Public Health Institute developed a framework exploring the intersections between social determinants of health and the causes and consequences of climate change.

1. Climate Change, Health,
& Health Inequities
November 12, 2014
Linda Rudolph, MD, MPH
linda.rudolph@phi.org
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“Climate change is the defining health challenge of our time.”
Margaret Chan, World Health Organization
“Climate change threatens our fragile existence on this planet.”
Jim Kim, World Bank

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"Social injustice is killing people on a grand scale.”
WHO Commission on the Social Determinants of Health, 2008

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http://nca2014.globalchange.gov/report/sectors/human-health
http://ipcc-
wg2.gov/AR5/images/uploads/WGIIAR5
Chap11_FGDall.pdf
http://www.ipcc.ch/pdf/assessment-report/ar5/syr/SYR_AR5_SPM.pdf
www.energy.ca.gov/2012publications/CEC-500-2012-007/CEC-500-2012-007.pdf

6. Climate-Health Pathway
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Adapted from Patz et.al. 2000 EnvHlthPersp

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Greenhouse
Gas
Emissions

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Global Climate Impacts
Warming
Warming
Hydrologic
Variability
Ocean Acidification
Sea Level Rise
Glacier &
Snowpack Loss

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Local Climate Impacts
http://c-change.la/temperature/
More Heat

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Local Climate Impacts
Wildfires
Coastal Flooding
Drought
Decreased Snowpack

11. Environmental & Socioeconomic
Intermediate
Factors

12.  Extreme weather injuries, drownings, fatalities
 Heat-related illnesses and deaths
 Air pollution impacts – respiratory, cardiovascular
 Allergic disease
 Infectious disease
 Water and food-borne disease
 Vector-borne disease
 Food insecurity and malnutrition
 Water insecurity
 Displacement and migration
 Stress and mental health impacts 12
Climate Health Impacts

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Heat Illness
Leading weather-related cause of death
 U.S. 1979 – 2003 : 8,015 deaths
California (2006): 655 deaths
 Europe (2003): > 70,000 excess deaths
•Russia (2010): 55,000 excess deaths
•1 million acres burnt
•25% drop in crop yields

14. Higher Temperatures Worsen Air Pollution
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15. Drought and Health
 Water quantity
 Water quality
 Food insecurity
 Wildfire
 Vector-born disease
 Dust
 Infectious disease
 Sanitation
 Recreational risk
 Mental Health
 Job loss & poverty

16. “Climate Gap”
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Climate
Health
Inequities

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Other Environmental Impacts

18. Health Inequities Pathway
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Adapted from Bay Area Regional Health Inequities Initiative

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Living Conditions:
Physical, Social, Economic, Services Environments

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"Social injustice is killing people on a grand scale.”
WHO Commission on the Social Determinants of Health, 2008

22. “Climate Gap”
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Climate
Health
Inequities

23. Climate Change Vulnerability & Resilience
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24. Root Causes
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 Reduce
 Greenhouse gases
 Air pollution
 Noise
 Infrastructure costs
 Community severance
 Increase
 Physical activity
 Social capital
 Reductions
 Respiratory disease
 Cardiovascular disease
 Diabetes
 Depression
 Osteoporosis
 Cancer
 Stress
 Avoidable increases
 Bike/ped injuries
Systems: Active Transportation Co-Benefits

28. ITHIM Preliminary Projections of Health Impacts of Increased Bicycling and
Walking: 4 to 19 minutes of daily physical activity, SCAG Region
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Change in disease
burden
Change in premature
deaths/yr
Cardiovascular Dis.* 12% 3,134
Diabetes 12% 374
Depression 3% <2
Dementia 6% 465
Breast cancer 3% 60
Colon Cancer 3% 75
Road traffic crashes 22% 315
* Ischemic heart disease, stroke, hypertensive heart disease

29.  Reduce
 Greenhouse gases
 Air pollution
 Fuel poverty
 Asthma
 Respiratory disease
 CVD
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• Reduce
• Asthma
• Respiratory
disease
• CVD
• Adverse birth
outcomes
Systems:
Clean Energy/Energy Efficiency Co-Benefits

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 Reductions
 GHG emissions
 Pesticide use
 Synthetic fertilizer use
 Food miles
 Antibiotic use
 Water pollution
 Soil erosion
 Biodiversity loss
 Meat consumption
 Unsustainable H2O consumption
 Increases
 Access affordable healthy food
 Rural community strength
 Agricultural land preservation
 Reductions
 Obesity
 Cardiovascular disease
 Cancer (breast, prostate,
colorectal)
 Type II Diabetes
 Antibiotic resistance
 Pesticide illness
Systems:
Sustainable Local Food Systems Co-Benefits

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Heat Resilience Co-Benefits
 Urban greening
 Reduce heat illness risk
 Places to be active
 Healthy food access
 Reduce storm water
run-off & flooding risk
 Replenish groundwater
 Reduce crime
 Decrease energy
consumption
 Lower energy costs
 Reduce air pollution
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Co-Benefits of Urban Greening

32. Co-harms
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34. IPCC AR5 Synthesis
Report
The Choices We Make Will Create Different Outcomes
With substantial
mitigation
Without
additional
mitigation
Change in average surface temperature (1986–2005 to 2081–2100)
AR5 WGI SPM

35. Highest levels CO2 in at least 800,000 years
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36. IPCC AR5 Synthesis
Report
The window for action is rapidly closing
65% of our carbon budget compatible with a 2°C goal already used
Amount Used
1870-2011:
515
GtC
Amount
Remaining:
275
GtC
Total Carbon
Budget:
790
GtC
AR5 WGI SPM

37. The Choice is Ours
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38. Climate Change is
a Health Emergency.
Climate,
Health, and
Equity in
All
Policies

39. Opportunities for Action
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 Consider climate, health, and equity impacts of all legislation
 Support AB32: full implementation of cap-and-trade; strong 2030
targets
 Oppose expansion of fossil fuel extraction/production
 Support rapid acceleration/increased funding for active
transportation; include health/equity accounting in transportation
planning
 Strengthen building standards for climate resilience
 Urge public pension systems to divest from fossil fuels
 Mandate implementation of extreme heat guidance
 Regulate methane leakage in gas
extraction/production/transport
 Support green zones and just transition
 Create incentives for sustainable ag and peri-urban ag
 Make polluters pay e.g. carbon tax, nitrogen fertilizer tax
 Hold every agency and department accountable for CHE
 Be a leader. Talk to your constituents and colleagues

40. IPCC Key
Messages
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 Human influence on the
climate system is clear
 The more we disrupt our
climate, the more we risk
severe, pervasive and
irreversible impacts
 We have the means to
limit climate change and
build a more prosperous,
sustainable future
IPCC AR 5 Synthesis Report 2014
Linda’s Key
Messages
 Climate change is affecting our
health and well-being now.
 Climate change is a threat
multiplier, exacerbating
existing health challenges and
health inequities
 Low-income and communities
of color suffer a “climate gap”
 We can transform our systems
to create healthy, equitable,
sustainable communities

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