Kimberley R. Barker, MLIS, presents an introduction to the topic of climate change with a particular emphasis on health and healthcare.

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. 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

4. 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

5. 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 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."

6. 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

7. 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

8. 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 2019

9. 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

10. How do we
know that
climate
change
negatively
impacts
health?
(research)

11. 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

12. How Climate Change Leads to Deaths
• Direct
• Extreme heat
• Air pollution
• Flooding
• Storms
• Indirect
• 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
• Poverty
• Without investment in climate-resilient development, 100 million people may be
forced into extreme poverty (with its attendant health concerns) by 2030
• Increased heat exposure leads to less labor productivity and crop failures

13. Pressing
Climate
Change
Issues
• Air quality/pollution
• Heat/warming

14. Air Pollution

15. 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.

16. 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.

17. 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

18. 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

19. Heat/Warming Temperatures

20. “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.” https://climate.nasa.gov/scientific-
consensus/

21. August 2018 was the 406th straight month
during which global mean temperatures
were above the long-term mean.

22. 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

23. 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”
https://climate.nasa.gov/evidence/

24. 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”

25. 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

26. 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.”
https://www.wired.com/story/how-the-
climate-crisis-is-killing-us/

27. From the State of Climate Services 2020 Report, from the World Meteorological Organization

28. 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

29. 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.”

30. Climate Change
& Healthcare
Impacts to Health
&
Healthcare Facilities

31. Negative Environmental Effects of
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

32. 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
(flooding, wildfires, etc)
https://www.who.int/publications/i/item/climate-resilient-and-environmentally-sustainable-health-care-facilities

33. 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

34. 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

35. Responses to
Climate Change
Adaptation- attempts to manage
the impacts of climate change
Mitigation- attempts to reduce
the causes of climate change

36. 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

37. 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

38. Source: CDC

39. Mitigation Strategies
• Reduction of energy consumption
• Reduction of agricultural emissions
• Alternatives to fossil fuel
• Geoengineering
• Management
• Global
• Local
• Personal

40. Calgary
Canada
Climate
Program

41. How can Healthcare
Professionals Respond to
Climate Change?
Education & Practice

42. 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.
https://journals.lww.com/academicmedicine/Abstract/9000/Climate_Change_and_the_Practice_of_Medicine_.97003.aspx

43. Practice
• Prepare for interruptions to healthcare due to climate-related disasters
• Service interruptions
• Lack of supplies
• Educate patients about what climate change means
• Talk with patients about the risks that climate change pose in the areas in
which they live
• Health risks
• Natural disaster preparedness

44. Thank you!
Both this presentation and a recording of the class will be made available to you.

45. Questions?
Please reach out:
Kimberley@virginia.edu

46. RESOURCES
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https://scied.ucar.edu/shortcontent/mount-tambora-and-year-without-summer
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collapse.html
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droughts-that-changed-human-history/
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56. OTHER RESOURCES:
• NCEI tools for tracking extreme events- https://www.Ncdc.Noaa.Gov/climate-
information/extreme-events
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https://www.Climaterealityproject.Org/blog/top-climate-experts-follow-twitter
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0271.1
• AGMIP- https://agmip.org/#
• Feeling discouraged? Google “solar punk” for some inspiring artwork & ideas about
how we can reverse course on climate change.