EcoCare Conference

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Human Health in a Changing Climate
EcoCare Conference October 19, 2009 Peter Berry
Ph.D. Climate Change and Health Office Health
Canada
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Climate change is the biggest global health
threat of the 21st century
Lancet and UCL, 2009
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Key Climate Impacts Today

• Over 300,000 deaths per year
• Over 300 million people
• severely affected each year
• Over 100 billion US dollars of
• economic losses each year
• Over 20 million climate
• displaced people, with 1 million
• more each year

(Global Humanitarian Forum, 2009)
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Climate Change Impacts on Health
McMichael and Bertollini, 2009
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Recent Reports - International

• World Health Organization (2008) Protecting
  Health in Europe from a
• Changing Climate
• USA - Global Climate Change Impacts in the
  United States (2009)
• European Environment Agency (2008) Impacts of
  Europes Changing
• Climate
• Australia - Climate Change in Australia (2008)
• UN Food and Agriculture Organization Climate
  Change Implications for
• Food Safety
• Climate Change and Children A Human Security
  Challenge (Unicef, 2008)

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Recent Reports - Canadian

• Human Health in a Changing Climate A Canadian
  Assessment
• of Vulnerabilities and Adaptive Capacity
  (Health Canada, 2008)
• Emergency Management Taking a Health
  Perspective (Health
• Canada, 2009)
• Climate Change and Health in British Columbia
  (2008)
• Climate Change and Extreme Weather Designing
  Adaptation
• Policy (Henstra and McBean, 2009)
• From Impacts to Adaptation (NRCan, 2008)

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Climate Change and Health Vulnerability Assessment

• Table of Contents
• Introduction Health in a Changing Climate
• Assessment Methods
• Impacts of Climate Change on Water, Food, Vector
  and Rodent-borne Diseases in Canada
• Air Quality, Climate and Health
• Canadian Vulnerabilities to Natural Hazards and
  Extreme Weather
• Health Impacts of Climate Change in Quebec
• Health Impacts of Climate Change in Canadas
  North
• Vulnerabilities, Adaptation and Adaptive Capacity
  in Canada

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Air Quality

• Under 4 degree increase in temperature ozone
  levels would increase in Canadian communities
• Most affected areas Montreal, Toronto,
  Vancouver, Calgary, Edmonton, and Winnipeg
• Largest increase in Windsor Quebec corridor
• 312 more deaths
• 4.6 increase in health burden to Canadian
  society related to air pollution over 3-month
  summer period (1.3 Bil)
• PM2.5 levels to decrease

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• Climate change will increase risks
• associated with some infectious diseases

Possible spread of I. Scapularis in Canada under
climate change
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Health Impacts from Floods

• Drowning, injuries
• Shock, hyperthermia, cardiac arrest
• Wound infections dermatitis conjunctivitis
  gastrointestinal illnesses ear, nose, and throat
  infections water-borne diseases
• Psychosocial disturbances
• Waterborne infections (enterogenic Escherichia
  coli, Shigella, hepatitis A, leptospirosis,
  giardiasis, campylobacteriosis), dermatitis,
  conjunctivitis
• Vector-borne diseases
• Electrocutions, injuries lacerations skin
  punctures
• Food shortage, disruption of emergency response

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Frequency of Natural Disasters in Canada
Canadian Disaster Database, 2006
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Temperature-Mortality Relationships
Gosselin et al., 2008
2020 150 deaths 2050 550 deaths 2080 1400
deaths
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Extreme Heat - Vulnerable Populations

• Seniors
• Pre-existing disease
• Social factors (living alone)
• Use of certain drugs (e.g., antidepressants,
  alcohol, diuretics
• Impaired cognition (e.g., dementia)
• Housing (e.g., floor)
• Lack of air conditioning
• Physical activity overexertion or inactivity

2006 seniors 13 of population 2031 seniors
25 of population
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Climate System Surprises
Ocean Acidification
Melting of Polar Ice
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Adaptation Matters Heat alert and response
systems Europe WHO study indicated that most
of the 70,000 heat wave deaths in Europe in 2003
were preventable Recent study (2008) indicates
that a similar heat wave in France in 2006 lead
to approx. 4,000 less deaths due to
implementation of alert system United
States 1995 heat wave in US mid-west caused 514
deaths in Chicago Similar heat wave in 1999
resulted in only 119 deaths due to better
response plans
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Adaptation - The Critical Role of Public Health
Cases of dengue fever in Texas and Mexico
1982-2002
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The Adaptation Imperative
In the face of what we know about the serious
threats posed by climate change to health, the
question today is not whether public health
action is necessary, but what to do and how to do
it. Health systems should respond by helping to
strengthen disease control and health
protection. Dr. Marc Danzon WHO
Regional Director for Europe 2008
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International Day for Disaster Reduction 2009
Urgent action needed to protect hospitals from
natural hazards
WHO, October 14, 2009
WHO urges hospitals to join climate change
battle National
Post, May 22, 2009
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Adaptation Challenges

• What information not merely informs but changes
  behaviour?
• What is adaptation? What is needed to do to
  adapt?
• New activity? (e.g., heat alert system)
• Better activities? (e.g., public outreach
  maladaptation)
• More activities? (e.g., expanded surveillance)
• How do you mainstream adaptation?
• acquire information about implications of future
  climate
• consider climate in routine risk assessments
• institutionalize climate considerations into
  assessment
• and planning
• How do you take a multi-sectoral/jurisdictional
  approach?
• federal, provincial/territorial, municipal level
  collaboration
• health considerations in multi-sectoral planning
• What are the costs of adapting? What are the
  costs of not adapting?

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Knowledge of Health Risks
Environics, 2008
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Vulnerability of Canadians
Environics, 2008
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Protection from Climate Change Health Impacts
Environics, 2008
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• Health Portfolio Activities on
• Climate Change
• Extreme Heat and Health
• Adaptation in Northern Communities
• Climaterelated Infectious Diseases

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Health Canadas Extreme Heat Initiative

• Heat Alert and Response Systems
• Pilot systems in Canadian communities
• Best practices guidebook
• Health messaging to change behaviour
• Health Professional Interventions and
• Training
• Development of clinical guidelines
• Development of training materials

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Pilot heat alert and response systems

• Windsor, ON
• Fredericton, NB
• Winnipeg, MN
• Assiniboine Region, MN

http//www.euro.who.int/Document/E91347.pdf
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Heat health messaging

• Challenges
• Scientific basis for messages
• Changing behaviour of vulnerable populations
• Reaching public health authorities
• Reaching caregivers

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Clinical guidelines

• Doctors
• Nurses
• Home caregivers
• Paramedics
• Pharmacists
• Coaches
• Teachers

http//www.dh.gov.uk/en/Publicationsandstatistics
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• Canadians possess the knowledge, institutions
• and skills to reduce climate change health risks
• BUT these resources must be harnessed to
  address
• the challenges ahead
• public health officials should be engaged and
  supported
• public health programs should be
  mainstreamed
• best practices for adaptation must be
  identified
• collaborative partnerships must be built

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More information
Peter_Berry_at_hc-sc.gc.ca
Climatinfo_at_hc-sc.gc.ca