GLOBAL CLIMATE CHANGE AND HUMAN HEALTH

GLOBAL CLIMATE CHANGE AND HUMAN

HEALTH FROM SCIENCE TO PRACTICE

George Luber

Jay Lemery

Cover Design: Wiley

Cover Images: Grandmother and Child ©Andrew Penner / iStockphoto; Flood ©Constance Knox /

iStockphoto; Fire ©Scott Vickers / iStockphoto; Desert ©Yuriy_Kulik / iStockphoto; Hurricane ©Chieh

Cheng / iStockphoto; Foggy Background ©Simone Becchetti / iStockphoto

Copyright © 2015 by John Wiley & Sons, Inc. All rights reserved.

Published by Jossey-Bass

A Wiley Brand

One Montgomery Street, Suite 1000, San Francisco, CA 94104-4594—www.josseybass.com

No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by

any means, electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permitted

under Section 107 or 108 of the 1976 United States Copyright Act, without either the prior written permis­

sion of the publisher, or authorization through payment of the appropriate per-copy fee to the Copyright

Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400, fax 978-646-8600, or on

the Web at www.copyright.com. Requests to the publisher for permission should be addressed to the Permis­

sions Department, John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, 201-748-6011, fax 201-748­

6008, or online at www.wiley.com/go/permissions.

Limit of Liability/Disclaimer of Warranty: While the publisher and author have used their best ef orts in

preparing this book, they make no representations or warranties with respect to the accuracy or complete­

ness of the contents of this book and speciically disclaim any implied warranties of merchantability or

itness for a particular purpose. No warranty may be created or extended by sales representatives or written

sales materials. he advice and strategies contained herein may not be suitable for your situation. You should

consult with a professional where appropriate. Neither the publisher nor author shall be liable for any loss

of proit or any other commercial damages, including but not limited to special, incidental, consequential,

or other damages. Readers should be aware that Internet Web sites ofered as citations and/or sources for

further information may have changed or disappeared between the time this was written and when it is read.

Jossey-Bass books and products are available through most bookstores. To contact Jossey-Bass directly call

our Customer Care Department within the U.S. at 800-956-7739, outside the U.S. at 317-572-3986, or fax

317-572-4002.

Wiley publishes in a variety of print and electronic formats and by print-on-demand. Some material included

with standard print versions of this book may not be included in e-books or in print-on-demand. If this book

refers to media such as a CD or DVD that is not included in the version you purchased, you may download this

material at http://booksupport.wiley.com. For more information about Wiley products, visit www.wiley.com.

Library of Congress Cataloging-in-Publication Data

Luber, George, editor.

Global climate change and human health : from science to practice / George Luber, Jay Lemery.

pages cm

Includes index.

ISBN 978-1-118-50557-1 (pbk.) – ISBN 978-1-118-60358-1 (epub) – ISBN 978-1-118-50557-1 (pbk.)

1. Climatic changes—Health aspects. 2. Global warming—Health aspects. 3. Environmental

health. I. Lemery, Jay, editor. II. Title.

RA793.L83 2015

615.9’02—dc23

2015018120

Printed in the United States of America

first edition

PB Printing 10 9 8 7 6 5 4 3 2 1

CONTENTS

Dedication . . . . . . . . . . . . . . . . . . . . . xi

he Editors. . . . . . . . . . . . . . . . . . . . xxi

he Contributors . . . . . . . . . . . . . . . . . xxiii

Introduction . . . . . . . . . . . . . . . . . . . xiii

Acknowledgments . . . . . . . . . . . . . . . . . xix

Part 1: Our Changing Planet: Emergent Risks

for Human Health . . . . . . . . . . . . . . . . . . . . . 1

Chapter 1 Primer on Climate Science . . . . . . . . . . . . . 3

Christopher K. Uejio, James D. Tamerius, Karen Wertz, Katie M. Konchar

Scientiic Consensus . . . . . . . . . . . . . . . . . 4

Weather, Climate Variability, Climate Change, and

Scientii c heory . . . . . . . . . . . . . . . . . . 5

Energy Balance . . . . . . . . . . . . . . . . . . . 7

Evidence of a Changing Climate . . . . . . . . . . . . . 12

Climate Models . . . . . . . . . . . . . . . . . . . 19

Projected Future Climate Changes . . . . . . . . . . . . 24

Conclusion. . . . . . . . . . . . . . . . . . . . . 27

Chapter 2 Extreme Weather Events: The Role of Public Health in

Disaster Risk Reduction as a Means for Climate Change

Adaptation . . . . . . . . . . . . . . . . . . . 35

Mark E. Keim

Disasters Caused by Extreme Weather Events . . . . . . . . 36

Scope of the Problem . . . . . . . . . . . . . . . . . 37

Public Health Impact of Extreme Weather Disasters . . . . . . 39

Managing the Public Health Risk of Extreme Weather Disasters . . 55

Conclusion. . . . . . . . . . . . . . . . . . . . . 66

Chapter 3 Extreme and Changing Meteorological

Conditions on the Human Health Condition . . . . . . 77

Daniel P. Johnson, Austin C. Stanforth, Kavya Urs Beerval

Social, Environmental, and Individual Factors within Well-Known

Climate-Related Health Risks. . . . . . . . . . . . . . 78

vi Contents

Case Study . . . . . . . . . . . . . . . . . . . . . 86

Conclusion. . . . . . . . . . . . . . . . . . . . . 94

Part 2: The Health Consequences of Climate Change . . . . . . 101

Chapter 4 Changes in Hydrology and Its Impacts on

Waterborne Disease . . . . . . . . . . . . . . 103

Jan C. Semenza

Changes in Hydrology due to Climate Change . . . . . . . 104

Waterborne Pathogens . . . . . . . . . . . . . . . 114

Other Infectious Diseases . . . . . . . . . . . . . . 119

Adaptation Strategies . . . . . . . . . . . . . . . . 121

Conclusion. . . . . . . . . . . . . . . . . . . . 124

Chapter 5 Ozone, Oppressive Air Masses,

and Degraded Air Quality . . . . . . . . . . . . 137

Kim Knowlton

Climate Change and Air Quality . . . . . . . . . . . . 138

Future Projections of Climate Change’s Ef ects

Mitigation: Health Beneits of Reducing Carbon Pollution

Adaptation: Climate Health Preparedness and Reducing

Air Pollution–Vulnerable Populations . . . . . . . . . . 152

on Air Pollution . . . . . . . . . . . . . . . . . 154

and Associated Co-Pollutant Air Pollution . . . . . . . . 155

Air Pollution Vulnerability . . . . . . . . . . . . . 158

Conclusion. . . . . . . . . . . . . . . . . . . . 159

Chapter 6 Efects of Climate Change on Noninfectious

Waterborne Threats . . . . . . . . . . . . . . 171

Lorraine C. Backer

Harmful Algal Blooms. . . . . . . . . . . . . . . . 172

Climate Change and Harmful Algal Blooms . . . . . . . . 181

Conclusion. . . . . . . . . . . . . . . . . . . . 186

Chapter 7 Climate Change, Carbon Dioxide, and Public Health:

The Plant Biology Perspective . . . . . . . . . . 195

Lewis H. Ziska, Kristie L. Ebi

Direct Consequences . . . . . . . . . . . . . . . . 196

Indirect Consequences . . . . . . . . . . . . . . . 203

Uncertainties and Research Priorities . . . . . . . . . . 208

Conclusion. . . . . . . . . . . . . . . . . . . . 212

viiContents

Chapter 8 Climate and Its Impacts on Vector-Borne and

Zoonotic Diseases . . . . . . . . . . . . . . . 221

Charles B. Beard, Jada F. Garofalo, Kenneth L. Gage

Malaria . . . . . . . . . . . . . . . . . . . . . 225

he Recent Expansion of Dengue . . . . . . . . . . . . 231

he Sudden Emergence of West Nile Virus–Associated Illnesses . 238

Lyme Disease in the United States . . . . . . . . . . . 245

Rabies in Wild Carnivores and Bats . . . . . . . . . . . 249

Conclusion. . . . . . . . . . . . . . . . . . . . 255

Chapter 9 Addressing the Challenges of Climate Change to

Food Security, Safety, and Nutrition . . . . . . . . 267

Cristina Tirado

Climate Change and Food Security: Impacts on

Availability, Stability, Access, and Food Utilization . . . . . 268

Cobeneits of Sustainable Food Production, Sustainable

Policy Coherence and Good Governance for Climate

Climate Change Impacts on Food Stability and Access . . . . 271

Climate Change and Food Safety . . . . . . . . . . . . 273

Agriculture Impacts on Climate Change . . . . . . . . . 279

Biofuel Production Challenges for Food Security and Nutrition . 280

Climate Change and Undernutrition. . . . . . . . . . . 281

Nutrition-Sensitive Climate Change Adaptation. . . . . . . 282

Nutrition-Sensitive Climate Change Mitigation . . . . . . . 292

Implications of Dietary Patterns to Climate and Nutrition . . . 293

Food Consumption, and Food Waste Reduction . . . . . . 294

Change and Nutrition . . . . . . . . . . . . . . . 295

Conclusion. . . . . . . . . . . . . . . . . . . . 297

Chapter 10 Climate Change and Population Mental Health . . . 311

Abdulrahman M. El-Sayed, Sandro Galea

Mechanisms . . . . . . . . . . . . . . . . . . . 313

A Disproportionate Burden . . . . . . . . . . . . . . 321

Conclusion. . . . . . . . . . . . . . . . . . . . 323

Part 3: The Public Health Approach to Climate Change . . . . . 333

Chapter 11 Improving the Surveillance of

Climate-Sensitive Diseases . . . . . . . . . . . 335

Pierre Gosselin, Diane Bélanger, Mathilde Pascal,

Philippe Pirard, Christovam Barcellos

Environmental Monitoring . . . . . . . . . . . . . . 337

viii Contents

Health Surveillance for Climate Risks . . . . . . . . . . 341

Risk Mapping Approaches . . . . . . . . . . . . . . 347

Pollens and Allergies . . . . . . . . . . . . . . . . 348

Decision Making from Surveillance Information . . . . . . 350

Efectiveness of Prevention and Adaptation Measures . . . . . 351

Identiication and Ranking of Hazardous Situations . . . . . 352

Communication . . . . . . . . . . . . . . . . . . 353

Future Improvements to Be Promoted . . . . . . . . . . 353

Conclusion. . . . . . . . . . . . . . . . . . . . 355

Chapter 12 Climate and Health Vulnerability Assessments:

A Practical Approach. . . . . . . . . . . . . . 363

Diarmid Campbell-Lendrum, Joy Guillemot, Kristie L. Ebi

What Health Issues Should a Vulnerability and

Adaptation Assessment Cover? . . . . . . . . . . . . 364

What Other Nonclimate Factors

Should Be Considered? . . . . . . . . . . . . . . . 366

Vulnerability and Adaptation Assessment . . . . . . . . . 368

Understanding Future Impacts on Health . . . . . . . . . 373

Identifying and Prioritizing Health Adaptation Measures . . . 375

Integration, Implementation, and Iteration . . . . . . . . 378

Conclusion. . . . . . . . . . . . . . . . . . . . 381

Chapter 13 Climate Change Health Impact Projections:

Looking into the Future . . . . . . . . . . . . 385

Jeremy Hess

A Conceptual Overview of Climate Change

Health Impact Projections . . . . . . . . . . . . . . 387

Merging Data Streams in the Climate Change

Health Impact Model . . . . . . . . . . . . . . . 396

Frontiers in Climate Change Health Impact Projection . . . . 398

Conclusion. . . . . . . . . . . . . . . . . . . . 400

Chapter 14 Community-Based Sentinel Surveillance as an

Innovative Tool to Measure the Health Ef ects of

Climate Change in Remote Alaska . . . . . . . . 407

David Driscoll

he Public Health Context: Sentinel Surveillance and

Community-Based Research in Public Health . . . . . . . 408

Climate and Health in the Far North. . . . . . . . . . . 411

What We Did and Why . . . . . . . . . . . . . . . 417

 

ixContents

Findings, Reporting Back to the Community, and

Adaptation Plans . . . . . . . . . . . . . . . . . 422

Conclusion. . . . . . . . . . . . . . . . . . . . 425

Chapter 15 Protecting Environmental Justice Communities

from the Detrimental Impacts of Climate Change . . 431

Cecilia Martinez, Nicky Sheats

Climate Resiliency and Environmental Justice . . . . . . . 435

Heat Waves, Environmental Justice, and Climate Change . . . 442

Extreme Weather Events and Environmental Justice . . . . . 446

Indigenous Rights and Climate Change. . . . . . . . . . 448

Summary and Recommendations . . . . . . . . . . . . 452

Conclusion. . . . . . . . . . . . . . . . . . . . 455

Chapter 16 Climate Change Communication . . . . . . . . . 467

Stuart Capstick, Adam Corner, Nick Pidgeon

Public Understanding of Climate Change and Principles of

Climate Change Communication . . . . . . . . . . . 469

Communicating the Impacts of Climate Change . . . . . . 479

Communicating Climate Change through a Focus on Health . . 485

Conclusion. . . . . . . . . . . . . . . . . . . . 490

Part 4: Taking Action: Adaptation, Mitigation, and Governance . . 503

Chapter 17 International Perspective on

Climate Change Adaptation . . . . . . . . . . . 505

Kristie L. Ebi

Historical Perspective . . . . . . . . . . . . . . . . 506

Framework for Adaptation . . . . . . . . . . . . . . 509

Assessing Adaptation Needs and Options . . . . . . . . . 510

National Adaptation Programmes of Action

and National Adaptation Plans . . . . . . . . . . . . 514

Adaptation Options. . . . . . . . . . . . . . . . . 516

Conclusion. . . . . . . . . . . . . . . . . . . . 523

Chapter 18 Health Cobeneits of Climate

Mitigation Strategies. . . . . . . . . . . . . . 533

Linda Rudolph, Maxwell J. Richardson

Climate Change Impacts, Mitigation Strategies,

and Cobeneits . . . . . . . . . . . . . . . . . . 534

Conclusion. . . . . . . . . . . . . . . . . . . . 561

x Contents

Chapter 19 Mitigation: International Institutions and

Global Governance . . . . . . . . . . . . . . 579

Farah Faisal, Perry Shei eld

he Climate hreat for Human Health . . . . . . . . . . 580

Climate Change Governance . . . . . . . . . . . . . 581

UNFCCC and Health . . . . . . . . . . . . . . . . 583

Beyond the UNFCCC Process . . . . . . . . . . . . . 585

Public Health Governance . . . . . . . . . . . . . . 590

Clinical Correlations . . . . . . . . . . . . . . . . 592

Disaster Relief/Migration: UN Oice for the Coordination

of Humanitarian Afairs . . . . . . . . . . . . . . 593

Way Forward . . . . . . . . . . . . . . . . . . . 595

Conclusion. . . . . . . . . . . . . . . . . . . . 596

Chapter 20 Climate Change and the Right to Health . . . . . . 601

Carmel Williams

What Is the Right to Health? . . . . . . . . . . . . . 601

Climate Change and Its Impact on the

Human Rights–Based Approaches to

Right to Health. . . . . . . . . . . . . . . . . . 603

Climate Change . . . . . . . . . . . . . . . . . 605

Conclusion . . . . . . . . . . . . . . . . . . . 612

Index . . . . . . . . . . . . . . . . . . . . . . . . 617

I have many people to thank for the privilege and opportunity to spend

my days working on such an important issue. This book is dedicated to all

of those who have shared their wisdom, ofered mentorship, gave oppor­

tunity, and provided support, especially my mother, Maureen Ward; my

mentors: Elois Ann and Brent Berlin, Carol Rubin, and Mike McGeehin; and

of course, to my wife, Holly, and our sons, Lucas, Gustav, and Axel, for all of

their support and love.

George Luber

* * *

To the educators of the Glens Falls, New York School District—may you

continue to inspire; and of course, to my girls, Maeve and Zada,

and my loving wife, Taryn.

Jay Lemery

INTRODUCTION

Throughout history, the sky has served as a metaphor for the vast, wide

open, and endless horizons. he notion that humans could in some

way alter this vast expanse would have been unimaginable. It was not until

our explorations into space in the 1960s that this notion began to be chal­

lenged. h e irst astronauts to leave the Earth reported that the atmosphere

looked like a “thin blue line” in contrast to the enormous mass of the planet.

heir eyes were not deceived; the atmosphere that envelops the Earth is

thin—so thin that if the Earth were shrunk down to the size of a desktop

globe, one would need only a sheet of plastic wrap to approximate the thick­

ness of the atmosphere. he atmosphere is a mere sixty miles thick, com­

pared with the eight-thousand-mile diameter of the Earth.

Following the publication of the irst images from Earth’s orbit, the

widely held notion that the atmosphere is too vast to alter in any mean­

ingful way was begun to be challenged by direct observational evidence.

Meticulous measurements by Charles Keeling at the National Oceanic and

Atmospheric Administration’s (NOAA) Mauna Loa Observatory, begin­

ning in 1956 and uninterrupted to date, have provided clear documentation

of the year-on-year rise in global atmospheric carbon dioxide (CO2) levels,

providing crucial observational evidence that the chemistry of the atmo­

sphere is changing (i gure I.1).

his change is substantial. At the start of the Industrial Revolution, it

has been estimated that the globally averaged concentration of CO2 in our

atmosphere was around 280 parts per million (ppm). By 1956 it was close

to 320 ppm, and in the intervening ifty years, this level has risen to over

400 ppm, principally as a result of the burning of fossil fuels and land use

and land cover changes.

Among its many properties, the atmosphere serves to help keep the sur­

face of the Earth warm enough to sustain life. his is possible through the

greenhouse efect in which the atmosphere allows solar radiation to pass

through, generally unchanged, and trapping some of the outgoing infra­

red radiation that is emitted from the Earth’s surface. he balance between

incoming and outgoing energy is critical to maintaining some type of energy/

temperature equilibrium at the Earth’s surface. When this energy balance is

altered, through an increase in inputs (solar energy) into the system or changes

Figure I.1 Atmospheric Carbon Dioxide at Mauna Loa

Scripps Institution of Oceanography (scrippsco2.ucsd.edu/).

xiv Introduction

in Earth’s atmospheric composition that alter how much of this incoming

energy is captured (either naturally by volcanic emissions, or human activities

such as the burning of fossil fuels or through land cover changes), changes in

the Earth’s surface temperature, and in turn its climate become evident.

Documenting and assessing the evidence for these potential changes in

the Earth’s climate system is the job of the Intergovernmental Panel on Cli­

mate Change (IPCC), a selected volunteer group of experts in the numer­

ous disciplines and sectors with a perspective on climate change. One of the

IPCC’s main purpose is to undertake a periodic assessment every seven years

to review and summarize the strength of the evidence around climate change,

including the physical science basis and evidence, impacts in numerous sec­

tors (e.g., agriculture, water, energy, public health), and regional impacts.

he Fourth Assessment Report of the IPCC was a landmark docu­

ment and worthy of receiving the Nobel Peace Prize, not least for stating

unequivocally that the Earth’s climate is changing and that humans are

principally responsible (IPCC 2007). his, and subsequent IPCC reports

(IPCC 2012, 2013), have strengthened the evidence base on human-induced

climate change. hese reports have not only highlighted the complexities

and magnitude of the climate change problem, but they have provided a

solid evidence and rationale for action on a number of fronts. What they

have concluded is that the global efects of climate change are already

apparent from numerous observations of the destabilization of natural sys­

tems. hese impacts include the melting and degradation of continental ice

caps and glaciers, the warming and acidiication of oceans, rising sea levels,

xvIntroduction

an increase in frost-free days, and, not least, increases in extreme weather

events such as heat waves, heavy rainfall events, drought, high storm surge,

and tropical cyclones.

We can also expect substantial regional diferences in the type and

magnitude of these impacts. Some regions will become wetter, some dryer,

and some will see no change. Consider this: the hird US National Climate

Assessment reported that Grand Junction, Colorado, has warmed 3.2°F

over the past century, while parts of southern Alabama actually cooled,

dropping 0.6°F in the same time period (Melillo et al. 2014).

At an increasing rate, evidence is accumulating that the health threats

of climate change are already afecting communities across the globe. From

the direct efects of weather extremes on morbidity and mortality to the

potential for profound changes in disease ecology and geography brought

about by state shifts in the Earth’s system, climate change will be the dei n­

ing issue for public health in this century (Chan 2008).

Climate change poses to threaten health in a variety of ways. Most of the

health threats of climate change that have been identiied are not new ones;

injury and death from heat waves and extreme weather events; reduced air

quality from ozone, aeroallergens, and wildire smoke; and from illnesses

transmitted by food, water, and disease carriers such as mosquitoes and

ticks. hese health threats have always been with us, taking advantage of

weaknesses and vulnerabilities in certain parts of our communities, par­

ticularly the young, old, the sick, economically disadvantaged, and culturally

marginalized (Luber et al. 2014). For these groups, climate change represents

yet another, perhaps more powerful, threat to their health and well-being.

Climate change will also threaten the critical systems and infrastruc­

ture we rely on to keep us safe and healthy: communication and transpor­

tation during emergencies, food and water systems during drought, the

energy grid during prolonged heat waves. As the magnitude and frequency

of extreme weather events increase, the resilience of these systems will be

tested, and vulnerabilities will become more exposed. It is in this sense that

climate change will serve as “risk multiplier” by amplifying both the expo­

sures that bring about health risks and highlighting the vulnerabilities to

these exposures as well.

In developing a global picture of the health impacts of climate change,

it is important to acknowledge that these health impacts will dif er substan­

tially by location and pathway of exposure. h ese diferences can be thought

of as a function of the attributes of the population that confer vulnerability

(the old and young, the prevalence of comorbidities, socioeconomic status),

attributes of place that mediate exposure (loodplain, coastal zone, urban

heat island), as well as the adaptive capacity of public health and associated

xvi Introduction

infrastructure that helps maintain access to clean food and water and pub­

lic health preparedness decisions that have been made in advance.

he picture is complicated, to say the least. Disentangling all of these

interactions is a diicult task, requiring the expertise and perspectives of

many disciplines. he purpose of this book is to bring together, in a single

volume, these various perspectives—theoretical, methodological, and dis­

ciplinary—that should be brought to bear on such a critical challenge. In

order to educate and empower the next generation of students and scien­

tists to address this challenge, the four parts of this book span a science-to­

practice continuum that promotes an evidence-based approach to public

health practice and decision making.

Part 1, “Our Changing Planet: Emergent Risks for Human Health,”

begins with an overview primer on climate science, with attention to rel­

evant concepts for public health. he next two chapters summarize the

various climate-related meteorological hazards and exposures that will

increasingly become emergent risks for human health.

Part 2, “he Health Consequences of Climate Change,” focuses more

closely on speciic exposure pathways that will be altered with climate

change and reviews the evidence base for the various health impacts of

climate change, including waterborne disease, respiratory impacts from

ozone, emissions, aeroallergens, harmful algal blooms, vector-borne and

zoonotic disease, nutritional impacts, and mental health.

In Part 3, “he Public Health Approach to Climate Change,” the focus

turns to a discussion of the practice dimension of this book. It details the

various public health strategies and approaches that are already being

developed to prepare for climate change. he authors cover a wide variety

of practical and methodological approaches to climate change and health

assessments including public health surveillance for climate change, con­

ducting vulnerability assessments, and modeling future health impacts.

he part concludes with three chapters that describe important concepts

to consider from a public health perspective: adopting a community-based

approach, environmental justice as a critical dimension of risk, and the

importance of communication approaches as agents of change.

Part 4, “Taking Action: Adaptation, Mitigation, and Governance,” turns

to an action-oriented perspective, outlining the various eforts and strate­

gies that have been developed so far to tackle the enormous challenge of

climate change. Emissions trajectories tell us that some warming is unavoid­

able and we must adapt. he how and why of such an endeavor is presented

in the irst chapter in this part before turning attention to tackling the root

cause of the climate change crisis: increased emissions. h is discussion

focuses on a strategy to promote these mitigation eforts by seizing on the

xvii Introduction

dual beneits, for both health and emissions, of certain strategies. Under­

pinning both adaptation and mitigation eforts is the governance structure

that allows, or prevents, this from happening, and the various institutional

and governance requirements for this to indeed happen are discussed. And

the last chapter explores issues of climate justice and the likelihood that the

most vulnerable among us will bear the heaviest burdens of climate change.

We have included pedagogical elements to facilitate both learning and

instruction. Key terms and a comprehensive glossary introduce and rein­

force the lexicon of this ield. Key concepts and discussion questions will

keep the learner oriented to the big picture messages throughout the chap­

ters. To facilitate educators, we have provided visual presentation materials

(PowerPoint) to complement each lecture. And inally, because this book

topic straddles both public health and clinical medicine, we have provided

“Clinical Correlates” sections in each chapter to facilitate understanding

and discussion of the health impacts that will face individual care providers.

We consider this last point to be a signii cant diferentiator for our

book—that this text will be relevant for both MPH and MD/DO students.

So much of the intransigence of policymakers worldwide is due to a lack of

clear risk assessment of the insidious and often abstract threat of climate

change. And when one compounds this with the fact that cutting-edge sci­

ence by its very nature is uncertain, tough decisions related to climate or

energy policy are easily undercut by a fear of commitment to any particular

course of action, leaving inertia as the best rational choice.

his is where you come in as a science educator. hose of us in public

health and clinical medicine are ideal interlocutors, society’s go-betweens

in translating abstract medical science into plans for healthy living.

Research in social science supports that risks identiied in terms of human

life, such as “your mother’s risk of cancer” or “your child’s risk of asthma,”

are much more efective fulcrums for change than abstract concepts. h is

is our hope for the book: to empower you with the knowledge to explain sci­

ence in terms of health risks that can be readily understood and to be part

of a movement to elevate public discourse to a more accurate assessment of

risks and benei ts. his is how meaningful change can occur and how we

may have a chance to bequeath to our children a planet with a safe environ­

ment and stable climate.

An instructor’s supplement is available at www.wiley.com/go/luber.

Additional materials such as videos, podcasts, and readings can be found at

www.josseybasspublichealth.com. Comments about this book are invited

and can be sent to publichealth@wiley.com.

References

Chan, M. 2008. “he Impact of Climate Change on Human Health.” April 7.

IPCC. 2007. Climate Change 2007: he Physical Science Basis. Contribution of

Working Group I to the Fourth Assessment Report of the Intergovernmental

Panel on Climate Change, edited by S. Solomon,, D. Qin, M. Manning, Z. Chen,

M. Marquis, K.B. Averyt, M. Tignor, and H. L. Miller. Cambridge: Cambridge

University Press.

IPCC. 2012. Managing the Risks of Extreme Events and Disasters to Advance

Climate Change Adaptation. A Special Report of Working Groups I and

II of the Intergovernmental Panel on Climate Change, edited by C. B. Field,

V. Barros, T. F. Stocker, D. Qin, D. J. Dokken, K. L. Ebi, M. D. Mastrandrea,

et al. Cambridge: Cambridge University Press.

IPCC. 2013. Climate Change 2013: he Physical Science Basis. Contribution of

Working Group I to the Fifth Assessment Report of the Intergovernmental Panel

on Climate Change, edited by T. F. Stocker, D. Qin, G.-K. Plattner, M. Tignor,

S. K. Allen, J. Boschung, A. Nauels, et al. Cambridge: Cambridge University

Press.

Luber, G., K. Knowlton, J. Balbus, H. Frumkin, M. Hayden, J. Hess, M. McGeehin,

et al. 2014. “Human Health.” Climate Change Impacts in the United States: h e

hird National Climate Assessment, edited by J. M. Melillo, T. Richmond, and

G. W. Yohe,, 220-256. Washington DC U.S. Global Change Research Program.

Melillo, J. M., T. Richmond, and G. W. Yohe, eds. 2014. Climate Change Impacts

in the United States: h e hird National Climate Assessment. Washington DC

U.S. Global Change Research Program.

ACKNOWLEDGMENTS

We thank the “Clinical Correlates” editor, Cecilia Sorenson, MD; and edito­

rial assistants Amanda Bond, Marisa Burton, Danika Evans, Sabrina Geer,

DVM, Katharine Joy, and Amita Kulkarni. We also thank the Educational

Materials editor, Carolyn Meyer, MD; and educational assistants Gavriel

Roda and Rachel VanderWel. We are also indebted to proposal reviewers

Kristie L. Ebi, Paul S. Auerbach, and Damon Chaky who provided valuable

feedback on the original book proposal. Edward Avol, Qinghua Sun, Justin

Remais, and Ivan Ramirez provided thoughtful and constructive comments

on the complete draft manuscript.

THE EDITORS

George Luber is a Medical Anthropologist and Chief of the Climate and

Health Program at the National Center for Environmental Health, Cen­

ters for Disease Control and Prevention (CDC). Since receiving his PhD in

Medical Anthropology from the University of Georgia and joining CDC in

2002, he has served as an Epidemic Intelligence Service (EIS) oi cer and

senior health scientist.

In addition to managing the Climate and Health Program at CDC,

Luber is a cochair of the Climate Change and Human Health Workgroup

at the US Global Change Research Program, a member of the American

Anthropological Association’s Presidential Task Force on Climate Change,

a convening lead author for the hird US National Climate Assessment,

and a lead author for the Fifth Assessment Report of the Intergovernmen­

tal Panel on Climate Change. In 2015, Luber was proiled on the Weather

Channel’s Climate 25. He is also adjunct professor in the Departments

of Environmental Health, Anthropology, and Environmental Science at

Emory University.

h e indings and conclusions in this report are my own and do not nec­

essarily represent the views of the Centers for Disease Control and Preven­

tion/Agency for Toxic Substances and Disease Registry.

* * * Jay Lemery is an Associate Professor of Emergency Medicine at the Univer­

sity of Colorado School of Medicine and is Chief of the Section of Wilder­

ness and Environmental Medicine. He is the immediate past-President of

the Wilderness Medical Society and is currently the EMS medical director

for the US Antarctic Program. Lemery serves as a consultant for the Climate

and Health Program at the Centers for Disease Control and Prevention and

sits on the Institute of Medicine’s Roundtable on Environmental Health

Sciences, Research, and Medicine. He is a fellow of the American College of

Emergency Physicians and a past term member of the Council on Foreign

Relations. From 2005 to 2012, he was the director of Cornell Wilderness

Medicine and a member of the Global Health Steering Committee at the

Weill Cornell Medical College.

xxii The Editors

Lemery was an Echols Scholar at the University of Virginia and received

his MD from the Geisel School of Medicine at Dartmouth. From 2003 to

2004, he was chief resident in emergency medicine at NYU and Bellevue

Hospitals. He also holds academic appointments at the Weill Cornell Medi­

cal College and the Harvard School of Public Health (FXB Center), where

he is a contributing editor for its journal Health and Human Rights and

was guest editor for the June 2014 edition on climate justice. He is ai liate

faculty of the Colorado School of Public Health.

THE CONTRIBUTORS

Lorraine C. Backer, PhD, MPH, National Center for Environmental

Health, Centers for Disease Control and Prevention, Atlanta, Georgia

Christovam Barcellos, PhD, Oswaldo Cruz Foundation-Fiocruz, Rio de

Janeiro, Brazil

Charles B. Beard, PhD, Division of Vector-Borne Diseases, National Cen­

ter for Emerging and Zoonotic Infectious Diseases, Centers for Disease

Control and Prevention, Fort Collins, Colorado

Diane Bélanger, PhD, Université Laval, Ouranos, Canada

Diarmid Campbell-Lendrum, DPhil, World Health Organization,

Department of Public Health, Environmental and Social Determinants of

Health, Geneva, Switzerland

Stuart Capstick, PhD, School of Psychology, Cardif University, Cardif ,

United Kingdom

Adam Corner, PhD, School of Psychology, Cardif University, Cardif ,

United Kingdom

David Driscoll, MPH, PhD, Institute for Circumpolar Health Studies,

University of Alaska Anchorage, Anchorage, Alaska

Abdulrahman M. El-Sayed, MD, PhD, Mailman School of Public Health,

Columbia University, New York, New York

Kristie L. Ebi, PhD, MPH, ClimAdapt, Los Altos, California

Farah Faisal, BA, International Institutions and Global Governance,

Council on Foreign Relations,

Kenneth L. Gage, PhD, Division of Vector-Borne Diseases, National Cen­

ter for Emerging and Zoonotic Infectious Diseases, Centers for Disease

Control and Prevention, Fort Collins, Colorado

Sandro Galea, MD, MPH, DrPH, School of Public Health, Boston Univer­

sity, Boston, Massachusetts

xxiv The Contributors

Jada F. Garofalo, MS, Division of Vector-Borne Diseases, National Center

for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control

and Prevention, Fort Collins, Colorado

Pierre Gosselin, MD, MPH, Department of Social and Preventive

Medicine, Faculty of Medicine, Université Laval, Ouranos, Canada

Joy Guillemot, DrPH, World Health Organization, Department of Public

Health, Environmental and Social Determinants of Health, Geneva,

Switzerland

Jeremy Hess, MD, MPH, Emergency Medicine, Environmental Health,

Emory University Schools of Medicine and Public Health, Atlanta, Georgia

Daniel P. Johnson, PhD, Department of Geography, Indiana University–

Purdue University Indianapolis, Indianapolis, Indiana

Mark E. Keim, MD, MBA, DISASTERDOC, Lawrenceville, Georgia

Kim Knowlton, DrPH, Natural Resources Defense Council, Mailman

School of Public Health, Columbia University, New York, New York

Katie M. Konchar, MS, Tallahassee, Florida

Cecilia Martinez, PhD, Center for Earth, Energy and Democracy,

Minneapolis, Minnesota

Peter Montague, PhD, Environmental Research Foundation, Annapolis,

Maryland

Mathilde Pascal, PhD, Institut de Veille Sanitaire, Paris, France

Nick Pidgeon, PhD, School of Psychology, Cardif University, Cardif ,

United Kingdom

Philippe Pirard, MD, Institut de Veille Sanitaire, Paris, France

Maxwell J. Richardson, MPH, MCP, Public Health Institute, Oakland,

California

Linda Rudolph, MD, MPH, Center for Climate Change and Health, Pub­

lic Health Institute, Oakland, California

Jan C. Semenza, PhD, MPH, MA, Oice of the Chief Scientist, European

Centre for Disease Prevention and Control, Stockholm, Sweden

Nicky Sheats, JD, PhD, Center for the Urban Environment, h omas Edi­

son State College, Trenton, New Jersey

xxvThe Contributors

Perry Shei eld, MD, Departments of Preventive Medicine and Pediatrics,

School of Medicine, Mt. Sinai Hospital, New York, New York

Austin C. Stanforth, MS, Department of Geography, Indiana University–

Purdue University Indianapolis, Indianapolis, Indiana

James D. Tamerius, PhD, Department of Geographical and Sustainability

Sciences, University of Iowa, Iowa City, Iowa

Cristina Tirado, DVM, MS, PhD, University of California Los Angeles,

Institute for Environment and Sustainability, Los Angeles, California

Christopher K. Uejio, PhD, Department of Geography and Program in

Public Health, Florida State University, Tallahassee, Florida

Karen Wertz, MA, Department of Geography, Florida State University,

Tallahassee, Florida

Carmel Williams, PhD, Fellow, School of Population Health, University of

Auckland, New Zealand; Fellow, FXB Center for Health and Human Rights,

Harvard TH Chan School of Public Health, Boston, Massachusetts

Lewis H. Ziska, PhD, Crop Systems and Global Change Laboratory, US

Department of Agriculture, Beltsville, Maryland

GLOBAL CLIMATE CHANGE AND HUMAN HEALTH