Climate Change, Environmental Health and Non-Communicable Diseases

John M. Balbus, MD, MPH

Senior Advisor for Public Health National Institute of Environmental Health Sciences

PHI Side Event at UN High Level Meeting on Non-Communicable Diseases

September 19, 2011

Overview

• Environmental factors cause a significant fraction of Non-Communicable Diseases

• Global epidemics of diabetes, obesity and cardiovascular disease are creating ever-growing populations with increased vulnerability to climate change stressors

• Policies and solutions put in place to address climate change can have significant benefits for NCD’s, and vice versa

Global burden of disease due to the modifiable environment

http://www.who.int/quantifying_ehimpacts/en/

The environmental burden of disease

Pruss-Ustun and Corvalán, 2006

Identifying synergies and opportunities for co-benefits

“Rest assured, in this day and age, ever more sophisticated and costly medicines, devices, and technologies will not be able to save the situation. They will not avert an impending disaster. Only smart, farsighted policies can do this.”

Dr. Margaret ChanDirector-General of the World Health OrganizationOpening remarks at the WHO Global Forum27 April 2011

Meeting research needs

• Asthma, respiratory allergies and airway diseases

• Cancer

• Cardiovascular disease and stroke

• Foodborne diseases and nutrition

• Heat-related morbidity and mortality

• Human developmental effects

• Mental health and stress-related disorders

• Neurological diseases and disorders

• Vectorborne and zoonotic diseases

• Weather related morbidity and mortality

Asthma, Respiratory Allergies, and Airway Diseases

May become more prevalent because of:

• increased human exposure to pollen (due to altered growing seasons)

• molds (from extreme or more frequent precipitation)

• air pollution and aerosolized marine toxins

Mitigation/Adaptation measures:

• Reduced fossil fuel combustion lowers air pollutants

• Household insulation and ventilation could worsen IAQ

Cancer

Climate change may result in:• Altered fate and transport of

carcinogens• Changes in air pollution levels• Prolonged ozone depletion and

increased human exposure to UV

Mitigation/Adaptation measures:• Reduced fossil fuel combustion

lowers carcinogenic air pollutant levels

• Increased active transportation raises physical activity levels and reduces cancer risk

• Alternative fuels and energy-related materials may introduce novel carcinogens

Cardiovascular Disease and Stroke Existing cardiovascular disease may be exacerbated by:• increasing heat stress• increasing exposure to

particulate air pollution

• changing the distribution of zoonotic vectors that cause infectious diseases linked with cardiovascular disease.

Mitigation/adaptation measures:• Reduced fossil fuel use reduces

exposure to air pollutants with cardiovascular toxicity

• Increased active transportation raises physical activity levels, reducing cardiovascular risks

Mental Health and Stress-Related Disorders Extreme weather events related to climate change may result in:• geographic displacement of

populations• damage to property• loss of loved ones• chronic stress, all of which can negatively affect mental health.

Adaptation/Mitigation measures:• Effective adaptation should

reduce psychological trauma and stress

USGCRP Interdisciplinary Project: The Interagency Group on Climate Change

and Human Health

Chartered December 2009Demonstration of “end to

end” science in service of societal needs

Co-chaired by NIEHS, CDC and NOAA 11+ agencies involved

Synergistic solutions: improving cookstoves in the developing world

• Cookstove smoke kills nearly 2 million people each year

• More than half of those deaths are from COPD

• Black carbon from incomplete combustion contributes to atmospheric warming

• Improved cookstoves can improve health and equity and reduce short-lived climate forcing

http://cleancookstoves.org/