McLeod_Public Health Impacts

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					   Public Health Impacts
            and
Climate Change Adaptation
       Environmental Public Health
     Police
                                                         Home
      EMS         Community             Churches Corrections
                                                         Health
                   Centers         MCOs
                               Health
                             Department                             Parks
                         Schools
                                             Elected
  Doctors     Hospitals                     Officials Nursing Mass Transit
                   Philanthropist                      Homes
                                            Environmental
                        Civic Groups            Health
        CHCs                                                       Fire
                                  Tribal Health
Laboratory                                               Economic
               Drug            Mental      Employers
 Facilities                                            Development
             Treatment         Health
HEALTH IMPACTS OF CLIMATE CHANGE




 Fourth Assessment Report of the Intergovernmental Panel on Climate
 Change, 2007
Potential Health Effects of Climate Change

    Heat
    Air pollution
    Severe weather
    Vectorborne diseases
    Waterborne diseases
    Foodborne diseases
    Water and Food supply
    Mental health
    Environmental Refugees
ENVIRONMENTAL PUBLIC HEALTH HAZARDS


 Cuyahoga County, OH

                    Mortality Injuries   Total

 SEVERE
 WEATHER               27.44    80.14 107.58
 HEAT/DROUGHT             18       56      74
 WINTER
 WEATHER               15.15    87.27 102.42
 TORNADO               14.15    149.5 163.65
 LIGHTNING             14.01    31.25    45.26
                                                 Pop: 1,275,709
 source: SHELDUS, 1960- 6.24
 FLOODING                       14.83    21.07   (2009 U.S. Census
 2009                                            est)
 COASTAL                   0         0       0
Organic Enrichment
Nutrient Enrichment
  Low In-stream
 Dissolved Oxygen
      Toxicity
  Sedimentation
Habitat Degradation
  Hydrocarbons
 Too Much Water
      Bacteria
   Heavy Metals
   Yet Unknown
    Impairment
  ENVIRONMENTAL PUBLIC HEALTH HAZARDS
  Water Quality**
Cause of                           Pops Most                     Adaptation
Pollution   Health Effects         Affected     Diseases         Measures
Combined    Water Shortages        Low SES      Cholera          Public
Storm and                                       Cyclospora       Education
            Food- Water-, &        Elderly      Cryptosporidiosi
Sanitary
            Vector-borne                        s                Watershed
Sewers                             Children
            Diseases                            Campylobacte     Management
Nonpoint                           Swimmers     rLeptospirosis
            Exposure to Toxic                                    Water
Source                                          Hantavirus
            Chemicals              Outdoor                       Treatment
Pollution                                       Malaria
                                   Recreation
                                                Dengue           Vector Control
Water
Scarcity                                        Rift Valley
                                                                 Medical Care
                                                Fever
Hazardous                                       Encephalitis     Food Safety
Algal                                           Chikungunya
            data sources:
Blooms      Food Insecurity                     mycotoxins
            Disease Surveillance                algal toxins
            ED/Ambulatory Visits                Lyme
            Focused Observation
                                                Babeosis
                                                RMSF
ENVIRONMENTAL PUBLIC HEALTH HAZARDS
Water Quality
Facilities Releasing Toxic Chemicals, 2007   Location of Combined Sewers




                                               U.S. EPA, 2007


                                             Projected Changes in Annual
                                                                  Runoff



PollutionWatch, 2010



                                                U.S. Global Change Research
                                                Program, 2009
ENVIRONMENTAL PUBLIC HEALTH HAZARDS
Extreme Heat
Weather                                      Adaptation
Event           Health Effected   Affected   Measures
Heat            Heat Stress       Elderly    Architecture
Waves           and exhaustion
                                  Athletes   Air
                Cardiovascular               Conditioning/
1995                              Socially
             failure                         cooling centers
Chicago heat                      Isolated
wave, 106    Respiratory                     Early Warning
degrees                           Poor
               distress                      Systems
Fahrenheit,
with a heat                                  Community
index of 126                                 Response,
degrees for                                  networks and
one week,                                    neighbor
525 people
                                             support
died over a 5-
day period
                Data sources:
                ED/ambulatory
Data sources:   visits
Daily           Hospitalization
Tmin/Tmax       admissions
Air Quality in a Changing Climate

       Air Temperature
             +
        Air Stagnancy
             +

          Emissions
                         Pollen, Ozone, Asthma,
             =
                         Allergic reactions, COPD,
                         Cardio vascular issues
         Air Quality
ENVIRONMENTAL PUBLIC HEALTH HAZARDS
Severe Weather
Weather                                              Adaptation
Event         Health Effects    Pops Most Affected   Measures
Anomalies     Slips and Falls   Dwellers in Northern Public Education
                                Climates
(rain, ice,   Motor Vehicle                          Mass Transit
fog, hail,    Crashes           Elderly
                                                     Work at home
severe        Flooding          Drivers
thunderstor                                          Early warning
              Waterborne                             systems
m, wind,
              disease
drought,                                             Enhanced Food/
etc.)         Hypothermia                            Water Delivery
              Fatalities
              Food & Water
              Shortages
              Malnutrition


              data sources:
              ED Visits
ENVIRONMENTAL PUBLIC HEALTH HAZARDS
Winter Weather

Year   Hypothermia      Other Deaths    Total deaths
           Primary     w/ mention of   associated w/
         Underlying     hypothermia     hypothermia
             Cause

2005        16              27              43
2006        13              14              27
2007        21              18              39
2008        19              27              46
2009        15              21              36
Ohio Department of Health, Center for Public           Top Ten Worst Winter
Health Statistics and Informatics (source: ohio.gov,
Ohio Committee for Severe Weather Awareness)
                                                          Cities
                                                       1. Cleveland
                                                       8. Columbus
ENVIRONMENTAL PUBLIC HEALTH HAZARDS
Severe Weather/Tornados
Population, Number of Catastrophes, and Losses in U.S. Over
Time




Credit: Easterling et. al., 2000
     Mental Health Concerns
• Anxiety, despair, depression, post
  traumatic stress


          Societal Concerns
• Forced migration
• Civil conflict
• Refugees
Which climate change health impact(s)
    are likely in Northeast Ohio?
1.   Vector borne diseases
                                                50%   50%
2.   Waterborne diseases
3.   Respiratory diseases and
     conditions
4.   Chronic diseases
5.   Mental health and stress
     disorders
6.   Foodborne diseases/access
     to food
7.   Forced migration
8.   All of the above

                                 0%   0%   0%               0%   0%   0%

                                 1    2    3     4     5     6    7    8
What is the role of public health in environmental
sustainability & climate change?

INTERNATIONAL      1. Integrate public health into policy
                      goals
                   2. Applied research of policies
                                                    (WHO,
FEDERAL            1. Educate policymakers
                      2009)
                   2. Evaluate proposed policies
                                                  (Frumkin et
                      al., 2008)
STATE              1. Public health surveillance
                   2. Incorporate health into climate
                      change action plans and adaptation
                      plans
                                     (Trust for America’s
LOCAL                 Emergency
                   1. Health, 2009) preparedness and
                      response
                   2. Adaptation planning
      Emergency Preparedness
•   National Incident Management System
•   State Emergency Management Agency
•   Cuyahoga Co. Emergency Management
•   Local Emergency Coordinators
•   Contract agencies and entities
•   Local Emergency Planning Committee
•   Individuals
                    Plan & Prepare
• Communication Plan
    Develop a family communication plan.
• Emergency Supply Kit
    Create an emergency supply kit.
• Citizen Corp
    Learn how you can be involved in your community.

Prepare for All Hazards

Dam Failure              Earthquake     Fire or Wildfire
Flood    Hazardous Material      Heat
Landslide       Nuclear Power Plant Emergency
Terrorism       Thunderstorm
Tornado         Winter Storm

•   http://ja.cuyahogacounty.us/en-US/preparedness-links.aspx
Protect Your Family
• Get informed
• Plan for emergencies
• Assemble a disaster supplies kit
• Effectively shelter
   – Prepare a safe room
   – Guidelines for managing water supplies
   – Guidelines for managing food supplies
• Get your children involved (kids site)
• Special needs & concerns
• Care for pets and livestock
       Protect Your Property
       Everyone faces the risk of natural disaster

• FEMA strongly encourages property owners and renters
  to fully explore their insurance needs and obtain
  adequate coverage before a disaster strikes.
• Buy flood insurance
• Is your home or prospective home is in a flood zone
• Get informed on the full range of insurance coverage
  available to individuals and businesses
• Prepare financially for disasters
• "How-to" Guides
• http://www.fema.gov/plan/index.shtm
   Defining Our Local Public Health Roles in
Environmental Sustainability & Climate Change?




    A Joint Workshop between the Cuyahoga County Board of Health, the
             Summit County Health District and Key Community Partners
                                                           May 13, 2010
                                                    8:00 am – 12:00 pm
Adele Houghton
President                          Furnace Run Park, Brushwood Pavilion
Adele Houghton Consulting, LLC             4955 Townsend Rd., Richfield
PUBLIC HEALTH POLICY STRATEGY

 I. Perform a regional scan of
    environmental hazards
 II. Identify the scope of influence
 III.Perform a gap analysis
 IV.Build a coalition of stakeholders
 V. Prioritize recommendations for
    action
  Would you participate in a coordinated gap
analysis and needs assessment related to public
           health on climate change?
1. Yes
2. No
 FOCUS ON CORE DISCIPLINES
                                Food Service
                                Water Quality
                                 Solid Waste
                                 Air Quality
Credit: Institute for Active                       Credit: James Gathany, CDC
Living, Columbus, OH           Chronic Disease     Public Health Image Library




Credit: Ahleong, Wikimedia     Credit: Benchill,   Credit: James M. Pease, NIH
   Do we need a coordinated climate change
 awareness, forecasting and response system in
            Northeast Ohio?
1. Yes
2. No
            Thank you
John McLeod, Director
Environmental Public Health
Cuyahoga County Board of Health
5550 Venture Drive
Parma, Ohio 44130
jmcleod@ccbh.net
216-201-2001 x1200
                               Citations
•   http://www.thedailygreen.com/environmental-news/latest/heat-waves-
    47121801#ixzz0TkpwKSSU<http://www.thedailygreen.com/environmental-
    news/latest/heat-waves-47121801>

•   World Health Organization. Protecting Health from Climate Change: Global
    Research Priorities. 2009:26. Available at:
    http://whqlibdoc.who.int/publications/2009/9789241598187_eng.pdf.

•   Health Problems Heat Up: Climate Change and the Public's Health. Trust
    for America's Health; 2009:58.
•   http://healthyamericans.org/reports/environment/TFAHClimateChangeWeb.pdf

•   Frumkin et. al., Climate Change: The Public Health Response, Am J Public
    Health. 2008;98:435–445.
•   EPA, A Screening Assessment of the Potential Impacts of Climate Change
    on Combined Sewer Overflow Mitigation in the Great Lakes and New
    England Regions, February 2008.
•   Houghton, Adele, Defining Our Local Public Health Roles in Environmental
    Sustainability & Climate Change. Richfield, Ohio May 13, 2010

				
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