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Climate Change & Healthcare 2023

  1. Climate Change & Its Effects on Healthcare: An Evidenced-based Overview Kimberley R. Barker, MLIS Librarian for Digital Life
  2. Note: This presentation (as with all other presentations created by Claude Moore Health Sciences librarians), is based on scientific fact. While I acknowledge that the concept of climate change and its effects on both the environment and people is debated, peer- reviewed work from credible sources overwhelmingly recognizes climate change, the role of humans in that change, and its effects on healthcare, as fact.
  3. Labor Acknowledgment We must acknowledge that the University of Virginia- its construction, growth, and development- was made possible through the coerced labor of enslaved Africans and African Americans. We are all indebted to their sacrifice. We recognize that the legacies of slavery are still present today and that racism continues to shape our laws, cultures, and institutions. - Terah ‘TJ’ Stewart, the Mid-America Arts Alliance, and Meggan Cashwell, Ph.D. - Photo credit: Sanjay Suchak
  4. Learning Objectives Learn to define climate change Learn about the most pressing issues Learn about the impact of climate change on health Learn about the strategies for managing climate change Learn about climate change indicators Learn about important events in the history of climate change study
  5. What is climate change? • “Climate change is a long-term change in the average weather patterns that have come to define Earth’s local, regional and global climates.”- NASA • “Climate change refers to significant changes in global temperature, precipitation, wind patterns and other measures of climate that occur over several decades or longer.”- UC-DAVIS
  6. Climate Attribution Science • a scientific process for establishing the principal causes or physical explanation for observed climate conditions and phenomena. • attribution requirements for a detected change are: • a demonstrated consistency with a combination of anthropogenic (aka “intentional, non- malicious behavior by humans that nonetheless harms the environment”) and natural external forcings • an inconsistency with "alternative, physically plausible explanations of recent climate change that exclude important elements of the given combination of forcings."
  7. A Brief History of Climate Change Events, 1 • Severe droughts precipitated the exodus of early humans from Africa • Climate observations date back to ancient Greece and Rome • Aristotle, Hippocrates, and Plato spoke about droughts and subsequent famine due to extreme weather events • Scientists theorize that abrupt climate change contributed to the fall of the Maya civilization
  8. A Brief History of Climate Change Events, 2 • The 1800s- beginnings of the Second Industrial Revolution • 1816- The Year Without a Summer • Famine: particulates from the explosion of Krakatoa blocked sunlight • Disease: Drought, then flooding, caused mutation in cholera bacteria in the Bay of Bengal; spread from Asia because none were resistant to the new strain • 1824- Joseph Fourier • Discovered the process whereby gases in the atmosphere trap the sun’s heat and coined the term “greenhouse gases” • 1860s- John Tyndall • Measured the capacity of water vapor and CO2 to trap infrared light • 1896- Nobel Prize winner Svante Arrhenius was the first to calculate human- driven contributions (through coal-burning) to the “greenhouse effect”, a term that he coined
  9. A Brief History of Climate Change Events, 3 • 1957- Roger Revelle (Scripps Institution of Oceanography) and Hans Suess (U.S. Geological Survey) discovered the chemical pathways of ocean CO2 uptake. Findings showed they had limited ability to absorb the CO2 released through burning fossil fuels. Refinement of their calculations hasn’t changed the basic conclusion. • 1965 President Johnson said publicly,"[t]his generation has altered the composition of the atmosphere on a global scale through ... a steady increase in carbon dioxide from the burning of fossil fuels." • In 1969 Senator Daniel Patrick Moynihan was warning of a dangerous sea-level rise of 10 feet or more. "Goodbye New York" he said. "Goodbye Washington.” • “Over a ten-year horizon, extreme weather and climate-change policy failures are seen as the gravest threats.” • from The Global Risks Report (World Economic Forum) 2019
  10. Climate Change Indicators • Glacier and sea ice melt • Increases sea level • Sea level • Causes change in precipitation • Affects the amount of groundwater and surface water • Causes flooding- threatens coastal communities and infrastructure • Determines which plants and animals can live in an area • Global temperature • Surface temperatures have risen at a rate of 0.15 every decade since 1901 • Rising sea temperatures • Oceans absorb more than 90% of heat trapped in atmosphere • Affects marine ecosystems, breeding, and migration of marine species. • Can lead to higher precipitation, tropical cyclones, and drought
  11. How do we know that climate change negatively impacts health? Research!
  12. The Cost of Climate Change • Human • WHO estimates an 250,000 additional deaths between 2030-2050 because of complications caused by climate change. • Currently, 150,000 deaths annually are caused by climate change. • Financial • By the year 2030 (according to the World Health Organization) the cost of direct damage to health is estimated to be between $2-4 billion/year
  13. How Climate Change Leads to Deaths - Directly • Extreme heat • Air pollution • Flooding • Storms
  14. How Climate Change Leads to Deaths • Indirectly • Undernutrition • Increasing evidence suggests that “rising carbon dioxide concentrations adversely affect the nutritional quality of major cereal crops, including lowering the levels of protein, a range of micronutrients, and B vitamins” and reduces the yields of vegetables and legumes, leading to increase of noncommunicable diseases
  15. How Climate Change Leads to Deaths • Indirectly • Poverty • Increased heat exposure leads to less labor productivity and crop failures • Without investment in climate-resilient development, 100 million people may be forced into extreme poverty (with its attendant health concerns) by 2030
  16. Pressing Climate Change Issues • Air quality/pollution • Heat/warming
  17. Air Pollution
  18. The EPA tracks air pollutants in two ways: • Air concentration • measuring pollutants in the ambient air at stations across the U.S. • Emissions of air pollutants • engineering estimates of the total tons of pollutants released into the air each year.
  19. Air Pollution: Six Major Pollutants PARTICLE POLLUTION GROUND-LEVEL OZONE CARBON MONOXIDE SULFUR OXIDES NITROGEN OXIDES LEAD Regulation (setting permissible levels) of the six is based on human health and environmental criteria.
  20. Air Pollution: Findings from Carnegie Mellon University • “Recent Increases in Air Pollution: Evidence and Implications for Mortality” • Between 2009-2016, average fine particulate matter decreased by 24.2% • Between 2016 and 2018, average fine particulate matter increased by 5.5% • Causes: • increases in economic activity • increases in wildfires • decreases in Clean Air Act enforcement actions • Costs of the increase • 9,700 additional premature deaths in 2018 • damages of $89 billion
  21. Air Pollution: Health Impacts • Respiratory illness and damage • Fecundity (DNA fragmentation in sperm; motility) • Inflammation • Cardiovascular disease • Impaired lung function • Allergies and asthma • Altered thyroid function • Malnutrition due to poor crop yield/ food insecurity • Cancer • Heart disease • Stroke
  22. Heat/Warming Temperatures
  23. “Temperature data showing rapid warming in the past few decades, the latest data going up to 2019. According to NASA data, 2016 was the warmest year since 1880, continuing a long-term trend of rising global temperatures. The 10 warmest years in the 140-year record all have occurred since 2005, with the six warmest years being the six most recent years. Credit: NASA/NOAA.” consensus/
  24. August 2018 was the 406th straight month during which global mean temperatures were above the long- term mean.
  25. Extreme weather events associated with heat/warming • Tornadoes* • Hurricanes* • Droughts* • Heatwaves* • Heavy rainstorms à flooding* • Wildfires* à Contribute to climate change through the release of massive amounts of carbon dioxide *event can cause loss of life, property, livelihood
  26. From NASA • “The planet's average surface temperature has risen about 2.05 degrees Fahrenheit (1.14 degrees Celsius) since the late 19th century, a change driven largely by increased carbon dioxide and other human-made emissions into the atmosphere.4 Most of the warming occurred in the past 40 years, with the six warmest years on record taking place since 2014. Not only was 2016 the warmest year on record, but eight months out of that year — from January through September, with the exception of June — were the warmest on record for those respective months. 5”
  27. Rising temps negatively impact crop yields • For every 1 degree Celsius that the Earth warms: • corn yields will drop an average of 7.4% • wheat yields will drop an average of 6% • rice yields will drop by 3.2% • soybean yields will drop by 3.1% “Temperature increase reduces global yields of major crops in four independent estimates”
  28. Rising temps cause drought, which is more bad news for crops. Earth’s temp rises; water cycle speeds up due to increased evaporation. Evaporation puts more water in air; increases precipitation increases storms and flooding, but increases drought in areas away from storm paths Drought impacts crops through slowed growth, decrease of vitamins and nutrients in the plants Decreased vitamins and nutrients leads to poor nutrition for affected populations
  29. Rising temps mean lost productivity • “… in the southern US, businesses lost up to 20 percent of their potential daylight work hours in 2018’s hottest month. The drop in productivity translates directly into economic losses: Across the world in 2018, 133.6 billion potential work hours were lost due to heat.” is-killing-us/
  30. From the State of Climate Services 2020 Report, from the World Meteorological Organization
  31. Health problems related to increased heat/warming • Mental health • According to the CDC, there is a direct correlation between extreme heat and suicide completion • Drought/lack of green space negatively impacts human mental health • According to the EPA, more than 9,000 Americans have died of heat-related illnesses since 1979 • Increased illnesses, including: • Lyme disease • West Nile virus • Ragweed pollen allergies
  32. From “Global Risk of Deadly Heat”, 2017 • “Based on the climatic conditions of those lethal heat events, we identified a global threshold beyond which daily mean surface air temperature and relative humidity become deadly. Around 30% of the world’s population is currently exposed to climatic conditions exceeding this deadly threshold for at least 20 days a year. By 2100, this percentage is projected to increase to ∼48% under a scenario with drastic reductions of greenhouse gas emissions and ∼74% under a scenario of growing emissions. An increasing threat to human life from excess heat now seems almost inevitable, but will be greatly aggravated if greenhouse gases are not considerably reduced.”
  33. Plastics • In 2017, China stopped buying U.S. recycling • Because the U.S. has no real organized recycling program, recycling ended for the most part • Used plastics are baled and stored (where they leak into ground water) or are burned (releasing toxins into the air) • Chemicals in plastic have been linked to metabolic disorders (including obesity) and reduced fertility. • Every human on Earth is ingesting nearly 2,000 particles of plastic a week; “dosing us with five grams of plastics, many cut with chemicals linked to cancers, hormone disruption, and developmental delays.” • “Planet Plastic”- problem-recycling-myth-big-oil-950957/
  34. Climate Change & Healthcare Impacts to Health & Healthcare Facilities
  35. How is climate change affecting health/healthcare? • Increases in: • Heat-related illnesses • Infections • Asthma • Mental health disorders • Poor perinatal outcomes • Adverse experiences from trauma and displacement • Infectious diseases • Disaster-related disease, injury, and death
  36. Negative Environmental Effects caused by Healthcare Facilities • Emission of greenhouse gases • Poor management of waste (biological, chemical, radiological) • “Our health care facilities are part of the problem in terms of the carbon emissions that we create that actually does harm to the patients that we hope to serve…The health care industry is faced with this transition to producing less carbon, less greenhouse gas emissions in the care we provide, and I think physicians have an important voice in that discussion as well.” – Dr. Rebecca Philipsborn
  37. The Impact of Climate Change on Healthcare Facilities • Facilities must be built in such a way that they’re able to withstand the climate change stressors that are specific to their region • Sustainable energy source • Waste disposal • Architecture appropriate to events in the areas in which they’re located (flooding, wildfires, etc)
  38. Fundamental Requirements for Providing Safe & Quality Care in the Context of Climate Change (according to the World Health Organization) • Health workforce • Adequate number of trained humans empowered and informed • Water, sanitation, hygiene, and health care waste management • Safe management of healthcare waste; sanitation • Energy • Sustainable services • Infrastructure, technologies and products • Appropriate infrastructure, technologies, products
  39. Health Care Without Harm • “,forging a path for the health sector to close in on zero emissions by 2050 through a series of climate solutions that can protect public health from climate change while accelerating the transition to a low emission, resilient economy. These solutions must also address the need to increase social equity and access to health care.
  40. Two Responses to Climate Change • Adaptation- attempts to manage the impacts of climate change • Mitigation- attempts to reduce the causes of climate change
  41. Adaptation Strategies for Air, Water, Land • Smart growth communities • Smart building • Reduce emissions • Maintain/restore wetlands • Shoreline maintenance • Preserve/improve water quality • Habitat preservation • Contaminated site management • Groundwater remediation
  42. Adaptation Strategies for Public Health (EPA) • Extreme heat • Raise awareness • Offer incentives for reducing heat islands • Establish urban forestry programs • Retrofit public buildings • Add heat mitigation into policy, planning, design, and building standards and codes • Water quality • Understand (and plan for) seasonal and geographic waterborne illness risks • Assess vulnerabilities • Air quality • Understand health impacts of events such as wildfires
  43. Source: CDC
  44. Mitigation Strategies • Reduction of energy consumption • Reduction of agricultural emissions • Alternatives to fossil fuel • Geoengineering • Management • Global • Local • Personal
  45. Calgary Canada Climate Program
  46. How can Healthcare Professionals Respond to Climate Change? Education, Practice, Combating Mis/Disinformation
  47. Education in medical and nursing schools • Adopt educational frameworks such as the one proposed by Phillipsborn, et, al., which is predicated on three questions: • What are the harms to health from climate change? • How does climate change require adaptations in our clinical practice? • And how does climate change disrupt health care delivery?” - “Climate Change and the Practice of Medicine”, Academic Medicine: September 8, 2020. e_.97003.aspx
  48. Practice • Prepare for interruptions to healthcare due to climate-related disasters • Service interruptions • Supply chain interruptions • Educate patients about what climate change means • Talk with patients about the risks that climate change pose in the environment in which they live • Health risks • Natural disaster preparedness
  49. Mis/Disinformation • The Climate Deception Dossiers • 85 internal memos leaked from the fossil fuel industry • Forged letters to Congress • Fake grassroots organizations • Secret funding of research by a supposedly independent scientist • Efforts to create uncertainty about climate science • Industry has known about climate change since at least the 1970s • 1995- internal memo written by a team headed by a Mobil Corporation scientist distributed to many fossil fuel companies. • report warned unequivocally that burning the companies' products was causing climate change and that the relevant science "is well established and cannot be denied.” • Created misinformation campaigns to fool the public about the effect of fossils fuels on climate change
  50. Mis/Disinformation • Plastics manufacturers have known since the 1970s that plastics couldn’t be recycled, but spent millions of dollars promoting it to the public • Since 1950, 6.3 trillion kilo of plastic waste has been produced and not recycled even once • Every human on Earth is ingesting nearly 2,000 particles of plastic a week; “dosing us with five grams of plastics, many cut with chemicals linked to cancers, hormone disruption, and developmental delays.” • “Planet Plastic”- problem-recycling-myth-big-oil-950957/
  51. Mis/Disinformation • American Chemistry Council- trade group that represents plastic resins-producing oil and petrochemical companies. • 2016, “the ACC commissioned a study by the consultancy Trucost — ‘the world’s leading experts in quantifying and valuing the environmental impacts’ from industry. The ACC paid for the study to demonstrate that plastics are not easily replaceable, and that many common substitutes — particularly glass — carry higher environmental costs when factoring in weight for transportation. The Trucost finding that the ACC does not trumpet? ‘The environmental cost to society of consumer plastic products and packaging was over $139 billion in 2015,’ the report reveals. Without a dramatic change in course, Trucost predicts, that annual figure will soar to ‘$209 billion by 2025.’” • “Planet Plastic”- features/plastic-problem-recycling-myth-big-oil-950957/
  52. Thank you! Both this slide deck and a recording of the class will be made available to you.
  53. RESOURCES • Mount Tambora and the Year Without a Summer- • 300-Year Drought Was Downfall of Ancient Greece- collapse.html • 5 droughts that changed human history- droughts-that-changed-human-history/ • Drought and the Ancient Maya Civilization- climate-change/Drought%20and%20the%20Ancient%20Maya%20Civilization • WHO publishes guidance on climate resilient and environmentally sustainable health care facilities- climate-resilient-and-environmentally-sustainable-health-care-facilities • The 2019 report of The Lancet Countdown on health and climate change: ensuring that the health of a child born today is not defined by a changing climate-
  54. RESOURCES • Overview: Weather, Global Warming and Climate Change • • Science and Climate • • Climate Change • • Global Climate: How Do We Know? • What is attribution? •
  55. RESOURCES • Global Climate Change and Health: Challenges for Future Practitioners • • Climate Change and Health JAMA Network Open Call for Papers • • The Forgotten History Of Climate-Change Science- climate-change-science • Climate Change Adaptation Resource Center (ARC-X)- x/strategies-climate-change-adaptation • Tools for Climate Change Adaptation- change-adaptation • Hurricane ‘Price Tags’ Could Reveal the Cost of Global Warming- warming/
  56. RESOURCES • Maya I. Ragavan, Lucy E. Marcil and Arvin Garg. Climate Change as a Social Determinant of Health Pediatrics May 2020, 145 (5) e20193169; DOI: • Remigio RV, Jiang C, Raimann J, Kotanko P, Usvyat L, Maddux FW, Kinney P, Sapkota A. Association of Extreme Heat Events With Hospital Admission or Mortality Among Patients With End-Stage Renal Disease. JAMA Netw Open. 2019 Aug 2;2(8):e198904. doi: 10.1001/jamanetworkopen.2019.8904. PMID: 31397862; PMCID: PMC6692691. • Herrmann A, Sauerborn R. General Practitioners’ Perceptions of Heat Health Impacts on the Elderly in the Face of Climate Change—A Qualitative Study in Baden- Württemberg, Germany. Int J Environ Res Public Health 2018;15:843–3. • East African megadroughts between 135 and 75 thousand years ago and bearing on early-modern human origins- • Neumann, J. Climatic change as a topic in the classical Greek and Roman literature. Climatic Change 7, 441–454 (1985).
  57. RESOURCES • Climate and Health- Mental Health and Stress-Related Disorders. • How does climate change affect human health? • South EC, Hohl BC, Kondo MC, MacDonald JM, Branas CC. Effect of Greening Vacant Land on Mental Health of Community-Dwelling Adults: A Cluster Randomized Trial. JAMA Netw Open. 2018;1(3):e180298. doi:10.1001/jamanetworkopen.2018.0298 • Calgary Canada Climate Program - Change.aspx?redirect=/climateprogram • Mora, C., Dousset, B., Caldwell, I. et al. Global risk of deadly heat. Nature Clim Change 7, 501–506 (2017).
  58. RESOURCES • The Global Risks Report 2019- risks-report-2019 • Intergovernmental Panel on Climate Change- • Climate Time Machine- machine • AR5 Synthesis Report- IPCC, 2014: Climate Change 2014: Synthesis Report. Contribution of Working Groups I, II and III to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change [Core Writing Team, R.K. Pachauri and L.A. Meyer (eds.)]. IPCC, Geneva, Switzerland, 151 pp. • Topic 1: Observed Changes and their Causes; 1.6 Human Responses to Climate Change (p. 54) pdf
  59. RESOURCES • Sperm DNA fragmentation: An early and reliable marker of air pollution- • Ambient air pollution and male fecundity: A retrospective analysis of longitudinal data from a Chinese human sperm bank (2013–2018)-Environmental Research Volume 186, July 2020, 109528- • Ghorani-Azam A, Riahi-Zanjani B, Balali-Mood M. Effects of air pollution on human health and practical measures for prevention in Iran. J Res Med Sci. 2016;21:65. Published 2016 Sep 1. doi:10.4103/1735-1995.189646- • IPCC Fifth Assessment Report, Summary for Policymakers • B.D. Santer, “A search for human influences on the thermal structure of the atmosphere,” Nature vol 382, 4 July 1996, 39-46
  60. RESOURCES • Implications for the science of air pollution and health. Anderson, H Ross. The Lancet Respiratory Medicine, Volume 5, Issue 12, 916 – 918. DOI: 2600(17)30396-X • Temperature increase reduces global yields of major crops in four independent estimates • The Imperative for Climate Action to Protect Health. Andy Haines, M.D., and Kristie Ebi, M.P.H., Ph.D. January 17, 2019 N Engl J Med 2019; 380:263-273 DOI: 10.1056/NEJMra1807873 • Climate Change Is Transforming the World's Food Supply. Sara G. Miller. February 16, 2017. • Book chapter: Global Climate Change.
  61. RESOURCES • State of Climate Services 2020 Report- mandate/climate/state-of-climate-services-report . World Meteorological Organization • Climate Change Indicators: Drought- change-indicators-drought • Climate Change Indicators: Health and Society- indicators/health-society • Recent Increases in Air Pollution: Evidence and Implications for Mortality- • Doctors Push For Health Care To Address Climate Change In New Teaching Framework
  62. RESOURCES • Philipsborn, Rebecca Pass MD, MPA; Sheffield, Perry MD, MPH; White, Andrew MD; Osta, Amanda MD; Anderson, Marsha S. MD; Bernstein, Aaron MD, MPH. Climate Change and the Practice of Medicine, Academic Medicine: September 8, 2020 - Volume Publish Ahead of Print - Issue - doi: 10.1097/ACM.0000000000003719 - nd_the_Practice_of_Medicine_.97003.aspx • Rocklöv, Joacim & Tozan, Yesim. (2019). Climate change and the rising infectiousness of dengue. Emerging Topics in Life Sciences. 3. ETLS20180123. 10.1042/ETLS20180123. e_rising_infectiousness_of_dengue • How the Climate Crisis Is Killing Us, in 9 Alarming Charts-
  63. RESOURCES • Climate Disinformation- • The Climate Deception Dossiers: Internal Fossil Fuel Industry Memos Reveal Decades of Corporate Disinformation- • A Long Record of Lies on Climate Change- podcast from the Union of Concerned Scientists, April 217, 2021- • 10 MYTHS ABOUT CLIMATE CHANGE- climate-change • https://climate.Nasa.Gov/evidence/- NASA GLOBAL CLIMATE CHANGE- VITAL SIGNS OF THE PLANET • WASTE ONLY: How the Plastics Industry Is Fighting to Keep Polluting the World
  64. Resources • “We’re Setting the Record Straight on 9 Climate Change Myths”- Global Citizen- • 10 Climate Change Lies, and How to Catch Them- • How Big Oil Misled The Public Into Believing Plastic Would Be Recycled- would-be-recycled • “Planet Plastic: How Big Oil and Big Soda kept a global environmental calamity a secret for decades”- big-oil-950957/ • “Revealed: plastic ingestion by people could be equating to a credit card a week”- equating-to-a-credit-card-a-week • “Is plastic a threat to your health?”- threat-to-your-health
  65. OTHER RESOURCES: • NCEI tools for tracking extreme events- https://www.Ncdc.Noaa.Gov/climate- information/extreme-events • Top climate experts to follow on Twitter- https://www.Climaterealityproject.Org/blog/top-climate-experts-follow-twitter • The 2018 report of the Lancet countdown on health and climate change: shaping the health of nations for centuries to come. Https://www.Thelancet.Com/journals/lancet/article/PIIS0140-6736(18)32594-7/fulltext • An Interactive Online Course in Climate and Climate Change: Advancing Climate Literacy for Non–Atmospheric Science Majors- 0271.1 • AGMIP- • Feeling discouraged? Google “solar punk” for some inspiring artwork & ideas about how we can reverse course on climate change.
  66. Questions? Please reach out: