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S EA L EVEL R ISE I MPACTS ON THE P UBLIC H EALTH OF V ULNERABLE P OPULATIONS IN S OUTHEAST F LORIDA April 13 th , 2015 Steering Committee Meeting Update on FIHI/FAU Kresge Grant A GENDA I TEMS Welcome Presentation of Quarterly

  1. S EA L EVEL R ISE I MPACTS ON THE P UBLIC H EALTH OF V ULNERABLE P OPULATIONS IN S OUTHEAST F LORIDA April 13 th , 2015 Steering Committee Meeting Update on FIHI/FAU Kresge Grant

  2. A GENDA I TEMS  Welcome  Presentation of Quarterly Deliverables, Summary and Review  Introduction  Research Hypotheses, Goals and Definitions  Presentation Fred Bloetscher Research  Adaptive Capacity Diagram  Outreach Plan  Findings  Recommendations  Discussion and Advising

  3. M EETING G OALS By the end of the meeting members will:  Contribute insight for 2015 First Quarter products  Review and provide feedback on Outreach Plan  Consider additional next steps

  4. O RIGINAL R ESEARCH O BJECTIVES (1) Identify the communities in Southeast Florida (Palm Beach, Broward, Miami Dade and Monroe counties) that will be most vulnerable to sea level rise impacts in the coming decades (2) Identify specific potential public health risks and correlate these risks to identified populations under a 2030 and 2060 SLR scenario (3) Share this information with local decision makers to create more robust adaptation plans that include human health considerations; and (4) Develop a technical assistance guidebook and toolkit that can be shared with other coastal communities.

  5. H YPOTHESES :  If the prospects of socioeconomically vulnerable populations are not improved, these populations are more likely to suffer more severe non- chronic health impacts related to sea level rise than geographically vulnerable populations who tend to be more affluent and have a greater range of options and opportunities.  If adaptive management practices and investments are not put in place to create a built environment that is resilient to sea level and ground water rise in geographically vulnerable locations, and to preserve as much land as possible for future use, socioeconomically vulnerable populations are likely to be displaced by more affluent residents. Over time, these affluent residents will abandon geographically vulnerable locations for new locations that are less vulnerable to these impacts and currently populated by socioeconomic vulnerable populations.

  6. R ESEARCH O BJECTIVES  Identify the communities in Southeast Florida (Palm Beach, Broward, Miami Dade and Monroe counties) that will be most vulnerable to sea level rise impacts in the coming decades  Identify specific potential public health risks and correlate these risks to identified populations under a 2030 and 2060 SLR scenario  Share this information with local decision makers to create more robust adaptation plans that include human health considerations

  7. S TUDY G OAL O NE  Discuss displacement of vulnerable populations to vulnerable land  Communicate Sea Level Rise impact on vulnerable communities in Southeast Florida  Communicate impact on Public Health in vulnerable populations  Combine layers – health, physical, socio-economic vulnerability  Deliver impact statement and select 3 objectives/impact statements  Additional increased vulnerability to displacement to more geographically vulnerable locations and health

  8. S TUDY G OAL TWO  Determine policy and physical solutions to reduce socioeconomic vulnerability and health vulnerability  Better understand the intersection between health vulnerability, vulnerable populations, and vulnerable land dynamic - how to prevent progression toward increased vulnerability  Less resources may approximately equal adverse health impacts;

  9. D EFINITIONS  Geographically Vulnerable: land may flood regularly with 3 feet Sea Level Rise  Socioeconomically Vulnerable Population: based on variables including geographic/geology, SES, older, lower income, language, lower education level  Vulnerable health: vector/waterborne impacts associated with flooding

  10. T IDE T RENDS 10

  11. Layer Base Secondary 1 LiDAR Topography D ATABASE 2 Groundwater Contours 3 High, high tides and critical tide conditions 4 Census Data Populaiton numbers Education Income Age 5 Property Specific data (property Appraiser or Tax Collector Land area Land Use Land Value Building Value Building Age Impervious Area Homestead exemptions Elderly Veterans Handicapped 6 Zoning 7 Economic Centers (Census) 8 FEMA Flood Maps Repetitive Loss maps 9 Emergency Response Codes 10 Health Impacts

  12. G EOGRAPHIC V ULNERABILITY - M IAMI - D ADE /B ROWARD

  13. G EOGRAPHIC V ULNERABILITY M ONROE C OUNTY 13

  14. G EOGRAPHIC V ULNERABILITY 33040 (K EY W EST ) Summary < 0 Storage ZCTA5CE10 Current1ft SLR 2ft SLR 3ft SLR 33040 41.4% 53.6% 68.4% 81.2% 14

  15. G EOGRAPHIC V ULNERABILITY P ALM B EACH C OUNTY

  16. S OUTHEAST F LORIDA V ULNERABILITY I NDEX : H EALTH AND S OCIAL D ENOMINATORS Sub-index Sub-index Sub-index Socio-economic Physical vulnerability Burden of Disease vulnerability to SLR Number of cases in ED Age Percent area Number of hospitalizations Race/Ethnicity vulnerable to Asthma Income 1, 2 and 3 ft of SLR COPD Education Diabetes Housing Heart failure Poverty Myocardial infarction Family structure Pneumonia Serviced population Data sources: Data sources: Data sources: FL Department of Health 2010 Census NOAA UDS Mapper American Community FGDL Survey 2007-2011

  17. S OUTHEAST F LORIDA V ULNERABILITY I NDEX : H EALTH AND S OCIAL D ENOMINATORS Sub-index Sub-index Burden of Disease Socio-economic vulnerability Variables: Variables: Percentage of population over age 65 Number of cases Crude rate per 100,000 Percentage of population over age 75 Age-adjusted rate / 100,000 Median Household Income % Low-Income Population Confidence intervals Percentage of Housing Units that are Mobile Homes, Relative SE % Pop in Poverty # of Health Centers Serving ZCTA Total # Health Center Patients Percentage of households receiving Public assistance, Unserved (by Health Centers) Low- Percentage of total population that are White % Non-White Income Population Percentage of population that does not speak English well Health Center Penetration of Low- Percentage of population over 25 with less than 8th Grade Income Population Health Center Penetration of Total education Population Percentage of population over 25 with less than High School education Percentage of households that consist of single persons over 65 Percentage of population with disabilities

  18. F LOOD P RONE W /G IARDIA RISK T ODAY 18

  19. D ISEASES A SSOCIATED W / C LIMATE  Giardia (flooding)  Cryptosporidiosis (flooding)  Dengue (water)  Chikungunya (water) 19

  20. K OOPMAN AND L ONGINI 1994 Koopman and Longini, 1994

  21. G IARDIA I NFECTIVITY ( INFECTION RATE /1,000,000) 25000 20000 Infection Rate 15000 10000 5000 0 0 5 10 15 20 25 30 35 Percent inundated 21

  22. S OUTHEAST F LORIDA Variables (axes F1 and F2: 46.02 %) V ULNERABILITY 1 F ACTORS : 0.75 3 ft SLR Vuln Percent; H EALTH AND S OCIAL 2 ft SLR Vuln EDUCATIONAL 1 ft SLR Pot Vuln. ATTAINMENT - Less Current Pot Vuln Percent below poverty than 9th grade 1 ft SLR Vuln 0.5 level; Estimate; Estimate; 2 ft SLR Pot Vuln Estimate; In labor force: - Estimate; Median income Current Vuln F ACTORS Population for whom EDUCATIONAL Unemployed: in the past 12 months -- - Estimate; poverty status is ATTAINMENT - 9th to Total: Households receiving determined 12th grade, no diploma HOUSEHOLDS BY food stamps; Estimate; TYPE - Total households Total; Estimate; Below poverty level; Percent; With one or more people Households 0.25 Estimate; AGE - 65 years Total; Estimate; EDUCATIONAL 60 years and over Population for whom and over ATTAINMENT - 9th to 3 ft SLR Pot Vuln. Total; Estimate; With poverty status is 12th grade, no diploma one or more people 60 Households receiving determined F2 (13.20 %) Estimate; years and over Estimate; LANGUAGE food stamps; Estimate; Pmeumonia Average EDUCATIONAL SPOKEN AT HOME - POVERTY STATUS IN Crude Rate per 100,000 Percent below poverty ATTAINMENT - Less 0 Language other than THE PAST 12 MONTHS level; Estimate; AGE - 65 than 9th grade Below poverty level; English - Speak English - Below poverty level years and over TP_NONWHITE less than "very well" Estimate; Population for Giardia Average Crude whom poverty status is Households receiving Rate per 100,000 Heart Failure Average food stamps; Estimate; Households receiving determined Crude Rate per 100,000 With children under 18 food stamps; Estimate; Diabeters Average Crude -0.25 years Households Total; Estimate; Rate per 100,000 Asthma Average Crude POVERTY STATUS IN Rate per 100,000 COPD Average Crude THE PAST 12 MONTHS Rate per 100,000 - Below poverty level -0.5 -0.75 -1 -1 -0.75 -0.5 -0.25 0 0.25 0.5 0.75 1 F1 (32.82 %)

  23. C ONCEPTUAL M ODEL : I NTERSECTION OF S OCIAL - T ERRESTRIAL V ULNERABILITY T ODAY Social Vulnerability Geographic Exposure Disease – vector/water (not acute/chronic conditions Adaptive Capacity

  24. I NTERSECTION OF S OCIAL -G EOGRAPHIC V ULNERABILITY T=T1 ( FUTURE ) Social Vulnerability Geographic Exposure Disease Adaptive Capacity

  25. I NTERSECTION OF S OCIAL -T ERRESTRIAL V ULNERABILITY T= T 2 ( FUTURE – T IPPING POINT ?) Social Vulnerability Geographic Exposure Adaptive Capacity Disease Becomes Difficult

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