Human Health under a
         Changing Climate
                Perry Sheffield, MD, MPH
Assistant Professor, Pediatrics and Preventive Medicine
            Mount Sinai S h l of M di i
            M      t Si i School f Medicine
Cary Institute forum on “Climate Change in the Hudson
          Valley: Preparing at the Local Level”
                                         Level
                     October 22, 2011
Health Effects of Climate Change - Direct
 Climate Impacts         Direct Health Effects


  More intense and       Heat stress,
  frequent Heat Waves    cardiovascular disease


  Stagnant Air Masses,   Asthma, respiratory
  Air Pollution          illness, cardiovascular
                                ,
                         disease
  More Frequent Heavy     Drowning, direct injury
  Rainfall Events

                              Slide text from G. Luber, CDC.
Health Effects of Climate Change - Indirect
   Climate Impacts        Indirect Health Effects

   Effects on key          Impacts on vector-borne and
                                       vector borne
   ecosystem parameters    zoonotic disease



   Heavy precipitation
                           Water-borne diseases,
   events will become
                           harmful algal blooms,
   more frequent
           q

   Increase in areas       Changes in food sources,
   affected by drought     malnutrition, forced
                           migration

                                       Slide text from G. Luber, CDC.
Heat Waves and Public Health
• Heat wave or extreme heat events
   – Period of very hot and humid weather that can
     make people very sick and even lead to death
           p p         y
• Scientists project that NYC could have 40 to 89
  days annually with 90 degree heat – or hotter
     y         y            g
• NYC August 2006: 40 heat stroke deaths and
  100 more deaths than expected

                          Slide text from Nathan Graber, NYC DOH
Ground-level ozone (O3)




      from Queensland Government EPA, www.epa.qld.gov.au
Change in O3-related asthma emergency department
 visits for children (0–17 years) in 2020s vs 1990s




                                 Sheffield et al, AJPM 2011.
Climate, Pollen
       ,
 and Asthma:
   possible
 mechanisms




From: Beggs and Bambrick,
        EHP 2005
West Nile virus in mosquitoes,
   New York State, 2008




                                 NYSERDA
                                  ClimAID
                                   team,
                                   2010.
Vulnerability factors – extreme heat example

1. Underlying medical conditions
 •   Heart d lung di
     H t and l    diseases, e.g.
2. Demographics
 •   Race, age, education
     R           d   ti
3. Housing
 •   Top floor apartments, air conditioning
4. Community geography
 •   Heat island, vegetation density



                   O’Neill & Ebi, JOEM 2009
Survey of local health departments in NYS




                             Carr et al, JPHMP In press.
Heat adaptation efforts
•   Policy: Emergency plan, weather service alerts
•   Surveillance
    S     ill
•   Structural interventions: cooling centers, A/C’s
•   Education/outreach
Take-Home Messages
                       g
 Health effects from heat, air pollution, and
  pollen and other risks are more challenging to
  address as climate changes in the U.S.
 Along with climate change, vulnerability factors
                      change
  will be key in determining health impacts
 More surveillance systems are needed to track
  key climate-health indicators
 Adaptation planning can begin now with
  currently available information

Climate Change and Human Health

  • 1.
    Human Health undera Changing Climate Perry Sheffield, MD, MPH Assistant Professor, Pediatrics and Preventive Medicine Mount Sinai S h l of M di i M t Si i School f Medicine Cary Institute forum on “Climate Change in the Hudson Valley: Preparing at the Local Level” Level October 22, 2011
  • 2.
    Health Effects ofClimate Change - Direct Climate Impacts Direct Health Effects More intense and Heat stress, frequent Heat Waves cardiovascular disease Stagnant Air Masses, Asthma, respiratory Air Pollution illness, cardiovascular , disease More Frequent Heavy Drowning, direct injury Rainfall Events Slide text from G. Luber, CDC.
  • 3.
    Health Effects ofClimate Change - Indirect Climate Impacts Indirect Health Effects Effects on key Impacts on vector-borne and vector borne ecosystem parameters zoonotic disease Heavy precipitation Water-borne diseases, events will become harmful algal blooms, more frequent q Increase in areas Changes in food sources, affected by drought malnutrition, forced migration Slide text from G. Luber, CDC.
  • 4.
    Heat Waves andPublic Health • Heat wave or extreme heat events – Period of very hot and humid weather that can make people very sick and even lead to death p p y • Scientists project that NYC could have 40 to 89 days annually with 90 degree heat – or hotter y y g • NYC August 2006: 40 heat stroke deaths and 100 more deaths than expected Slide text from Nathan Graber, NYC DOH
  • 5.
    Ground-level ozone (O3) from Queensland Government EPA, www.epa.qld.gov.au
  • 6.
    Change in O3-relatedasthma emergency department visits for children (0–17 years) in 2020s vs 1990s Sheffield et al, AJPM 2011.
  • 7.
    Climate, Pollen , and Asthma: possible mechanisms From: Beggs and Bambrick, EHP 2005
  • 8.
    West Nile virusin mosquitoes, New York State, 2008 NYSERDA ClimAID team, 2010.
  • 9.
    Vulnerability factors –extreme heat example 1. Underlying medical conditions • Heart d lung di H t and l diseases, e.g. 2. Demographics • Race, age, education R d ti 3. Housing • Top floor apartments, air conditioning 4. Community geography • Heat island, vegetation density O’Neill & Ebi, JOEM 2009
  • 10.
    Survey of localhealth departments in NYS Carr et al, JPHMP In press.
  • 11.
    Heat adaptation efforts • Policy: Emergency plan, weather service alerts • Surveillance S ill • Structural interventions: cooling centers, A/C’s • Education/outreach
  • 12.
    Take-Home Messages g  Health effects from heat, air pollution, and pollen and other risks are more challenging to address as climate changes in the U.S.  Along with climate change, vulnerability factors change will be key in determining health impacts  More surveillance systems are needed to track key climate-health indicators  Adaptation planning can begin now with currently available information