Climate Change and Health Paul R. Epstein, M.D., M.P.H

CENTER FOR HEALTH AND THE GLOBAL ENVIRONMENT

HARVARD MEDICAL SCHOOL

Climate Change and Climate Change and HealthHealth

Paul R. Epstein, M.D., M.P.H.Paul R. Epstein, M.D., M.P.H.

Center for Health and the Global Center for Health and the Global EnvironmentEnvironment

Harvard Medical SchoolHarvard Medical Schoolhttp://www.med.harvard.edu/http://www.med.harvard.edu/chgechge

CENTER FOR HEALTH AND THE GLOBAL ENVIRONMENT

HARVARD MEDICAL SCHOOL

TMINS: WINTERS & NIGHTS

CENTER FOR HEALTH AND THE GLOBAL ENVIRONMENT

HARVARD MEDICAL SCHOOL

HEAT ISLAND EFFECT

CENTER FOR HEALTH AND THE GLOBAL ENVIRONMENT

HARVARD MEDICAL SCHOOL

ASTHMA

2-3foldsince1980

RESPIRATORY & CARDIOVASCULAR DISEASERESPIRATORY & CARDIOVASCULAR DISEASE

Indoor pollutants

Socioeconomic/emotional factors

Ground-level 0Ground-level 033

(T-dependant)(T-dependant)

FOSSIL FUEL-RELATED

Tree & Weed PollenTree & Weed Pollen

Diesel PM

Droughts, Fires & HazeDroughts, Fires & Haze

Floods & Fungi

CENTER FOR HEALTH AND THE GLOBAL ENVIRONMENT

HARVARD MEDICAL SCHOOL

Global Emergence, Resurgence & Global Emergence, Resurgence & Redistribution of Infectious Redistribution of Infectious

DiseasesDiseases30 DISEASES “NEW” TO MEDICINE SINCE 1976

HIV/AIDS Ebola

Legionnaires’ E. coli O157:H7

Multiple Antibiotic-Resistant Agents

Hantavirus Pulmonary Syndrome

Lyme Disease Nipah Virus

Vibrio cholerae O139 Arenaviruses

RESURGENT & REDISTRIBUTING

Malaria, Dengue Fever, West Nile Virus

VECTORSVECTORSMosquitoesMosquitoes

TicksTicksRodentsRodents

BatsBatsTsetse FliesTsetse Flies

FleasFleasLiceLice

SnailsSnailsAlgaeAlgae

CENTER FOR HEALTH AND THE GLOBAL ENVIRONMENT

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SARS-Severe acute respiratory syndrome

CORONAVIRUS

1. Mutation

2. Genetic recombination

3. Mouse hepatitis or chicken virus

4. (BT)

TRADE, TRAVEL, TOURISM

CENTER FOR HEALTH AND THE GLOBAL ENVIRONMENT

HARVARD MEDICAL SCHOOL-CDC-CDC

WEST NILE VIRUS

CENTER FOR HEALTH AND THE GLOBAL ENVIRONMENT

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WEST NILE VIRUS WEST NILE VIRUS HUMAN CASES & DEATHSHUMAN CASES & DEATHS

-Science 2002:297:1988

1999 2000 2001 2002 (17Sep)

1460

62 66 21

4161 cases

277 deaths

Feb ‘03

CENTER FOR HEALTH AND THE GLOBAL ENVIRONMENT

HARVARD MEDICAL SCHOOL

WNV: A DISEASE OF WILDLIFEWNV: A DISEASE OF WILDLIFE

230 SPECIES

INFECTED IN 2002

• 134 Bird spp., Raptors

• 14,045 Horses

• Zoo Penguins & Macaques

• Reptiles – Fla. Alligators

AVIAN FLYWAYSAVIAN FLYWAYS

CENTER FOR HEALTH AND THE GLOBAL ENVIRONMENT

HARVARD MEDICAL SCHOOL

-Lindgren & Gustafson. Lancet 2001;358:16-Lindgren & Gustafson. Lancet 2001;358:16

1980s 1990s

TICK DISTRIBUTION IN SWEDENTICK DISTRIBUTION IN SWEDEN

LYME DISEASE LYME DISEASE

CENTER FOR HEALTH AND THE GLOBAL ENVIRONMENT

HARVARD MEDICAL SCHOOL

CHANGES CHANGES IN IN

MONTANE MONTANE REGIONSREGIONS

CENTER FOR HEALTH AND THE GLOBAL ENVIRONMENT

HARVARD MEDICAL SCHOOL

CryosphereCryosphere

PlantsPlants

Mosquitoes

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HARVARD MEDICAL SCHOOL

Range Expansion of Soybean Cyst Nematode in North America

Crop Pests Crop Pests Generations/YearGenerations/Year

From: Rosenzweig et al., GC & HH 2001;2:90

CENTER FOR HEALTH AND THE GLOBAL ENVIRONMENT

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HURRICANE MITCHHURRICANE MITCHHURRICANE MITCH 1998

CENTER FOR HEALTH AND THE GLOBAL ENVIRONMENT

HARVARD MEDICAL SCHOOL

HURRICANE HURRICANE MITCHMITCH

IMPACTS ON HEALTHAND DEVELOPMENT

-- Malaria (>30,000 cases) -- Dengue fever (>1,000) -- Cholera (>30,000) -- Leptospirosis

DISEASE CLUSTERDISEASE CLUSTER

CENTER FOR HEALTH AND THE GLOBAL ENVIRONMENT

HARVARD MEDICAL SCHOOL

Poor Communities & Developing Nations Poor Communities & Developing Nations

Oil-related health consequences

Extraction: Nigeria, Ecuador, Mexico

Refining & benzene

Utility plants & mercury

Air pollution & inner city truck routes

Extreme weather events

Economic inequities

Vulnerabilities – coping, adaptation,

restoration, prevention,

public health infrastructure

But no nation is immune

Mozambique

CENTER FOR HEALTH AND THE GLOBAL ENVIRONMENT

HARVARD MEDICAL SCHOOL

EXTREME WEATHER EVENTS & EXTREME WEATHER EVENTS & DISEASE CLUSTERSDISEASE CLUSTERS

CENTER FOR HEALTH AND THE GLOBAL ENVIRONMENT

HARVARD MEDICAL SCHOOL

WEATHER ANOMALIES, TRAVEL WEATHER ANOMALIES, TRAVEL HAZARDS HAZARDS

and TRAUMA and TRAUMA

Fog, Ice Storms & Road TravelFog, Ice Storms & Road Travel

Floods & MudslidesFloods & Mudslides

Ice Instability, Heavy Precipitation & AvalanchesIce Instability, Heavy Precipitation & Avalanches

Infrastructure Damage and Water Q&QInfrastructure Damage and Water Q&Q

HEALTH & ECONOMIC IMPACTSHEALTH & ECONOMIC IMPACTS

CENTER FOR HEALTH AND THE GLOBAL ENVIRONMENT

HARVARD MEDICAL SCHOOL

SST Anomalies October 14 SST Anomalies October 14 20022002

Freshening of the North Atlantic

CENTER FOR HEALTH AND THE GLOBAL ENVIRONMENT

HARVARD MEDICAL SCHOOL

Deep Ocean WarmingDeep Ocean Warming

Levitus et al. Science 2000; 287: 2225Levitus et al. Science 2000; 287: 2225

CENTER FOR HEALTH AND THE GLOBAL ENVIRONMENT

HARVARD MEDICAL SCHOOL

Hoerling and Kumar, Science 2003 ;299: 691Hoerling and Kumar, Science 2003 ;299: 691

FRESHENING FRESHENING OF THE OF THE

NORTH NORTH ATLANTICATLANTIC

CENTER FOR HEALTH AND THE GLOBAL ENVIRONMENT

HARVARD MEDICAL SCHOOL

Exploration

Extraction

Transport

Refining

Transport

Air Pollution

Acid Rain

Climate Change

EutrophicationNOxs

Warming OceansCoral ReefsSLREWEsMelting Polar Ice

Harm

Marine

Mammals

Shore birds

Fisheries

Consumers

Livelihoods

OIL OIL LIFE CYCLE LIFE CYCLE COSTSCOSTS

Spills

&

Leaks MERCURY

CENTER FOR HEALTH AND THE GLOBAL ENVIRONMENT

HARVARD MEDICAL SCHOOL

EMERGING INFECTIOUS DISEASESEMERGING INFECTIOUS DISEASES HumansHumans

WildlifeWildlife TreesTrees

CropsCrops CoralCoral

Marine Marine LifeLife

CENTER FOR HEALTH AND THE GLOBAL ENVIRONMENT

HARVARD MEDICAL SCHOOL

Costs of Extreme Weather EventsCosts of Extreme Weather Events

UNEP Projections UNEP Projections

$150 Billion/yr w/in the Decade w/ Current Trends$150 Billion/yr w/in the Decade w/ Current Trends

CENTER FOR HEALTH AND THE GLOBAL ENVIRONMENT

HARVARD MEDICAL SCHOOL

BENEFITS & OPPORTUNITIESBENEFITS & OPPORTUNITIES

•Energy Efficiency (EE)

•Renewable Energy (RE) Technologies

•“Green Buildings” & Smart Growth

•Transport and Transit Systems

•Ecological Reconstruction

•Retrofitting Infrastructure THE ENGINE OF THE ENGINE OF GROWTHGROWTH

for thefor the

2121stst CENTURY CENTURY

FINANCIAL INCENTIVESFINANCIAL INCENTIVES& MARKET SIGNALS& MARKET SIGNALS

JOB

CREATION