This document summarizes a presentation on global climate change and its health impacts. It discusses how climate change is increasing temperatures, altering precipitation patterns, and intensifying extreme weather events. These climatic changes threaten to undermine progress on health issues like infectious diseases, food security and malnutrition. However, addressing climate change also presents opportunities to improve health through policies like active transportation that reduce emissions and encourage physical activity.

1. Jonathan Patz, MD, MPH Nelson Institute & Dept. Population Health Sciences University of Wisconsin - Madison 16th World Congress on Disaster and Emergency Medicine Victoria, Vancouver, May 12, 2009 Global Climate Change, Energy & Health: Foreboding Clouds & Silver Linings

2. IPCC 2001scenarios to 2100 ---------------- 

3. FOR CLIMATE QUESTIONS, SEND STRAIGHT TO : WWW.IPCC.CH Natural vs Anthropogenic climate forcing IPCC, 2006 Why the climatologists working for IPCC now are “90% certain” that today’s warming is from human activities

4. Changes in sea ice extent September 1980: 7.8 million square kilometers Sept 1980 Alaska Siberia Greenland The Arctic sea ice cover Courtesy: Don Perovich

5. Changes in sea ice extent September 2007: 4.2 million square kilometers Sept 2007 Alaska Siberia Greenland Courtesy: Don Perovich

6. Changes in sea ice extent Reduction from 1980 to 2007 Huge decrease in ice extent Courtesy: Don Perovich

7. Understanding: predictions of ice extent Observationed decline is faster! Stroeve et al. 2007 Courtesy: Don Perovich

8. But the polar bear might not be the only threatened species “ How it threatens your health”

9. CLIMATE CHANGE Temperature Rise 1 Sea level Rise 2 Hydrologic Extremes Urban Heat Island Effect Air Pollution & Aeroallergens Vector-borne Diseases Water-borne Diseases Water resources & food supply Mental Health & Environmental Refugees Heat Stress Cardiorespiratory failure Respiratory diseases, e.g., COPD & Asthma Malaria Dengue Encephalitis Hantavirus Rift Valley Fever Cholera Cyclospora Cryptosporidiosis Campylobacter Leptospirosis Malnutrition Diarrhea Toxic Red Tides Forced Migration Overcrowding Infectious diseases Human Conflicts 1 3°C by yr. 2100 2 40 cm “ “ IPCC estimates Patz, 1998 HEALTH EFFECTS OF CLIMATE CHANGE

13. Comparing the 2003 Heatwave to past summer climate European heat wave of 2003, from Schär et al., 2004

14. Probabilities of future extremes can be estimated given projections of mean temperature Peterson et al., 2007 2057 2007

17. Sensitivity of cereal yield to climate change IPCC 2006

20. Relationship between temperature and malaria parasite development time inside mosquito (“extrinsic incubation period” or EIP). EIP shortens at higher temps, so mosquitoes infectious sooner.

21. Relationship between malaria and altitude, Zimbabwe. Altitude a good surrogate for temperature: the average temperature decrease with height = 6°C per 1000 meters Source: Taylor and Mutambu, 1986

22. Baseline 2000 2025 2050 2075 2100 Source: Ebi et al, 2005

23. Baseline 2000 2025 2050 2075 2100 Source: Ebi et al, 2005

24. Daily hospitalizations for diarrhoea, by daily temperature, Lima, Peru. (Shaded region corresponds to 1997-98 El Niño event) Checkley et al, Lancet 2000 (J. Patz PI) Daily hospitalisations for diarrhoea Daily temperature 1997 1993 Overall estimate from regression analysis: 7% increase in daily cases per 1 o C rise 5 o C +33% El Niño

25. Climate change: It’s not just about warming.

26. Floods

27. USA: Combined sewer overflows (CSOs) Courtesy: Kellogg Schwab 1.2 trillion gal of sewage & stormwater a year discharged during combined sewer overflows – would keep Niagara Falls roaring for 18 days Center for Water & Health, JHU Bloomberg School of Public Health

28. Extreme Precipitation and Waterborne Disease Outbreaks in the United States, 1948 -1994 Project Sponsor: US EPA, Office of Research & Development PI: J. Patz

30. Milwaukee 1993 Cryptosporidiosis epidemic 405,000 exposed 54 fatalities Preceded by heaviest rainfall in 50 years

32. U.S. CCSP, 2008 Globally Averaged

33. Projected Changes in Extremes Globally IPCC (2007)

34. CLIMATE & LAND USE SYNERGY Hurricanes Mitch & Katrina

35. ~ 9,600 people perished , widespread water- and vector-borne diseases followed, and nearly one million people were left homeless . Areas with extensive deforestation or degraded hillsides suffered the greatest morbidity and mortality and point to the importance of vegetation cover and as a buffer to severe floods, and the long-term prevention of injuries and fatalities

36. wetland loss in the Mississippi delta (1839 to 2020) Barataria-Terrebonne Estuary Program 1839 1870 1993 2020

37. New Orleans after Hurricane Katrina

38. How will climate change affect coastal populations? Estimated population impacted by sea level rise for selected counties, 2030 Dr. Annemarie Shneider (SAGE)

39. Ethics Climate Change and Health

42. Patz, Gibbs et al. 2007 Americans emit 6-times the global average CO 2 per capita Based on Smith et al. 2004. Distribution of 166,000 deaths/yr from recent warming. Based on McMichael et al 2004.

43. Key reason for banning smoking. Shouldn’t we consider climate change in the same way?

44. Patz, Gibbs et al. 2007

45. Millennium Development Goals (MDGs) 1- Eradicate extreme poverty and hunger 2- Achieve universal primary education 3- Promote gender equality and empower women 4- Reduce child mortality 5- Improve maternal health 6- Combat major diseases (HIV/AIDS, malaria, others) 7- Ensure environmental sustainability 8- Develop a global partnership for development Might climate change reverse progress on these priority fronts?

46. Source: National Geographic “ GROWING FUEL: The Wrong Way: The Right Way” October, 2007, National Geographic BIOFUELS: Where climate change, land use, energy, and health concerns come together … that is, the cure must not be worse than the disease!

48. The Good News about climate change and our health

49. Energy consumption per person and life expectancy Wilkinson et al, 2007

50. The opportunity for improving health determinants We can reduce: The 800,000 annual deaths from urban air pollution The loss of 1.9 million deaths, and 19 million years of healthy life, from physical inactivity WHO, 2007

52. Ten Leading Causes of US Deaths per Year (CDC, 2004)

53. Percentage of trips by transport mode for US work trips 1960-2000 TRENDS IN TRANSPORTATION: Reliance on our cars

54. 1/3 of US CO 2 emissions come from transportation sector Gurinder Osan/Associated Press US Dept. of Energy, 2005

60. The Heat Island

61. Heat early-warning systems save lives Figure 3: Summer daily heat-index measures, heat-related mortality, and heat-related emergency medical service (EMS) runs: Milwaukee, WI, 1995 and 1999 (Source: Weisskopf, Anderson, Foldy, Hanrahan et al. 2002).

64. Air Quality and Human Health If 20% of car trips in Madison replaced by bicycle trips… 12.21% ozone reduction & 2.07% PM 2.5 reduction 1,906 fewer asthma cases per yr 4,765 fewer missed days of school per yr 14,587 fewer cases of acute respiratory symptoms/yr Save over $40 million in costs from reduced exposure to ozone and particulate matter

65. Money Saved from Reduced Ozone Exposure Per Year - Madison $ 17,454,707 /year Total $ 15,910,536 / year Mortality $ 759,018 / year Acute Respiratory Symptoms $ 357,299 / year School Loss Days $ 179,901 / year Worker Productivity $ 147,498 / year Asthma Exacerbation $ 99,391 / year Hospital Admissions $ 1,064 / year Emergency Room Visits

67. Greenhouse Gas Mitigation If 20% of car trips in Madison replaced by bicycle trips… 33,374,395 lbs CO 2 saved (16,687 tons) 4.2% reduction in the total amount of carbon dioxide emissions in Madison

68. Urban planning is public health and disaster planning policy!

69. “ Be the change you wish to see in the world.” Gandhi

70. Thank you! [email_address] www. sage.wisc.edu

71. A cautionary note

72. All Eyes on Biofuels Number of Scientific Articles with keyword “ biofuels ” Matt Johnston, SAGE, UW-Madison

73. All Eyes on Biofuels… Biofuels Binaries: Not an simple black-or-white issue Matt Johnston, SAGE, UW-Madison

75. Diesel and fertilizer to produce corn for ethanol production results in more PM 2.5 than burning the equivalent amount of gasoline ! Hill et al. unpublished data Life Cycle Analysis shows need for Health Impact Assessment in Energy Policy

76. Billions of gallons of water consumed Source: IATP 2006 ethanol and water report Ecosystem impacts More corn ethanol = Less water Couresy: David Wallinga