Climate Change, Respiratory Health, and Equity Asthma Regional - PowerPoint PPT Presentation

Climate Change, Respiratory Health, and Equity Asthma Regional Council of New England May 14, 2019 Renee N. Salas, MD, MPH, MS Burke Fellow and Affiliated Faculty, Harvard Global Health Institute Lead, Lancet Countdown United States Brief Founder & Chair, Society of Academic Emergency Medicine Climate & Health Interest Group Department of Emergency Medicine, Massachusetts General Hospital / Harvard Medical School

Disclosures None

My Journey

Global Moral Imperative Public Domain Image Costello et al, Lancet 2009

Making Climate Change Personal Health Public Domain Image

Audience Poll Prior Exposure to Climate Change & Health

Agenda • Climate Change in the Northeast • Implications for Respiratory Health and Equity • Opportunities

The Essentials of Climate Change in the Northeast

Greenhouse Gas Emissions

Greenhouse Gases

Rising Atmospheric CO2 https://climate.nasa.gov/climate_resources/24/

Northeast: Canary in the Coal Mine Public Domain Image

Increasing Global Temperature https://data.giss.nasa.gov/gistemp/graphs/#

U.S. 2018 Experience https://www.ncdc.noaa.gov/billions/

NE Will Reach 2°C by 2035 NCA4 2018

Sea Level Rise https://www.epa.gov/climate-indicators/climate-change-indicators-sea-level

NE Sea Level Rise 3-4 x Higher EPA

Northeast Continental Shelf Sea Surface Temperatures NCA4 2018

Annual Massachusetts Precipitation

Seasonal Precipitation Changes USGCRP, 2017

Our 2018 Precipitation Experience 3rd wettest year in 124 years https://www.ncei.noaa.gov/

Billion-Dollar Weather & Climate Disasters Figure Source: NOAA NCEI

U.S. 2018 Experience https://www.ncdc.noaa.gov/billions/

Climate Change, Respiratory Health, and Equity

Center for Disease Control (CDC). (2015, July 26). Climate effects on health. Retrieved from https://www.cdc.gov/climateandhealth/effects/

Top 20 Most Challenging Places for Asthma #1 – Springfield, MA #8 – Boston, MA #11 – New Haven, CT #13 – Hartford, CT Includes: Air quality Pollen counts Poverty Rate of uninsured https://www.aafa.org/media/2420/aafa-2019-asthma-capitals-report.pdf

Climate Change and Air Pollution Orru H et al (2017)

World Health Organization Estimates 7 million deaths annually from fossil fuel combustion indoor and outdoor pollutants worldwide WHO COP24 Special Report – Health & Climate Change (2018)

Air Pollution in U.S. EPA 2018

Massachusetts Air Pollution Facts: PM All counties with data = A ALA 2019 State of the Air

Massachusetts Air Pollution Facts: Ozone Counties ranked from B (Middlesex) to F (Barnstable) ALA 2019 State of the Air

Annual Massachusetts Temperatures Ozone Levels in Massachusetts: Past Year Mass Air Online

Change in Ozone by 2030 USGCRP 2016

Death from Ozone by 2030 USGCRP 2016

Air Pollution Facts 141.1 million live in counties with unhealthy levels ALA 2019 State of the Air

Massachusetts Air Pollution Facts Nearly 847,000 with Asthma & 700,000 in poverty ALA 2019 State of the Air

Mortality in the Elderly: PM 2.5 and Ozone Di et al, JAMA 2017

Oak Pollen Levels EPA Report – Multi-Model Framework, 2017

Asthma ED Visits: Adults & Pediatric EPA Report – Multi-Model Framework, 2017

Pollen Levels GeoHealth, Volume: 3, Issue: 1, Pages: 11-27, First published: 15 December 2018, DOI: (10.1029/2018GH000153)

Asthma Visits with Pollen Exposure GeoHealth, Volume: 3, Issue: 1, Pages: 11-27, First published: 15 December 2018, DOI: (10.1029/2018GH000153)

Temperature & Pediatric Asthma Change in maximum temperature from 27C to 32C Atlanta, GA Stronger RRs: Non-white O’Lenick et al (2018) – Environ Res.

Wildfires: Wettstein et al (2018) 2015 California Wildfires; OSHPD Emergency Department Dataset J Am Heart Assoc. 2018;7

Wildfires: Liu et al (2017) 2004-2009 California Wildfires; Medicare Beneficiaries Epidemiology, 2017: 28(1): 77-85

Wildfires: Liu et al (2017) Increased Risk of Admission… Women (10.4%) vs Men (3.7%) Black (21.7%) vs White (6.9%) -- Not statistically significant Lower-education county (12.7%) vs Higher-education country (6.1%) 2004-2009 California Wildfires; Medicare Beneficiaries Epidemiology, 2017: 28(1): 77-85 // Liu et al Am J Epidemiol.

Risk for Negative Health Impacts from Climate Change Globally… 100 million Public Domain Images

Social Determinants of Health USGCRP, 2016

Vulnerable Populations • Low Income • Communities of Color • Immigrant Groups (limited English) • Indigenous Peoples • Vulnerable Occupational Groups • Persons with Disabilities USGCRP, 2016

Opportunities

Opportunities Mitigation Adaptation

Mitigation Health Professionals are Trusted Sources Salas et al Lancet Countdown U.S. Brief, 2018

Mitigation IPCC, AR5, 2014

Mitigation in the Northeast Salas RIMJ 2019

Mitigation in the Northeast Salas RIMJ 2019

Example: Weymouth Compressor Station https://www.patriotledger.com/opinion/20190412/baker-and-larocque-compressor-station- threatens-weymouths-health-and-safety

Healthcare Sustainability HCWH / Practice Greenhealth – from A. Collins

Adaptation How can we use data? Vaidyanathan et al, PNAS 2019

Local Assessments: SVI USGCRP, 2016

The Path Forward USGCRP, 2016

Discussion & Questions Thank you!