Protecting our Health from Professionals Climate Change: a Training Course for Public Health

1
Protecting our Health from Professionals Climate
Change a Training Course for Public Health

• Chapter 15 What Makes Individuals and
  Populations Vulnerable to the Effects of Climate
  Change on Health?

2
Overview This Module

• Defines terms
• Discusses the causes of vulnerability to disease
  and injury resulting from climate change
• Describes current and past examples of
  vulnerability to effects of heat, famine and
  storms
• Points to opportunities to reduce vulnerability
  and improve population health

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Definition of Vulnerability

• The degree to which a system is susceptible to,
  and unable to cope with, adverse effects of
  climate change
• Intergovernmental Panel on Climate Change,
  Fourth Assessment Report 2007
• (IPCC AR4, 2007)

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Definition of Vulnerability (cont.)
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Determinants of Vulnerability

• Character, magnitude, and rate of climate change
• Sensitivity to climate change
• Coping capacity (adaptation)

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Example of Vulnerability to Climate Change
Coral Reefs

• Reasons

• Exposed to rapid ocean warming
• Sensitive to small increases in temperature
• Limited adaptive capacity

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Determinants of Health Vulnerability to Climate
Change

• Biological
• Physical
• Geographical
• Social
• Economical
• Political

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Heat wave Europe

• Heat index, Summer 2003

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Heat-Related Deaths Who Was at Greatest Risk?
(England and Wales, 19932003)

• Older people age factor
• Women gender factor
• People living in London geographical factor
  Those in nursing and care homes social and
  political factor

Hajat et al., 2007
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Adaptation Heat Wave in France 2006
Fouillet et al., 2008
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Effects of 2006 Heat Wave in France

• 2,065 excess deaths (July 1128)
• Number expected based on the rates seen during
  the 2003 heat wave 6,452
• Possible explanations
• Model imperfections (over-estimate of expected
  deaths)
• Reduced vulnerability (e.g., heat warning system,
  better informed public, more responsive health
  services)

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Climate Change and Pacific Ocean Sea Level Rise
Sea level rise 2843 cm Increase in tropical
storm intensity likely
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Vulnerability of Pacific Islands to Sea Level Rise
Woodward et al., 1998
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Typhoon Impacts by Classification a Preparedness
Evaluation
Loss of life due to typhoons is decreasing owing
to better preparedness (Fukuma,1993)
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Cartogram Greenhouse Gas Emissions in 2002
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Cartogram Climate Change Health Impacts
Note Uses only data on deaths from malaria and
dengue fever, diarrhoea, malnutrition, drowning
(and heatstroke for OECD countries)
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Vulnerability to the Future Effects of Climate
Change

• The rich will find their world to be more
  expensive, inconvenient, uncomfortable, disrupted
  and colorless in general, more unpleasant and
  unpredictable, perhaps greatly so. The poor will
  die.
• Kirk R. Smith, 2008
• Professor Environmental Health Sciences
• University of California, Berkeley

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Hurricane Katrina Crossing the Gulf of Mexico
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Diminishing Number of Death Due to Hurricanes
Striking Cuba, 19982002
Oxfam America, 2004
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Foundation of Low Storm Mortality in Cuba

• Tangible preparedness assets stockpiles, plans,
  equipment, early warning systems
• Infrastructure high levels of literacy, rural
  development, access to reliable health care
• Social capital engagement of local communities,
  high levels of participation, commitment to
  reconstruction and recovery

Oxfam America, 2004
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Vulnerability and Climate Variability The Case
of India 18761878
The more one hears about this famine, the more
one feels that such a hideous record of human
suffering and destruction the world has never
seen before. Florence Nightingale, 1877
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Effect of El Niño on Rainfall

• JuneAugust
• 40 years of data to 2000
• Red dots drier than usual during El Niño
• Blue dots more rainfall
• Size of circle size of effect

KNMI, 2009
El Niño events associated with weakening
easterlies, warming of the western Pacific, and
shift in rainfall patterns
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The 1877 El Niño Was Not Particularly Severe
Davis, 2000
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But it Resulted in Intense Famine
Davis, 2000
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Famine in Relation to Food Production, India
18751878
Mid-1876 monsoon fails, drought begins in SW
India
Late 1876 price of food rises steeply,
migrations begin
Mid-1877 famine deaths begin total between 6
and 10 million
1877 record grain exports to UK
No. Deaths
Davis, 2000
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Central India 18601890 Wheat Boom Made Mass
Hunger More Likely

• Aggressive promotion of wheat (for export)
  instead of millet and gram (for local
  consumption)
• Production subsidised by destructive soil mining
  and high levels of household debt
• Community-controlled reserves replaced by remote
  stockpiles with no moral or regulatory restraint
  on speculation
• Neglect of public works (irrigation especially)

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Pacific Does Modern Agriculture Reduce
Vulnerability to Climate Variability?

• Traditional Agriculture

• Modern Agriculture

• Crop diversity
• Drought-resistant staples (e.g., taro, yam)
• Robust methods of food preservation
• Strong social networks
• Inter-island trade systems

• Cash cropping
• Reliance on imported staples (e.g., rice)
• Unreliable methods of food preservation (e.g.,
  refrigerators)
• Attenuated social networks
• Trade systems global, not local

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Conclusions

• Vulnerability susceptibility to adverse effects
  inability to adapt
• Causes of vulnerability include biological
  characteristics, the physical environment, social
  circumstances, and national and international
  politics
• Opportunities to reduce vulnerability cover a
  correspondingly wide range
• Reducing vulnerability to damage resulting from
  climate change will bring other substantial
  benefits, earlier