Climate Change and Public Health:The Role of CDC

Michael A. McGeehin, Ph.D., M.S.P.H.Director, Environmental Hazards and Health Effects,

National Center for Environmental Health, CDC

February 17, 2008

Agenda

• Is climate change real?• Is climate change a health issue?• Is there a public health role?• What is the role of CDC?• A few parting thoughts.

IPCC 2007 Reports

Potential Health Effects of Climate Change

Climate change:

• Temperature rise

• Sea level rise

• Hydrologic extremes

HEATHEAT Heat stress, cardiovascular failure

SEVERE WEATHERSEVERE WEATHER Injuries, fatalities

AIR POLLUTIONAIR POLLUTION Asthma, cardiovascular disease

ALLERGIESALLERGIES Resp allergies, poison ivy

VECTOR-BORNE DISEASESVECTOR-BORNE DISEASES Malaria, dengue, hantavirus, encephalitis, Rift Valley fever

WATER-BORNE DISEASESWATER-BORNE DISEASES Cholera, cryptosporidiosis, campylobacter, leptospirosis

WATER AND FOOD SUPPLYWATER AND FOOD SUPPLY Malnutrition, diarrhea, harmful algal blooms

MENTAL HEALTHMENTAL HEALTH Anxiety, post-traumatic stress, depression, despair

ENVIRONMENTAL ENVIRONMENTAL REFUGEESREFUGEES Forced migration, civil

conflict

The direct health effects of heat

European heat wave, 2003

Vandentorren et al. Mortality in 13 French cities during the August 2003 heat wave. Am J Public Health 2004; 94(9):1518-20.

UK 2,091

Italy 3,134

France 14,802

Portugal 1,854

Spain 4,151

Switzerland

975

Netherlands

1,400-2,200

Germany 1,410

TOTAL29,817-30,617

CONFIRMED MORTALITY

Haines et al. Climate change and human health: Impacts, vulnerability and public health. Public Health 2006;120:585-96.

TIME LINE (FRANCE)

Severe weather events

Hurricane intensity (Saffir-Simpson scale categories 1 to 5), global, 1970-2004, including number of storms by category (A) and proportion of storms in each category (B). Bold curve in (A) is the maximum global hurricane wind speed (in m/sec). Dashed lines show the 1970–2004 average numbers in each category. Source: Webster et al., Science 2005;309:1844-46.

Climate change and severe weather events, 1972-2004

0.00

0.04

0.08

0.12

0.16

0.20

Apr May Jun Jul Aug Sep Oct

O3

(ppm

)

Ozone Season in Atlanta

Unhealthful

Source: M. Chang, Ph.D., Georgia Tech

Allergies

Ragweed• Genus Ambrosia

• ↑ CO2 and temperature → ↑ pollen counts, longer growing season

Source: Ziska et al., J Allerg Clin Immunol 2003;111:290-95;Graphic: Wall Street Journal, 3 May 2007.

Poison Ivy• Toxicodendron radicans

• ↑ CO2 leads to– ↑ photosynthesis– ↑ water use efficiency– ↑ growth– ↑ biomass– More allergenic urushiol

• Greater CO2 stimulation than most other woody species

Source: Mohan et al. PNAS 2006;103:9086-89.

The predictable…

…and the surprising

Potential Health Effects of Climate Change

Climate change:

• Temperature rise

• Sea level rise

• Hydrologic extremes

HEATHEAT Heat stress, cardiovascular failure

SEVERE WEATHERSEVERE WEATHER Injuries, fatalities

AIR POLLUTIONAIR POLLUTION Asthma, cardiovascular disease

ALLERGIESALLERGIES Resp allergies, poison ivy

VECTOR-BORNE DISEASESVECTOR-BORNE DISEASES Malaria, dengue, hantavirus, encephalitis, Rift Valley fever

WATER-BORNE DISEASESWATER-BORNE DISEASES Cholera, cryptosporidiosis, campylobacter, leptospirosis

WATER AND FOOD SUPPLYWATER AND FOOD SUPPLY Malnutrition, diarrhea, harmful algal blooms

MENTAL HEALTHMENTAL HEALTH Anxiety, post-traumatic stress, depression, despair

ENVIRONMENTAL ENVIRONMENTAL REFUGEESREFUGEES Forced migration, civil

conflict

Public Health Action on Climate ChangeTrack diseases

and trends related to

climate change

Communicate effectively on

climate change

Heat wave and severe storm response plans;

focus on the most vulnerable

Public health

workforce prepared to

respond

Investigate infectious water-, food-, and vector-

borne disease outbreaks

Partnerships with private sector, civic groups, NGOs, faith

community, etc.

Study and predict links between climate change

and health

The role of CDC

• Surveillance and data collection

• Outbreak investigations

• Technical assistance– Forecasting and modeling– Preparedness planning

• Research

• Education

• Training and capacity-building

A few parting thoughts: Four Cs

• Conceptualizing• Communicating• Complexity• Co-benefits

“Mitigation and Adaptation”

“Preparedness and Prevention”

or

Care for the individual

patient Care for the communityCare for

future generations

THE CLINICAL APPROACH THE PUBLIC

HEALTH APPROACH

THE LEGACY APPROACH

• Intergenerational responsibility•Stewardship

Effective health communication

Despair

Anxiety

The ScreamEdvard Munch does Climate Change

“Think of the verbs associated with environmentalism and conservation: ‘stop,’ ‘restrict,’ ‘reverse,’ prevent,’ ‘regulate,’ and ‘constrain.’ All of them direct our thinking to stopping the bad, not creating the good.”

The need for positive, aspirational messages.

““I have a nightmare…”I have a nightmare…”

““I have a dream…”I have a dream…”

“The challenge of climate change is so massive, so global, and so complex that it can only be overcome if we look beyond the issue categories of the past and embrace a grand new vision for the future.”

The need for bold, cross-cutting thinking.

Complexity

Reality (simplified)

Looking over the horizon

Source: IPCC

Population growthPopulation growth

“Hubbert’s peak”

Source: Hubbert, 1956

Peak petroleum

Limits on landLimits on land

Limits on water

Promoting co-benefits

Climate Change Synergies

Heat wave plans including “buddy systems”

↑ social capital

↓ Vehicular travel↓ car crashes; clean air; ↑ physical activity

↑ Fuel efficiency ↓ air pollution

Locally grown foodFresh food; ↓ pesticide exposure; local business

Energy-efficient buildings ↓ operating costs

Alternative energy sources Business opportunities

Co-benefits: Trees

• Carbon sequestration • Cooler temperatures• Reduced energy demand• Clean water• Clean air• Protection from sunlight• Venues for physical activity• Noise reduction• Mental health• Spiritual fulfillment

Co-benefits: Food and nutrition

Suddenly, Bob realizes that he’s “part of the problem.”

Physical activity

Air pollution

And by the way…

Infrastructure costs Social capital

CO2 emission

s

Depression

Injuries

Osteoporosis

Co-benefits: Transportation

Summary

• Climate change is real.

• Climate change is a health issue.

• There a public health role.

• There is an important role for CDC.

Thank you!