Capacity Building and Training for Extreme Heat Event Awareness and Education

1. Capacity Building and Training for Extreme Heat Event Awareness and Education Carla Campbell, MD, MS, FAAP Associate Professor of Public Health, UTEP

2. Loss of habitat and diversity • Species range shifts • Ecosystem services • Land degradation • Stratospheric ozone depletion • Weather-related deaths • Infectious diseases • Air quality - respiratory illnesses Climate Changes TemperatureSea Level Rise Precipitation • Geographic range • Health, composition, and productivity Coastal Areas • Erosion and inundation of coastal lands • Costs of protecting vulnerable lands Changes in precipitation, water quality, and water supply Water Resources Forests Agriculture • Pest management • Irrigation demand • Crop yields • Desertification and land degradation Expected Impacts of Climate Change Ecosystems Health

3. Environmental Impacts ofClimate Change • More extreme temperatures • Sea level rise • Stronger hurricanes and storm surges • Increased precipitation and flooding • Increased droughts and water scarcity • More frequent wildfires • Increased ozone concentrations and diminished air quality • Increased pollen and natural air pollutants • Increased range for disease vectors • Farmers and fishers more vulnerable NOAA USFS NOAA

4. The Environmental Impacts of Climate Change will Affect Human Health Source: Living Water International / Flickr www.water.cc • Air Pollution: respiratory and other • Temperature extremes: heat stress • Aggravation of preexisting conditions • Infectious disease changes • Increase in water-,food- and vector-borne diseases • Increased illness, injury, mortality • Injuries and deaths from extreme weather events • Mental health disorders • Population displacement • Food insecurity, instability and conflict: malnutrition/starvation Source: Sabbir, Wikimedia Commons

5. Extreme Temperatures: Heat Waves • Most vulnerable populations: • Young children and the elderly • People living alone, socially isolated, or mentally ill • Socio-economically disadvantaged people • People lacking access to air conditioning or cooling spaces • People with chronic (cardiorespiratory) diseases or bedridden • People who work outside • Urban poor due to heat islandeffects • Increase in heat related illnesses and mortality: • Heat stroke • Heat exhaustion • Heat cramps CDC CDC CDC

6. Urban Heat Islands • absorbing and retaining materials – can raise local temperature 2 – 10 F Oke 1987 and World Meteorological Organization 1984

7. Heat Wave Examples 2006 California heat wave • Daytime temperatures > 100 degrees for 2 weeks • Record nighttime highs • > 1 million people lost electricity • Death toll: 150-450 • Excess ER visits: 16,000 • Excess hospitalizations: 1000 2003 European heat wave • Death toll > 45,000 1995 Chicago heat wave • Death toll: 900 NASA NASA

8. How Do These Cities Plan for Extreme Heat Events? • Philadelphia, PA: Has the longest-running heat-health intervention program in the country, which is considered the “gold standard” for heat management in the US. Their brochure for the public is a good example. They communicate EHE warnings well. • Phoenix, AZ: Has the most extreme heat of all 4 cities. Has government and NGOs working on activities around EHE.

9. How Do These Cities Plan for Extreme Heat Events? • New York City, NY: Much larger than the other cities; has some heat preparedness systems in place, including syndromic surveillance that detected 125 deaths with an underlying cause of “heat” from 1999-2010 • Detroit, MI: Does not have centralized, formal plan for EHE, does have an all-hazard plan and Detroit Health Dept. houses the Office of PH Emergency Preparedness and Office of Homeland Security and Emergency Management

10. EL PASO HEAT STATISTICS These are apparently collected by the Fire Department, rather than the City of El Paso Department of Public Health. However, I did not receive any statistics in time, despite requesting them about a month ago. So can’t share the local experience with you.

11. TOOLS AND RESOURCES • Training tools: Check CDC, NOAA, EPA websites • Resources: CDC website, NOAA/National Weather Service:www.nws.noaa.gov/om/brochures/heatwave.pdf; EPA: https://www.epa.gov/heat-islands/lessons-learned-european-heat-wave-sacramento-uhi-strategy-epa-supplemental • Outreach activities:Billboards, brochures, ads on buses and subways, PSAs on radio and TV, briefing of public officials, disaster drills including heat wave plans

12. Climate and Health Programwww.cdc.gov/climateandhealth/default.htm • Keeping Cool in a Heat Wave|PSAs for Disasters • emergency.cdc.gov/disasters/psa/heatwave.asp • Script. This is an important message from the U.S. Department of Health and Human Services. In a heat wave, keeping your cool will keep you healthy. • Extreme Heat Prevention Guide - Part 1 • emergency.cdc.gov/disasters/extremeheat/heat_guide.asp • Heat-related deaths and illness are preventable yet annually many people succumb to extreme heat. ... A heat wave combined with a drought is a very dangerous situation

13. How to Achieve Increased Resilience for Managing EHE in the El Paso/Juarez border region Develop program using Philadelphia’s plan as a guide and example, but perhaps incorporating elements from the other cities or suggestions from CDC/NOAA/EPA, etc. Involvethe entire city infrastructure, including the incident command center, the all-hazards plan, the health department and health facilities, the fire and police departments, etc.; include all parties actively engaged in emergency response