Climate Change and Health; impact and adaption issues

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Climate Change and Healthimpact and adaption
issues

• Professor Philippa Howden-Chapman
• Dr Simon Hales
• Dr Nick Wilson
• He Kainga Oranga/ Housing and Health Research
  Programme
• NZ Centre for Sustainable Cities
• University of Otago, Wellington

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Adaptation

• Adaptation is the adjustment in natural or human
  systems in response to actual or expected climate
  changes and their effects
• For social systems, adaptive capacity, resilience
  and vulnerability all matter
• Projections come from past observation, observed
  interventions and modelling
• Precautionary action essential equitable

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Outline

• Potential health effects 2C scenario
• Local effects of heat, air pollution
• Altered infectious disease distribution (IPCC)
• Potential health effects 4C scenario
• Increase in above effects
• Likely major impact of global (incl. Pacific)
  social disruption
• Adaptation measures (both scenarios)
• Housing, infrastructure (e.g. energy, water)
• Adaptation measures (high carbon scenario)
• Lifeboat NZ

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Estimated health impacts of low-carbon scenarios
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Heat-related diseases

• In Auckland and Christchurch, a small number of
  heat-related deaths occur annually in people aged
  over 65 and will increase (McMichael et al.,
  2003).
• Current 1600 excess winter deaths likely to
  decline
• N.B. European heat-waves in 2003 killed 70,000
  people epidemiological models did not predict
  this scale of mortality

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Health effects of increasing temperatures

• Warmer temperatures and increased rainfall
  variability are likely to increase the intensity
  and frequency of food-borne and water-borne
  diseases.
• Higher than average temperatures lead to 30 of
  reported European cases of salmonellosis. In UK,
  monthly incidence of food poisoning most strongly
  associated with the temperatures occurring in the
  previous two to five weeks.

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Health effects of increasing temperatures

• Deaths in forest fires
• Impacts on aero-allergens and photochemical smog
  in cities uncertain. Increase in bushfires and
  smoke would increase hospital admissions for
  cardio-respiratory conditions.

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Infectious disease

• Warmer temperatures and increased rainfall
  variability are likely to increase food-borne and
  water-borne diseases.
• Infectious agents (protozoa, bacteria and
  viruses) and vector organisms (mosquitoes, ticks
  and sand-flies) no thermostatic mechanisms, so
  reproduction and survival rates are strongly
  affected by fluctuations in temperature.

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Water quality

• Increasing irregularity of supply
• Social gradient in water quality in New Zealand
• Water metering and charging could further
  increase inequalities and infectious diseases
• Households need right to minimum amount of water
  at no charge -- important for cleanliness and
  contagion control

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Rise of respiratory diseases

• Rise of tuberculosis globally and nationally
• Crowding from population movement increases
  transmission of TB

Baker M, Das D, Venugopal K, Howden-Chapman P.
Tuberculosis associated with household crowding
in a developed country. Journal of Epidemiology
Community Health 200800018doi10.1136/jech.200
7.063610.
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Rise of infectious diseases

• Parts of the North Island likely to become
  suitable for breeding of the mosquitoes that are
  major dengue vector
• Much of NZ becomes receptive to other
  less-efficient vector species
• The risk of dengue in NZ likely to remain below
  the threshold for local transmission beyond 2050,
  under both scenarios.

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Vulnerability

• People living in remote communities are likely to
  be at increased risk due to their particular
  living conditions and poor access to services.
• Relationship between drought, suicide and severe
  mental health impacts in rural communities

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Not all have equal opportunity

• Vulnerable populations have
• Low income and little wealth
• Less educated
• The very young and old
• Sole parents with children
• Those with chronic illnesses and disabilities
• Those living in socio-economically disadvantaged,
  residentially segregated areas
• Those who suffer racial discrimination

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• Vulnerable are risk averse
• Those with economic power are risk-takers
• Poor bear consequences
• (Paul Slovic)

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Drowning

• Number of people at risk from flooding by coastal
  storm surges projected to increase
• Currently 75 million people at risk
• Projected 200 million in mid-range climate
  scenarios (40cm rise in sea level by 2080s)

• Patz JA, Campbell-Lendrum D, Holloway T, Foley
  JA. Impact of regional climate change on human
  health. Nature 2005Vol 438doi10.1038/nature0418
  8.

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Extreme climate eventsHurricane Katrina

• Structural factors affected poor black people
  most
• Levees poorly maintained
• Residentially segregated to low lying areas
• Little public transport
• Corruption, no functional emergency plan
• Poor policy implementation

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Adaptation to 2C
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Adaption at different societal levels

• Structural changes - shifting whole towns
• Food production
• Population movements - refugees
• Urban design
• Housing
• Regulation of markets in energy water-
• equity as well as efficiency

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Adaptive capacity differs

• Capability and functioning both important
• Wealth, income, social and cultural capital
  increase ability to adapt
• Adaptive responses should not increase
• health inequalities
• Social gradients in health vs tipping point

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Structural changes

• Location of settlements (in relation to
  availability of secure water supplies, sea level
  rise and extreme events)
• Infrastructure (water, electricity, transport,
  communications) and ability to withstand climate
  extremes
• Such as floods

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Experts called in to help solve Kaeo's flooding
dilemma 500AM Tuesday Jul 17, 2007By Tony
Gee                                    Enginee
rs and technical experts will be called to
flood-hit Kaeo in about two weeks to identify
long-term options aimed at reducing the constant
risk of flooding in the small Far North
town. Kaeo copped 273mm of rain in 12 hours last
Tuesday, adding fresh recovery woes to those
almost overcome since the deluge that swept
through the area on March 29. The future of the
flood-prone town and others like it was raised
last week by Prime Minister Helen Clark, who
suggested it might be time to consider whether
such centres should be relocated.
More rain yesterday flooded some bridges in the
North, stranding Kerikeri pilot Gary Hansen at
Wellsford. Photo / Greg Bowker The big storm -
North Island 2007 July month of weather extremes
and contrasts Tower says July weather claims
2.7m over budget
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Urban Form

• 85 of New Zealander live in cities
• Urban sprawl increases carbon emissions
• Heat islands increase surrounding temperatures
  2C, 5-11C warmer than surrounding rural areas
• People in suburbs and exurbs have longer commutes
  less exercise, more obesity

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Urban form adaptations

• Need intensification of inner-city housing
• Unless work, housing and amenities are close
  together people will use their cars
• Public transport should be dominant mode of
  transport
• Government 2009 Policy Statement on Land
  Transport 10.7 billion over next 10 years for
  State highways - 0.6 billion for public transport

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Adaptation to heat-waves

• Reduction of urban heat island effects
• Passive cooling of buildings
• Close monitoring through social networks
  important to prevent deaths in extreme weather
• Lack of trust can keep people locked in
  over-heated rooms

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Other examples of adaptation policy in housing a
strong case for

• greater provision of extended family housing for
  families in chain migration
• increases in social and health service
• higher proportion of social housing in all
  regions (presently only 5)
• ethnically integrated suburbs -strength of weak
  ties
• Household right to minimum amount of water
  important for cleanliness and contagion control
• Greater use of grey water and rain water in
  cities (with appropriate safeguards against
  mosquito breeding)

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Likely (NZ) health impacts in a high carbon world?
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• Health impacts would intensify
• However, not appropriate to simply extrapolate
  existing quantitative models of health impact
• Effects of global social dislocation likely to
  predominate (major indirect effect on NZ via
  migration)

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Vince (2009) in New Scientist a high carbon
world
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Adaptation to a high carbon world

• National adaptation measures likely to be
  increasingly ineffective (especially in poor
  countries)
• Challenge to optimise global land use
  (Schellnhuber, 2009)
• (Mitigation Adaptation Development)

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Mind Game - Optimizing Allocation of Agricultural
Sites
1995 share of agriculture
(Müller et al. 2006)
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Mind Game - Optimizing Allocation of Agricultural
Sites
Globally optimized production scheme (pop. of 12
billion, diet of 1995)
(Müller et al. 2006)
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Global solutions

• In exchange for protection of critical
  biodiversity in the poor South
• the rich North provides food security, and a
  guarantee of migration rights

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Population movementsNZ as lifeboat

• Worsening of extremes floods, droughts, storms,
  fires
• Sea level rise (esp Pacific islands, low lying
  deltas)
• Reduced food security (esp Africa, Asia)
• Global solutions needed?

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Co-benefits of NZ shifting to a low-carbon society

• WIN/WIN policies
• More energy efficient housing benefiting health
  education reducing energy costs
• Better support for active transport (cycling,
  walking) will improve health (heart health, lower
  cancer risks etc)
• Cleaner non-carbon energy sources will reduce air
  pollution
• Improved urban design will have benefits for
  social capital, mental health
• Lower carbon diets (less meat) will reduce risks
  of heart disease and cancer

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Conclusions

• Health effects of climate change should be an
  important driver of adaptation policy
• Predominant health effects through extreme
  weather events infectious diseases
• Adaptation possible in urban form and housing
• Building linking social capital important
• Co-benefits of moving to low-carbon economy
• Possibility of positive contribution to GDP

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Conclusions

• High carbon scenario likely to involve major
  global social disruption.
• Cant extrapolate health impacts in a simple
  linear fashion
• Need global optimisation of land use, exchange of
  migration rights and food security in return for
  protection of terrestrial commons?

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References

• Hales S, Black W, Skelly C, Salmond C, Weinstein
  P. Social deprivation and the public health risks
  of community drinking water supplies in New
  Zealand. Journal of Epidemiology and Community
  Health 200357581-583.
• Hales S, Woodward A. Potential health impacts and
  policy responses. In Chapman R, Boston J,
  Schwass M, editors. Confronting Climate Change
  Critical issues for New Zealand. Wellington
  Victoria University Press, 2006117-123.
• Hales S, Howden-Chapman P, Baker M, Menne B,
  Woodruff R, Woodward A. Implications of global
  climate change for housing, human settlements and
  public health. Review of Environmental Health
  200722(4)295-302.
• Hennessy, K., B. Fitzharris, B.C. Bates, N.
  Harvey, S.M. Howden, L. Hughes, J. Salinger and
  R. Warrick, 2007 Australia and New Zealand.
  Climate Change 2007 Impacts, Adaptation and
  Vulnerability. Contribution of Working Group II
  to the Fourth Assessment Report of the
  Intergovernmental Panel on Climate Change, M.L.
  Parry, O.F. Canziani, J.P. Palutikof, P.J. van
  der Linden and C.E. Hanson, Eds., Cambridge
  University Press, Cambridge, UK, 507-540.
• Schellnhuber (Copenhagen talk) http//climatecongr
  ess.ku.dk/presentations/webcasts/