme Heat Extreme Heat Events An extreme heat event is characterized by weather that is substantially hotter and/or more humid for a particular location at a particular time

18. Extreme Heat • Extreme heat events can cause: • Heat tetany (hyperventilation) • Heat rash • Heat cramps • Heat exhaustion • Heat edema (swelling) • Heat syncope (fainting) • Heat stroke • Death

19. Extreme Heat • Risk Factors • Lack of air conditioning in home • Low socioeconomic status • Living in urban areas • Living in topmost floor of a dwelling • Living in nursing homes or being bedridden • Living alone or a lack of social or family ties • Prolonged sun exposure • Drinking alcohol • Exercising outside on warm days

20. Extreme Heat • Vulnerable Populations • Everyone • Elderly persons 65 years and older • Especially those who live alone • Children • Persons with pre-existing disease conditions • Persons taking certain medications • Athletes • Outdoor workers • Homeless

21. Urban Heat Islands • Higher temperatures in urban areas relative to surrounding suburban and rural areas can be caused by: • Reduced vegetation and green space • Heat-absorbing surfaces, such as pavement • Heat-reflecting surfaces, including many building materials • Skyscrapers obstructing free air flow Images from the Metropolitan Design Center Image Bank. Used with permission.

22. Outline • Climate Change in Minnesota • Health Impacts of Climate • Extreme Heat Events • Air Quality: Pollutants and Allergens • Flooding and Drought • Other Impacts • The High Cost of Disasters • The Role of Public Health

23. Air Pollutants and Allergens • Climate change may affect exposures to air pollutants by: • Creating both more windiness and more air stagnation events • Increasing temperatures which . . . • Increase pollution from fossil fuel combustion to meet electricity demand for increased air conditioner use • Increase production of natural sources of air pollutant emissions • Increase formation of ozone • Lengthening the allergy season, creating more potent allergens Image from the Metropolitan Design Center Image Bank. Used with permission.

24. Air Pollutants and Allergens Ground-Level Ozone Health Impacts Populations at Risk Effects of acute exposure: Acute exposure to elevated ozone can lead to hospitalization or death Effect of long-term exposure: Decreased lung function and new-onset asthma Elevated ozone can exacerbate other conditions, such as asthma and allergies Due to increased exposure: Healthy people, especially athletes and outdoor workers in landscape and construction who may be exposed to higher levels of ozone for longer periods of time on high pollution days Due to sensitivity: Persons with respiratory and cardiovascular diseases Older adults and children

25. Air Pollutants and Allergens Particulate Matter Health Impacts Populations at Risk Effects of acute exposure: Short-term decrease in lung function Exacerbation of respiratory and cardiovascular diseases Hospitalization and death Effect of long-term exposure: Respiratory and cardiovascular diseases Cardiopulmonary and lung cancer deaths Due to increased exposure: Persons living or working in urban areas, especially near high-traffic corridors and/or stationary sources of PM (such as factories or power plants) Due to sensitivity: Persons with respiratory and cardiovascular diseases Elderly and children Persons with asthma and/or allergies

26. Air Pollutants and Allergens • Climate change impact on allergenic pollen: • Increased pollen production • Longer pollen season • Increased potency of airborne allergens • Proliferation of weedy plant species that are known producers of allergenic pollen • Introduction of new allergen-producing plant species

27. Air Pollutants and Allergens • Mold growth is encouraged by moisture: • Increased precipitation and flooding • Increased humidity • Increase in plant growth/plant biomass decay (leaf litter) • Improper installation or management of air conditioning systems can create conditions ripe for mold (Image Source: Terry Brennan, http://www.epa.gov/mold/moldcourse/imagegallery5.html)

28. Outline • Climate Change in Minnesota • Health Impacts of Climate • Extreme Heat Events • Air Quality: Pollutants and Allergens • Flooding and Drought • Other Impacts • The High Cost of Disasters • The Role of Public Health

29. Flooding • On average, the overall rainfall in Minnesota is increasing. • In Minnesota, the frequency of storms with 3 or more inches of rainfall has increased 104% in the last 50 years. • Examples of severe floods in Minnesota’s history include: • April 1997: Red River Valley • August 2007: Southeast Minnesota • June 2012: Duluth

30. Flooding Health Impacts • physical injuries (including drowning) • allergies (mold) • food and water-borne illnesses • food security • displacement • mental health issues • interruption of emergency services

31. Drought Changing natural and social factors play a role in how drought affects society, economy, and environment. Factors include: • Timing of drought • Temperature • Population density and growth • Development and implementation of water supply technology • Land use patterns

32. Drought Health Impacts • Reduced lake and wetland levels and stream flows • Potential concentration of pollutants • Decreased water supply for drinking and agriculture • Negative effects on soil moisture and crop progress will impact food security • Increased risk of wildfires

33. Outline • Climate Change in Minnesota • Health Impacts of Climate • Extreme Heat Events • Air Quality: Pollutants and Allergens • Flooding and Drought • Other Impacts • The High Cost of Disasters • The Role of Public Health

34. Other Impacts of Public Health Concern Vectorborne Diseases Climate changes such as warmer temperatures, increased rainfall, longer warm season and less severe winters can impact the range and incidence of vectorborne disease. Risk is also impacted by land use, population density, and human behavior. Black-legged ticks (“deer ticks”), which carry Lyme disease, are most active on warm, humid days. They are also most abundant in wooded or brushy areas with abundant small animals and deer. If those areas are one where many people live, work, or visit for recreation, the incidence of tick-borne disease can be high. For more information on climate and vectorborne disease, visit: http://www.health.state.mn.us/divs/idepc/dtopics/vectorborne/climate.html

35. Other Impacts of Public Health Concern Power Outages • Demand for electricity increases in warmer climates in order to air condition homes and businesses. • Increased temperatures may reduce the efficiency of power production in facilities that require water for cooling. • Severe storms and flooding can interrupt power service through damaged and destroyed infrastructure • Brownouts: intentionally reduced voltage in a power supply system used for load reduction in an emergency; may prevent black outs but can have other impacts

36. Outline • Climate Change in Minnesota • Health Impacts of Climate • Extreme Heat Events • Air Quality: Pollutants and Allergens • Flooding and Drought • Other Impacts • The High Cost of Disasters • The Role of Public Health

37. The High Cost of Disasters

38. The High Cost of Disasters 2012 Duluth Flood: A 500 Year Storm Event • Total rainfall in excess of 10 inches resulted in severe flash flooding and river flooding • $108 million in damage in infrastructure alone • damages to roads, bridges, water and sewer systems, electric utilities, and communications infrastructure • Damage to 1,700 homes and 100 businesses included structural damage, loss of utilities, sewage back up, and the subsequent sustained heat and humidity exacerbated mold growth • Estimated damages for these homes and businesses exceed $12 million Photo credits: Rachel Agurkis (top), Derek Montgomery for MPR (bottom)

39. The High Cost of Disasters

40. The High Cost of Disasters

41. The High Cost of Disasters • Recent case study analysis of 6 climate-related disasters estimated the associated health care costs: • US Ozone Air Pollution, 2000-2002 • California Heat Wave, 2006 • Florida Hurricane Season, 2004 • Louisiana West Nile Virus Outbreak, 2002 • North Dakota Red River Flooding, 2009 • Southern California Wildfires, 2003 • The associated health care costs alone topped $14 billion • 1,689 premature deaths • 8,992 hospitalizations • 21,113 emergency visits • 734,398 outpatient visits

42. Outline • Climate Change in Minnesota • Health Impacts of Climate • Extreme Heat Events • Air Quality: Pollutants and Allergens • Flooding and Drought • Other Impacts • The High Cost of Disasters • The Role of Public Health

43. Climate Change and Public Health Mitigation Public Health Role Adaptation Measures Climate Changes Events Health Outcomes Extreme Heat Air Pollutants & Allergens Drought Changes in Environment & Habitat Severe Storms & Flooding Wildfire Heat-related illness and death Cardiovascular disease, stroke Respiratory Illness Injuries and Drowning Vector-borne illness Displacement Waterborne and foodborne illness Stress, Mental Illness Extreme Precipitation Risk Factors (positive and negative) Increased Humidity Increased Temperature

44. Public Health Strategies Mitigation • Promote activities that reduce harmful emissions • Active communities that make biking, walking, and/or public transportation safe and convenient • Telecommuting or other work schedule alternatives that do not require employees to drive daily • Reduce the production of harmful air pollutants by: • Improving energy efficiency • Reduce energy consumption • Use alternatives to fossil fuels • Reduce combustion of fossil fuels Images from the Metropolitan Design Center Image Bank. Used with permission.

45. Public Health Strategies Adaptation • Monitoring conditions and providing useful information to the public • Extreme heat events • Air Quality Index • Disasters • Community and infrastructure planning • Retention ponds and wetlands increase water storage • Pervious surfaces and rain gardens increase infiltration, reducing run-off • Increasing capacity of stormwater systems • Reduce the urban heat island effect by maintaining green space in urban areas • Emergency Preparedness • Robust all-hazards plans that include annexes for severe storms, extreme heat, power loss • Identification and understanding of high-risk and vulnerable populations

46. Communicating Climate Change The Yale Project on Climate Change Communication identified six distinct American audiences, each of which responds to the issue of climate change in markedly different ways. Alarmed Concerned Cautious Disengaged Doubtful Dismissive 27% 25% 10% 10% 15% 12% Highest belief in climate change Most concerned Most motivated Lowest belief in climate change Least concerned Least motivated

47. Communicating Climate Change Alarmed Concerned Cautious Disengaged Doubtful Dismissive 27% 25% 10% 10% 15% 12% • Completely convinced that climate change is real • Believe that people are already being harmed by climate change • Supportive of personal and policy action • Believe that climate change is real • Feel that dangerous impacts of climate change will be seen in 10 years • Supportive of personal and policy action • Unsure whether climate change is occurring • Believe the impacts of climate change will be seen in 25 years • Do not believe personal actions or the actions of a single nation will make any difference

48. Communicating Climate Change Alarmed Concerned Cautious Disengaged Doubtful Dismissive 27% 25% 10% 10% 15% 12% • Less convinced that climate change is happening • Believe that impacts of climate change will be felt in 50 years • Do not feel that immediate action is needed • Unconcerned about whether or not climate change is occurring • Believe the impacts of climate change will be felt in 100 years • Do not feel that immediate action is needed • The only segment that is completely unconcerned about climate change because they do not believe it is happening

49. Communicating Climate Change • Most Americans think of climate change in geographically and temporally distant terms • Few Americans, without prompting, report that climate change has any connection to human health

50. Communicating Climate Change Communications Strategies • Frame climate change as a human health issue • Localize climate change • Emphasize the health co-benefits associated with climate change action