Resilient Cities st World Congress on Cities and Adaptation to Climate Change Bonn, Germany May 29, 2010

Transcription

1 Robert Kononowech PhD Student, Environmental Health Sciences Marie O Neill Assistant Professor, Epidemiology & Environmental Health Sciences School of Public Health University of Michigan Resilient Cities st World Congress on Cities and Adaptation to Climate Change Bonn, Germany May 29, 2010

2 Overview Introduction on climate change, heat and health Public health prevention strategies Health research examples Local action on heat and health Translating health research into adaptive/mitigative decision tools Next steps and conclusions

3 Climate change, heat and health Frequency, intensity, duration of heat waves/ hot weather projected to increase Mortality during hot weather is well-studied Vulnerabilities by age, health status, SES, race, housing, air conditioning access, community social characteristics Relatively little known about morbidity Exposure to heat in epidemiology frequently assigned on the basis of airport temperature monitoring stations for a whole region

4 Heat Waves Two or more days of excessively hot weather (definitions can vary) A period of abnormally and uncomfortably hot and usually humid weather (Glossary of Meteorology) 1995 Chicago Heat Wave ~600 heat-related deaths over the span of 5 days Most deaths were among low-income elderly High humidity, temp reached a high of 106⁰F (41.1 ⁰C) 2003 European Heat Wave More than 35,000 heat-related deaths across Europe from June to August 2003 Mostly elderly and sick

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6 Preventive Strategies Heat Health Warning Systems (HHWS) Interventions triggered when forecast meteorological conditions are oppressively hot Reverse 911 calls, text messages to mobile phones Opening cooling centers to assist low-income and elderly population Increase the prevalence and use of air conditioning (not sustainable-other limitations) Alterations to the built environment Plant trees, increase albedo of manmade structures, improve building ventilation, etc Local public health initiatives Education and outreach Reduce emissions of greenhouse gases

7 Maximum Temperature 10 August 2003 Excess Mortality France 14,800 Portugal 1,316

8 Heat Health Warning Systems Source: ABC News Australia

9 Increased Air Conditioning Access Project ElderCool:

10 Increase Albedo & Plant Trees

11 Heat health research at Michigan Focus on disproportionate impacts Low income, elders, communities of color Aim to package research results for effective communication Developing tools of relevance for public health action Involve policymakers and local communities in problem identification, research design, needs assessment, translation of findings into action

12 3 major research projects Heat-related hospital admissions among the elderly: Community, socio-economic and medical determinants of vulnerability and economic impacts ctdetail/abstract/7884/report/0 Climate change, heatwaves, and health: Local tools for sustainability, equity, and prevention Reducing social disparities of heatwave impacts in a changing climate htm#7

13 Heat and hospital admissions among the elderly: Community, socio-economic and medical determinants of vulnerability and economic impacts U. S.Environmental Protection Agency Science to Achieve Results (STAR) grant R (January 2006-December 2010) Project goals Better understand health consequences of climate change and variability by studying heat and daily hospital admissions among elderly people in U.S. cities ( ) Evaluate individual/community determinants of vulnerability Estimate economic impacts Disseminate results to local governments to foster and inform preventive action Investigators: Marie O Neill, Ana Diez-Roux, Dan Brown (U of Michigan); Missy Stults, Michael Hughes (ICLEI: Local Governments for Sustainability); Joel Schwartz and Antonella Zanobetti (Harvard)

14 Reducing social disparities of heat wave impacts in a changing climate U.S. Centers for Disease Control and Prevention Grant R18 EH (Sept August 2011) Explore how to better translate evidence-based interventions intended to reduce social disparities in the health impacts of heat waves (e.g. heat wave health warning systems, tree planting and modifications to the built environment) to other settings. The goal is to encourage the widespread adoption of effective local programs to prevent illness and save lives during heat waves. Qualitative and quantitative approaches Case studies: Detroit, MI; Phoenix, AZ, New York, NY, Philadelphia, PA Investigators: Marie O Neill, Edith Parker, Richard Rood (U of Michigan) Sabrina McCormick (George Washington U.) Missy Stults, Michael Hughes (ICLEI: Local Governments for Sustainability) Joel Schwartz and Antonella Zanobetti (Harvard) Kristie Ebi (ESS/LLC)

15 Climate change, heat waves and health: Local tools for sustainability, equity and protection Funded by: Graham Environmental Sustainability Institute, University of Michigan (June 2008-May 2011) Conduct an interview-based needs assessment (among residents and government officials of Detroit, Michigan) Develop a heat vulnerability mapping decision support tool and demographic vulnerability indicators temperature data; satellite images of land-cover relevant to heat exposure (green space, built environment characteristics); demographic vulnerability indicators derived from the U.S. Census (percent poverty, race/ethnic composition, elderly residents, and single-person households) Design a prototype simple, inexpensive HHWS that could be implemented in Detroit and validate the system using historical health outcome data Primary Investigators: Marie O Neill, Richard Rood, Daniel Brown, Edith Parker

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17 But: the gradient is not just urban to rural! Within urban areas, there is strong patterning of both heat exposure and social vulnerability to heat* Vulnerability mapping has been proposed as a tool to help target Heat wave Health Warning System interventions, which are now triggered based on one temperature monitor for a large area * e.g., Harlan SL, Brazel AJ, Prashad L, Stefanov WL, Larsen L Neighborhood microclimates and vulnerability to heat stress. Social Science & Medicine 63(11): 2847.

18 Heat and health: Information for prevention, equity and sustainability E 3 E 4 G 3 G 4 P 3 P 4 E 1 E 2 E n G 1 G 2 G n P 1 P 2 P n Environmental Exposures Geographical Information Population Information Heat warning Cityscape VP 1 VP 2

19 Census tract level data from Detroit showing green space and population characteristics relevant to vulnerability

20 High resolution heat profile: London London slides used with permission of Glenn MacGregor

21 Spatial variation of heat sensitivity: London Index based on: Pop > 85 Long-term limiting illness Living in a flat Living in medical/care institutions Deprivation

22 High heat sensitivity mapped over surface temperature

23 Convergence of surface temperature hotspots and areas of high sensitivity Is this pattern of joint occurrence a good predictor of the spatial variation of mortality? Are these maps a useful tool for action?

24 Local action on heat and health Few U.S. cities currently have programs Bernard SM, McGeehin MA. Municipal heat wave response plans. American Journal of Public Health 2004;94(9): Balbus J, Ebi KL, Finzer L, Malina C, Chadwick A, McBride D, Chuk M, Maibach E. Are We Ready? Preparing for the public health challenges of climate change National Association of City and County Health Officials (NACCHO)/Environmental Defense O Neill MS, Jackman D, Wyman M, Manarolla X, Gronlund CJ, Brown D, et al U.S. local action on heat and health: are we prepared for climate change? International Journal of Public Health. DOI /s

25 City preventive programs survey Administered by ICLEI under our EPA-funded study Survey Design Questions based in part on EPA Excessive Heat Events Guidebook Cover heat health warning systems, urban heat island mitigation (tree planting, reflective paving) Key results: Local leadership, resources and political support was most important in whether programs existed Local government staff most wanted to learn from case studies in other communities

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27 Future project plans Complete analyses of heat and hospital admissions Estimate costs of heat-related health impacts Consider projections of future temperature range and variability, future demographic profiles, and potential preventive/mitigative programs to forecast range of impacts Incorporate results into decision tool, interactively with end users, and hold workshops with participation from researchers, local leaders and other stakeholders

28 Heat Health decision tool Decision tool that will allow users to evaluate and compare the benefits and costs of various urban heat island mitigation and adaptation strategies Allow users to choose from various strategies such as tree planting or increasing the reflectivity (albedo) of buildings and roads Quantify the human health benefits gained from reducing temperature Reductions in heat-related morbidity and mortality Also taking into account the effects of air pollution Similar to some pre-existing decision tools like BenMAPand CAPPA

29 BenMAP Environmental Benefits Mapping and Analysis Program (BenMAP) Developed by the EPA A Geographic Information System (GIS) based tool for estimating the health impacts and economic costs associated with changes in ambient air pollution CAPPA Climate and Air Pollution Planning Assistant Developed by ICLEI-Local Governments for Sustainability (ICLEI) Excel-based decision-support tool containing data on over 100 emission-reduction strategies Allows users to compare cost and effectiveness of various reduction strategies and identify a custom reduction plan

30 Source: Neal Fann, U.S. Environmental Protection Agency, Office of Air Quality Planning and Standards

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33 CAPPA Interface Source ICLEI USA

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35 Heat Health Decision Tool Collaborating with ICLEI-Local Governments for Sustainability, EPA, researchers at Harvard Use mortality/morbidity effect estimates developed in our studies as analytical basis for decision tool Culminate in the creation of a free, easy-to-use decision tool intended for use by a wide variety of users: politicians, public health professionals, governmental agencies at the local, state or federal level, policy groups, nonprofit organizations, community outreach groups, researchers and scientists, etc

36 Heat Health Decision Tool (cont.) Develop a network of end-user collaborators to provide input and feedback from the very beginning of process Questions: Is this something that you would find useful? What other decision/planning/analysis tools do you use or think are useful? Are there other similar initiatives we should coordinate with? What useful characteristics would you like to see included? Other thoughts, input?

37 Prototype Decision Tool Table O'Neill MS, Carter R, Kish JK, et al. Preventing heat-related morbidity and mortality: new approaches in a changing climate. Maturitas 2009;64(2):

38 Concluding remarks Regardless of the nature of future climate change, or our research results, mitigation and adaptation activities pursued by local governments are good ideas Energy efficiency measures save money Better stewards for future generations Climate sensitive health impacts are an environmental and social justice issue Affect poor, elderly, young, and communities of color disproportionately Health sector is an important adaptation partner

39 Thank you! Marie O Neill marieo@umich.edu Robert Kononowech robertwk@umich.edu

40 Extra slides

41 Study population and data Health data: > 11.8 million Medicare billing records (65 years +) for all non-elective hospital admissions Evaluated during summers (May-Sept), Environmental data: outdoor monitors in cities Daily temperature and humidity Air pollutants (PM 10 and ozone)

42 Reid C, O'Neill MS, Gronlund CJ, Brines SJ, Brown D, Diez-Roux AV, et al Mapping Community Determinants of Heat Vulnerability Environ Health Perspect doi: /ehp ( ). 42

43 Health Predictions, Risk Assessment % No % Yes % Blank % Don't Know Are excessive heat events an issue for your city government? 49% 37% 16% 0% Has your city implemented any programs, policies or strategies to alleviate the dangerous effects of excessive heat events? 43% 43% 16% 0% Regularly review weather forecast information for the purpose of preparing for excessive heat events 13% 36% 53% 0% Develop quantitative estimates of potential health impacts related to hot weather (e.g., mortality) 29% 13% 60% 0% Evaluate other types of information in developing or implementing programs 21% 19% 61% 0% Have established criteria for identifying heat-attributable deaths and illness 20% 9% 67% 6% Maintain a current and accessible record of facilities and locations that may house individuals who are particularly vulnerable to heat-related illness (e.g., elderly, homeless) 19% 29% 53% 1% Other prediction/risk assessment activities 19% 16% 64% 3%

44 Driving Factors % Not at all important % Slightly important % Somewhat important % Quite importa nt % Extremely important Cost of Implementation 3% 1% 20% 21% 13% Local Government Leadership 3% 0% 4% 30% 21% Public Health impacts of heat 1% 1% 3% 24% 27% Economic impacts of hot weather 3% 7% 16% 20% 9% Greenhouse gas emissions mitigation 6% 9% 17% 17% 9%

45 Do community characteristics modify these associations? Based on previous literature, we identified variables that capture community characteristics relevant to heat/health risk, derived from four data sources U.S. Census (Geolytics CD, by county) American Housing Survey Satellite data on land-cover (green space) City prevention program survey

46 Variables from the U.S. Census Percent of population below the federally defined poverty line 25 years and older whose highest degree was less than a high school diploma or equivalency identified as being other than white race Percent single person households 65 years and older American Housing Survey Percent homes in proximity to water or green space Percent multi-story and multi-unit housing Percent homes in disrepair Air conditioning prevalence (total and by race and age)

47 Satellite data on green space US National Land Cover Data set (NLCD) for the year 1992 and 2001 U.S. Geological Survey free data source Green space defined as subset out of 21 different land cover classes County and zip-code polygons superimposed over maps to tabulate and link to health data

48 National Land Cover Data 1992