Energy and Public Health

Transcription

1 Energy and Public Health Dr. Carlos Dora, PhD Former Coordinator Environment and Health, WHO, Geneva Professor Environment and Health Governance and Justice, Columbia University, New YOrk

2 Energy and Health in Urban Areas Clean Air, few traffic injuries/ burns/intoxications, physical activity, waste managed, access to electricity

3 Integrating energy, health and climate into urban policies: synergies and co-benefits Clean Energy Housing Transport Waste Management Injuries, physical activity, noise, diet Air pollution Climate Change Local health impacts Global health impacts

4 How to identify relevant Health Impacts? Health Impact Assessment of urban policies (transport, housing, energy production waste etc.)

5 HIA procedure similar to EIAs Stakeholder consultation 1 Screening 2 Scoping 3 Appraisal 4 Reporting 5 Monitoring Quickly establishes "health relevance" of the policy or project. Is HIA required? Identifies key health issues & public concerns, establishes ToR, sets boundaries. Rapid or in-depth assessment of health impacts using available evidence who will be affected, baseline, prediction, significance, mitigation. Conclusions and recommendations to remove/mitigate negative impacts on health or to enhance positive. Action, where appropriate, to monitor actual impacts on health to enhance existing evidence base.

6 Part of Development Banks safeguards PS 1: S&E Assessment and Management Systems PS 2: Labour and Working Conditions PS 3: Pollution Prevention and Abatement PS 4: Community Health, Safety & Security PS 5: Land Acquisition and Involuntary Resettlement PS 6: Biodiversity Conservation and Sustainable Natural Resource Management PS 7: Indigenous Peoples PS 8: Cultural Heritage procedures (IFC example)

7 Modelling Transport scenarios for Sao Paulo, Brazil: Changes in DALYs for each scenario attributable to changes from air quality, physical activity and road injuries Injury Air pollution Physical activity Total SP EC London 2012 SP California SP 2040

8 Estimate costs of inaction - of not having a sustainable transport and land use policy Savings to health systems Reduction in out of pocket $

9 Health in the New Urban Agenda Habitat III Engaging people in exploring policies and opportunities for health and urban development

10 Air Pollution is a major risk to health Scientific evidence showing that particles smaller than 2.5mm penetrate deep into the lungs and blood stream and affects many body organs causing stroke, heart disease, cancers, COPD, pneumonia and other diseases (e.g. dementia, diabetes).

11 Health Impacts: Air Pollutants Products of incomplete combustion Outdoor Air Pollution CO2 emissions are not a direct problem for health---rather it is a mixture of pollutants that are released during the incomplete combustion of carbon-based fuels that have direct impacts on health. The products of incomplete combustion (PICS) include but are not limited to things like methane, poly-aromatic hydrocarbons, carbon monoxide, etc. PAH CH4 NOx CO2 CO CH2O NMVOCs SOx

12 It also affects the vascular systems causing strokes and heart attacks Physiopathology e.g. calcification of artery walls

13 Air pollution causes lung diseases Lungs exposed to tobacco and to Indoor air pollution Pathology slides - Courtesy Prof. Saldiva, São Paulo, Brazil

14 WHO Interactive Maps Air Pollution Exposure to PM2.5 Data integration: Satellite remote sensing Ground measurements Emission inventories Air transport models Country mean : 62 mg/m 3

15 Air Pollution in Cities Low and Middle Income Cities are Getting Worse Trend in PM 2.5 or PM 10 based on cities available in several versions of the database, by region 1. Region Africa (Sub-Saharan) America, LMI America, HI Eastern Mediterranean, LMI Eastern Mediterranean, HI Europe, LMI Europe, HI South-East Asia Western Pacific, LMI Western Pacific, HI World 3 Trend over the mean period NA 1 Criteria for inclusion: cities with measured PM2.5 or PM10 values in the three database versions covering a period of 3 years or more, or in two versions and covering a period of 4 years or more. 2 : No more than 5% change over the five-year period; : More than 5% decrease over the five-year period; : More than 5% increase over the five-year period. 3 The mean for the World is based on weighting by regional urban population. LMI: Low- and middle-income countries; HI: High-income; NA: Not available. Results are based on 795 cities and are to be interpreted with caution, as 1) cities included might not ensure representativeness, 2) yearly variations due for example to climatic changes can be important and 3) a 5-year comparison does not necessarily represent trends, in particular when changes are limited.

16 Energy and Health Care Facilities

17 Importance of energy to health services (in particular access to electricity) Easier recruitment and training Better staff morale Continued medical education Staff recruitment and retention Medical Services Energy Prolonged opening hours Wider range of services Better functionality of medical devices Administ ration and logistics Better communication Improved records management Improved cold chain Laboratory testing E-health Disease prevention and treatment Health and safety General hygiene improved Enhanced safety Staff and patient sense of security and safety Source: WHO & World Bank (2015). Access to Modern Energy Services for Health Facilities in Resource Constrained Settings.

18 'Greening' health facilities can expand coverage of maternal, child & emergency services 21-59% of health clinics in six African countries had NO electricity at all. Women give birth in the dark, by candlelight, by car headlights. 5-12% of clinics surveyed in the same six countries lacked access to clean water (from an "improved" protected well or piped source). Small solar panels generate basic electricity for lights, cold chain/vaccines, diagnostics, telecommunications, water pumps.

19 Strategic assessments Policies that can provide clean household energy & protect public health

20 Global data on Household Energy cooking, lighting and heating Indoor air pollution Burns from fires, Intoxications from kerosene use Time use by children in homes using polluting fuels 15hs vs 5 hs

21 WHO Indoor Air Quality Guidelines: for fuels and technologies used for cooking, heating and lighting in the home: 1. Don't use Kerosene 2. Don't use Coal 3. Use only very efficient cookstoves 4. Follow emission rates provided by the guidelines 5. Use clean fuels LPG, Biogas, ethanol in the transition

22 Energy Efficient Housing More climate friendly housing, and better siting/planning can: reduce deaths and illness from extreme heat/cold exposures & urban heat island effect; Improved natural ventilation and screening measures can protect health from: vector borne and respiratory diseases/tb; asthmas and allergies.

23 Health impacts of the Extractive industry

24 Health impacts associated with extractive industries activities Project induced pressures Population influx Rapid development High expectation of benefits Land use changes Environmental degradation or pollution Environmental, social, or institutional determinant of health affected Competition for resources or livelihood opportunities Competition for project related benefits Change in household/individual purchasing power Strain on infrastructure/social services Change in social demographics Exposure to environmental risk factors (chemicals, noise, air pollution, etc.) Loss of access to land Loss of biodiversity, ecosystems services Resulting health impacts Change in diet, nutritional status Increased risk for infectious diseases Non-communicable diseases Stress and mental health disorders Substance abuse, alcoholism Violence, crime, conflict Accidents and injuries

25 Health in the extractive industries (oil and gas, mining) Extractive industries vital economic sector for many developing countries few able to convert this wealth into social benefit Health impacts substantial, negative, often disproportionately borne by vulnerable segments of population Health impacts documented (known) and can be predicted, monitored, and managed if the appropriate systems are put in place

26 Transport and Health Outdoor urban air pollution 3.7 million deaths Physical inactivity 3.2 million deaths; 19 million healthy life years lost Traffic injuries 1.3 million deaths Traffic noise stress, memory loss and analytical impairment Climate change over deaths Access to vital goods and services, social networks/equity/cohesion under reported

27 Evidence synthesis What are the transport policies with excellent health performance? Walking, Cycling, Public Transport

28 Urban Health in SDGs HOUSING

29 Example: air pollution and climate change A global campaign to protect our health and climate by improving air quality MARCH

30 Visualize a healthier future