A Local Public Health Perspective on Global Climate Change

Angelo J. Bellomo Director of Environmental Health Los Angeles County Department of Public Health

The Mediterranean City: A Conference on Climate Change Adaption June 25, 2012

Mediterranean Climate Regions

California

Mediterranean Basin

Los Angeles County

Central Chile

Western Cape

Southwest Australia South Australia

Global Climate Change

2011 was the 11th warmest year since records began in 1850 2001-2010 was the warmest decade on record Since 1971, the global temperature has increased at a higher rate (0.166C per decade) than the average rate over the last 130 years (0.06C per decade)

Source: World Meteorological Organization Annual Statement on the Status of the Global Climate 2011. ww.wmo.int/pages/mediacentre/press_releases/pr_943_en.html

Climate Change in California

In California we expect to see:
Temperature increase of 2 - 5F by 2050, and 4 - 9F by 2100 Sea level rise of 12 - 18 inches by 2050 and 21 - 55 inches by 2100 Winter snow reduction across the entire state Precipitation increase, especially in the winter Three to five-fold increase in the number of days over 90F in Los Angeles

Source: 2009 Scenarios Project

Source: California Natural Resources Agency - 2009 Climate Change Adaptation Strategy

Climate Change Impact on Health

Source: Haines, et al, JAMA 2004

Anticipated Effects of Climate Change in Los Angeles County (I)

Rising coastal water
Coastal areas will become vulnerable to storms and flooding Loss of coastal wetlands and beach erosion Saltwater contamination of drinking water Potential damage to roads, highways and other infrastructure near coastal areas

Photo credit: Pacific Institute. Coast along Venice Beach and Marina Del Rey: Dark blue marks flooded area if sea level rises by 5 feet.

Anticipated Effects of Climate Change in Los Angeles County (II)

Reduced water availability Increased contaminant levels in water (e.g., arsenic, chromium) Warming of recreational waters (and associated algal blooms)

Photo credit (right picture): US Geological Survey, Dept of Interior

Anticipated Effects of Climate Change in Los Angeles County (III)

Flooding
Premature, rapid snowmelt in the
Sierras; potentially affecting half of Californias surface water supplies

Sever flooding may occur in winter and

spring; slower water flow in summer

Extreme weather events Storms, strong winds, heat waves

Anticipated Effects of Climate Change in Los Angeles County (IV)

Heat events
Los Angeles projected to have an increase of 62% - 88% in heatrelated mortality by 2080
Effects of extreme and prolonged heat exposures: heat cramps, heat exhaustion, heat stroke, heat syncope

Health impacts likely to be seen 1 to 3 days after the onset of the heat waves Devastating recent heat waves Chicago heat wave (5 days in 1995) 700 excess deaths European heat wave (August of 2003) 35,000 excess deaths

Anticipated Effects of Climate Change in Los Angeles County (V)

Increase in wildfires
Characteristic of the region Santa Ana winds may drive
heat waves, prolong fires, and hamper wildfire control

Climate models predict summer months

will be longer and hotter, resulting in dry soil and vegetation

Contributes to air pollution Affects ecosystem

Anticipated Effects of Climate Change in Los Angeles County (VI)

Degraded air quality
Increased temperature and carbon dioxide in atmosphere leads to: Increase in formation of ground-level ozone and smog Increased allergen production (e.g. pollen) Longer seasons for allergen producing weeds

Anticipated Effects of Climate Change in Los Angeles County (VII)

Ecosystem change Migration patterns of animals Destruction of vegetation due to presence of new pests Change/effects on seeding patterns Increased power outages

Health Impacts of Climate Change

Increased morbidity and mortality rates due to:
Respiratory illnesses
Reduced lung function, respiratory discomfort, exacerbation of chronic respiratory illnesses

Cardiovascular Illnesses Vector-borne illnesses

Increasing range or abundance of animal reservoirs & insect vectors Malaria, Dengue, West Nile Virus, etc. Q-Fever, Lyme disease Lengthening disease transmission cycles

Health Impacts of Climate Change

Increased morbidity and mortality due to:
Water and food-borne diseases
In recreational and drinking water outbreaks, bacteria is most common pathogen (followed by parasites and viruses) Cholera Amebiasis Cryptosporidiosis Vibrio infections from raw oysters Paralytic shellfish poisoning Most harmful pathogens are enteric Climate can affect a pathogens growth, survival, persistence, transmission and virulence

Heat related illnesses

Heat stroke, heat stress, etc.

Extreme Weather Events & Disease Clusters

Source: Epstein, Harvard Center for Health & Global Environment

Vulnerable Populations
Elderly: Population of senior citizens (> 60 years
old) in Los Angeles County is expected to increase by 83% by the year 2020

Children Immunocompromised individuals People residing in densely populated areas Individuals with chronic lung and/or heart conditions People who work outdoors Economically disadvantaged: Over 16% of
Los Angeles County residents are living under 100% Federal Poverty Level

Homeless

Los Angeles County - Background

4,060 square miles 88 incorporated cities and 2 islands 9.8 million residents (more than 41 States) 48% Latino, 28% White, 14% Asian/Pacific Islander, 9% African American, 1% American Indian Over 100 different languages spoken by significant size populations* 16% of entire population living in poverty
23% of children in poverty**

US Census Bureau: State and County QuickFacts, last revised Nov 2010 ; * July 1, 2008 Population and Poverty Estimates, prepared by Walter R. McDonald & Associates, Inc. (WRMA) for Urban Research; ** 2011 KIDS COUNT Data Book, Annie E. Casey Foundation. datacenter.kidscount.org/data/bystate/Rankings.aspx?state=CA&ind=412

Vulnerable Areas in Los Angeles County

Indicators:
Sea level rise Limited access to public transit Wildfire risk Large proportion of elderly living alone Socio economic factors

Conclusion: Urban and coastal areas are most at risk

Source: Ratio in Income Disparities in Relation to a Proposed Climate Change Vulnerability Screening Method for California P. English, et al.

Climate Change: Why Should Public Health Care?

It is our job to protect public health We have the appropriate skills:

To affect behavior change (i.e. help people adopt greener behaviors) To inform policy and advocate for community interests (i.e. encourage organizational and societal changes)

Addressing climate change is aligned with protecting and promoting health: many of the proposed solutions have cobenefits for health

Recognizing Co-benefits of Climate Change Response

Certain efforts to address climate change often yield other health benefits too Example A: strategy of reducing vehicle miles traveled
Primary result = lower motor vehicle GHG emissions Co-benefit = higher physical activity rates

Example B: strategy to promote cleaner energy production and cleaner fuels

Primary result = reduced GHG emissions from energy production Co-benefit = less air pollution + less respiratory distress

Source: Frumkin, et. al., AJPH March 08

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Public Health Response to Climate Change: Mitigation

Primary prevention = climate change mitigation Examples:
LA Citys Green LA: An action plan to lead the nation in reducing greenhouse gas emissions to 35% below 1990 levels by the year 2030 Los Angeles County Policy P-1050 - Purchase of Environmentally Preferable Products (Green Purchasing) Reduce energy usage Reduce, Reuse, Recycle Ride Share Program

Public Health Response to Climate Change: Mitigation

Primary prevention = climate change mitigation Examples:
Promote energy efficiency through changing regular lighting to more energy efficient lighting Encourage renewable energy power sources (solar energy and wind energy)

Public Health Response to Climate Change: Adaptation

Secondary/tertiary prevention = climate change adaptation Examples:

Efforts to prepare for and minimize health impacts of climate change Similar to public health preparedness for other uncertainties (e.g. pandemic flu, bioterrorist attack), so it is natural that PH sector is involved in adaptation efforts

Los Angeles County Public Healths Adaptation Approach

Actions

Monitoring

ADAPTATION

Communication

Los Angeles County Public Health: Actions

Actions

Monitoring

Enhance existing programs to meet new changes Enhance responses to emergencies Influence local planning and land use decisions

ADAPTATION

Communication

Los Angeles County Public Health: Monitoring

Increase monitoring and surveillance
Environmental Indicators
GHG, Pollen production
Actions

Monitoring

Health Outcome Indicators

Morbidity and Mortality Rates

ADAPTATION

Mitigation Indicators
Energy consumption, Renewable energy

Adaptation Indicators
Communication

Policy Indicators
Regulations, Participation of local governments

Los Angeles County Public Health: Communication

Actions

Monitoring

Inform the public on the effects and impacts of climate change through: Education & Training Public awareness campaigns

ADAPTATION

Communication

Notification system advisories & reports

Climate Change Demands an Integrated Response

Everyone will be affected by climate change We must educate ourselves, policy makers and the greater public Partnerships and collaboration is vital to reducing health impacts Public Health must:
increase understanding and research re health co-benefits ensure health co-benefits included in policy and cost assessments (e.g. HIAs) protect vulnerable populations (advocate for equity in mitigation and ensure equity in adaptation strategies) monitor health impacts of climate change

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