Health effects of climate changes: need for mitigating and adaptive measures

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Health effects of climate changes: need for mitigating and adaptive measures Thursday, 27 March 2014 Filoxenia Conference Centre, Nicosia, Cyprus International Conference ADAPTtoCLIMATE SESSION V: Climate change & Health P. Nicolopoulou-Stamati UoA Medical School MSc: Environment and Health. Capacity building for decision making

This presentation addresses the: Outline of the health effects of climate changes Highlight of mitigation and adaptation measures and It underlines the urgent need for action

Does climate change negatively affect human health

Climate changes may negatively affect human health both directly through extreme weather events outbreaks of climate sensitive diseases: malaria and dengue fever indirectly food and water insecurity issues

The problem and the response Climate changes and their health impacts can only be predicted within wide margins of uncertainty A precautionary approach and the complementary responses of adaptation and mitigation are proposed dealing with the health risks of global warming

Current situation Current climate change increasingly evolves as a major health risk and an important challenge to deal with. The changing climate and the severity of the health impacts reveal the urgent need to act and adopt mitigating and adaptation measures. Addressing environmental health in plans dealing with climate changes will result in benefits for natural environment, human and animal health.

Direct health effects of CC are related to Air quality Extreme weather conditions High temperatures and heat waves Floods and heavy precipitation Tropical cyclones Droughts

Indirect health effects of CC 1/3 Climate change is related to indirect health impacts which are affected by changes in the Earth s climate. It produces food and water insecurity resulting in economic decline In view of the fast increasing population in many developing countries these issues are of paramount importance.

Indirect health effects of CC 2/3 Sufficient food of good quality is basic in avoiding food insecurity and the associated negative health impacts. Reassurance of safe and enough water is essential Poor sanitation is a risk factor for the development of many diseases and related, influencing factors, such as already poor sanitation, overcrowding, unequal distribution of natural resources and poverty which all contribute increasing the vulnerability to climate sensitive diseases Water-borne diseases cannot be avoided when hygienic conditions are substandard and where there is insufficient access to safe drinking water Poverty can increase as a result of CC

Indirect health effects of CC 3/3 Energy consumption patterns and extreme temperature events may lead to increased energy needs for cooling or heating This is well documented in relation to the urban heat island effect Biofuels are considered able to counteract the increasing greenhouse gas emissions Biofuel crops need land and water which otherwise can be used to produce food in particular for poor and vulnerable populations In this way, biofuel crops contribute to food insecurity.

Vulnerability to CC Vulnerability is the degree to which a system is susceptible to, and unable to cope with, adverse effects of climate change, including climate variability and extremes. Vulnerability is a function of the character, magnitude, and rate of climate change and variation to which a system is exposed, its sensitivity, and its adaptive capacity. M.L. Parry, O.F. Canziani, J.P. Palutikof, P.J. van der Linden, C.E.Hanson, Climate Change 2007: Impacts, Adaptation and Vulnerability. Contribution of Working Group II to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change, Cambridge University Press, Cambridge 2007.

Social dimension of the CC Vulnerability is about the social dimension of the CC, because the poorest (low or zero income) and other social groups, such as children, elderly, sick people under medication, marginalized and homeless people, are more susceptible to CC and to extreme weather conditions CC aggravate social inequity and factors such as social class, gender, age, ethnicity, political decisions determine the intensity of the impact

Capacity to adaptation is a key element of vulnerability Even within the same geographical area, the adaptation capacity extremely differs among social groups. Vulnerable groups (including sick people) face higher risks from the same extreme weather events than the more privileged ones Areas which are (highly) vulnerable include many developing countries and coastal regions An example is provided by the developing small-island states. For them a natural disaster or the coral deterioration that can be attributed to CC, results in subsequent declines in the income from fishery and tourism

Geographical location: an important risk factor for vulnerability All coastal regions face adverse effects as a result of sea level rise and storms Other risk factors result from anarchic urbanization and especially from the emergence and existence of slums, i.e. the vast informal settlements characterized by overcrowding, lack of sanitation and of safe water (probable causes of diarrheal diseases) and many other socioeconomic and health related problems

Vulnerable groups The most vulnerable groups are not or underrepresented in decision-making. This concerns both whole countries and social groups. This increases their vulnerability and limits their adaptive capacity Decision making should take into account a socially fair burden sharing of the CC risks and avoid making the already vulnerable even more susceptible to CC Vulnerability is a function of factors changing over time and space. Vulnerability is not static and requires continuous efforts to determine and manage its real dimensions.

Uncertainty Different climate scenarios and forecasts allow predicting climate behaviour, but all of them are characterized by inherent uncertainties Part of this uncertainty is about predicting the extent of the health outcomes. Health outcomes are the result of complex interactions between climate, environmental policies, adaptation and mitigation measures, population growth and socioeconomics. Multi-causality and the resulting complexity make predictions uncertain

Example of uncertainty A primary uncertainty is related with the average increase in temperature which is forecasted for the end of this century and which ranges between 1.1 and 6.4 o C An increase of a few degrees above a threshold during summertime will cause a significant number of excess deaths Therefore, even a slight increase in temperature might result in significant effects. Moreover the range of the mathematical uncertainty by itself constitutes a risk.

In spite of the uncertainties, convincing evidence exists which indicates that heat morbidity and mortality will increase with increasing temperature. The geography and incidence of climate sensitive diseases will change worldwide Underestimation of the importance of the uncertainty increases the vulnerability which changes from one period to another

Adaptation strategies Effective adaptation strategies can be developed even if science is not able to accurately predict the natural phenomena If policy makers use scientific uncertainty as a justification for inertia or for acting at an inappropriately low level, lack of preparedness and health hazards are likely results The nature of adaptation and mitigation measures like clean technology and energy efficiency, increases the overall uncertainty. This is because the necessary degree of these measures cannot be determined exactly and only estimations are possible Decision makers have to deal with uncertainty and only a precautionary attitude can prevent and; if possible, reverse negative health trends

Mitigating measures are about reducing GHG emissions and counteract in this way the fundamental drivers of CC. Mitigation necessitates a policy of which also health will benefit as a result of the reduction of pollutant emissions, a more efficient use of resources, and an enhancement of GHG sinks which absorb these gases and remove them from the atmosphere Adaptation is about coping with CC effects as sea level rise, dryer climate, surface and ground water levels, wildfires and extreme weather events

Poverty, social problems, lack of understanding the problem and its seriousness, lack of planning, of policy and of know-how are common constraints to achieve adaptation interventions These obstacles reveal the ability of developed countries to adapt more effectively as compared to the developing ones Adaptation entails new treats to human health and some of them also offer opportunities improving health

Mitigation and adaptation are the two types of responses to CC that must be combined and considered as complementary to achieve positive results. In other words, adaptation measures alone may prove inefficient to deal with the impacts of global warming The capacity to adapt to CC and its impacts is influenced by a complex set of factors, including socioeconomic situation and policy choices. This shows that adaptation is a dynamic process, requiring continuous efforts

Strategies that should be adopted must apply the precautionary principle, decrease vulnerability and increase adaptive capacity Measures such as the increase of energy prices, as through additional taxes, have a counterproductive capacity and negatively affect both health and climate. (e.g. We experienced the situation in Athens in 2013-2014, through the use of cheap and low quality energy sources which increased the air pollution)

Mitigation and adaptation to CC Mitigation includes measures promoting the transition to sustainable energy, such as the use of solar, wind and water power, to CO 2 neutral buildings, cities and regions, and to a more efficient mobility Agriculture should be less globalized and demand less inputs of materials, products and energy Examples of mitigating measures include: the use of solar photovoltaic systems, the use of more efficient vehicles and lighting, recycling processes and reforestation because forests are a major carbon sink

Lifestyle and behavior can enhance mitigation efforts More bicycling and walking Adoption of personal energy-saving efforts Reduction of household waste Avoidance of superfluous consumption are environmentally friendly options that people can adopt to contribute to the mitigation processes

Adaptation measures Targets to increase resilience and reduce vulnerability to CC Refers to negative impacts that are currently ongoing and to their negative impacts that are expected during the following decades Can be applied in key sectors including energy use and management, water use, distribution and management, agriculture, infrastructure and settlements, human health, tourism and transport Are either technical or managerial and often require policy initiatives

Adaptation in the health care sector benefits health directly This can be realized by: awareness raising of the public and the decision makers funding health programs enhancing health infrastructure resilience improving surveillance of climate sensitive diseases organizing appropriate education and training programs for health professionals to transfer both explicit and tacit knowledge on climate change, its impacts and responses

Conclusions 1/3 Current climate change evolves towards a major health risk, causing direct and indirect effects and offers a real policy and management challenge. Climate outcomes and their health impacts can only be predicted within wide margins of uncertainty Uncertainty should not be used advocating inertia in the adoption of mitigation and adaptation measures A precautionary approach in the management responses allows reducing global warming related health risks.

Conclusions 2/3 Vulnerability varies among social classes, poor and wealthy nations, and over time. The severity of the CC related health impacts reveals the urgent need to act. Adequate planning incorporates environmental health. The measures proposed benefit both the natural environment and human health.

Conclusions 3/3 Unfortunately, the CC / environmental / health triple win situations are rare. Of core importance are comprehensive local, regional and national climate plans addressing CC effects in an integrated and societally supported way. Monitoring should make sure the plans reach their targets. Practical instruments as group purchases of green energy, eco-doctors, subventions, training, education and awareness significantly contribute to these plans and to transitions at the local level.

Thank you