global environmental change || climate change, extreme weather and climate events, and health...

Climate Change, Extreme Weather andClimate Events, and Health Impacts 70Aderita Sena, Carlos Corvalan, and Kristie Ebi

Contents

Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 605

Key Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 606

Extreme Weather and Climate Events Can Lead to Disasters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 607

Health Impacts of Weather and Climate Extreme Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 609

Extreme Weather Events Require Global to Local Actions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 610

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 612

Keywords

Weather and climate extremes • Floods • Droughts • Hurricanes • Heat waves •

Adaptation • Disaster risk reduction

Definitions

Disasters the International Strategy for Disaster Reduction (ISDR) defines disastersas “a serious disruption of the functioning of a community or a society involving

widespread human, material, economic, or environmental losses and impacts,

The views presented here are those of the authors and do not necessarily represent the views of

their respective organizations.

A. Sena (*)

Ministry of Health, Brasilia, Brazil

e-mail: [email protected]

C. Corvalan

Department of Medicine, Pan American Health Organization, Brasilia, Brazil


K. Ebi

ClimAdapt, LLC, Los Altos, CA, USA


Bill Freedman (ed.), Global Environmental Change,DOI 10.1007/978-94-007-5784-4_101,# Springer Science+Business Media Dordrecht 2014

605

mailto:[email protected]



which exceeds the ability of the affected community or society to cope using its

own resources.”

Resilience is the ability of a natural or human system to absorb disturbances

while retaining the same basic structure and ways of functioning, the capacity for

self-organization, and the capacity to adapt to stress and change.

Vulnerability is the susceptibility to harm, which can be defined in terms of

a population or a location. From a health perspective, vulnerability can be defined

as the summation of all risk and protective factors that ultimately determine

whether a subpopulation or region experiences adverse health outcomes due to

climate change. This includes factors that increase or decrease sensitivity, such as

population demographics, and factors that determine the ability of a community or

society to prepare for and recover from impacts, such as the status of and access to

public health and health-care services.

Risk is a product of the likelihood of exposure and the consequences of that

exposure. It arises from the interaction of a physically defined hazard (e.g., floods),

with the properties of the exposed system (its vulnerability). System vulnerability is

a critical determinant of the risk a region or subpopulation faces when exposed to

a particular hazard. Interventions to decrease vulnerability will decrease risk.

A disaster risk management model used by the health sector has three phases

with respective steps: (a) risk reduction (prevention, mitigation, and preparation),

(b) disaster management (alert and response), and (c) recovery (rehabilitation and

reconstruction).

Climate extremes (extreme weather and extreme climate events) are defined as

the occurrence of a value of a weather or climate variable above or below

a threshold value near the upper or lower ends of observed values of the variable.

Sources: (ISDR 2009a; PAHO/WHO 2011; IPCC 2012).

Key Information

Climate change is becoming more evident at the global level, in part through

changes in the frequency, intensity, and spatial extent of extreme weather and

climate events. These events include temperature extremes, floods, droughts,

severe storms, and forest fires. Although the evidence in terms of total health

burdens and attribution to climate change needs strengthening, these events are

increasingly affecting human health and well-being, as well as socioeconomic

development. Concern is in particular focused on poor countries and population

groups that are more likely to experience impacts when extreme events and

disasters occur.

Projections suggest that climate change will bring greater increases in extreme

weather and climate events, with some events expected to increase in severity,

frequency, and spatial extent (IPCC 2012). Extreme events can affect health

directly (e.g., from extreme temperature). Others are complex or indirect (such as

from floods, droughts, and hurricanes) because the resulting health impacts are

dislocated in space and time or because the health impacts result from another

606 A. Sena et al.

change that occurred following an extreme event. For example, changes in temper-

ature, precipitation, and humidity could affect the reproduction, development, and

behavior of some vectors, leading to increases (or decreases) in the incidence of

vector-borne diseases. Unplanned urbanization, deforestation, and destruction of

ecosystems, coupled with poverty and inequalities, increase health vulnerabilities

and the impact of extreme events. As a response to these risks, global to local

policies are recommending actions to mitigate climate change, manage the risks of

disasters, and protect health from adverse impacts. Plans include the revision of

unsustainable development policies and actions to minimize the negative impacts

on health and well-being.

Extreme Weather and Climate Events Can Lead to Disasters

A recent assessment by the Intergovernmental Panel on Climate Change (IPCC),

the Special Report on Managing the Risks of Extreme Events and Disasters toAdvance Climate Change Adaptation (SREX), concluded that a changing climate

leads to changes in the frequency, intensity, duration, spatial extent, and timing of

some weather and climate extremes (IPCC 2012). Continued greenhouse gas

emissions will further increase the likelihood of even more extreme events.

The health sector is insufficiently prepared to cope with the probability of

increasing extreme events. The key approaches for managing the risks are disaster

risk management and climate change adaptation. Both approaches aim to identify,

deploy, and monitor efficient and effective actions to decrease exposure to weather

and climate extremes and to increase resilience to events when they do occur.

Disaster risk management has traditionally focused on the near term, while climate

change adaptation generally has focused on increasing resilience to events over the

coming decades. The SREX increased cooperation and collaboration cross these

disciplines, highlighting that additional actions are needed at all levels, from local

to international, to manage current and projected future extreme events.

The risk of disasters is not evenly distributed among countries. The largest

mortality risk is concentrated in developing countries, with 95 % of the deaths due

to extreme events occurring in low-income countries, while most of the economic

losses occur in high-income countries (IPCC 2012). Mortality risk from disasters

is nearly 200 times higher in low-income countries as compared to OECD

(Organization for Economic Co-operation and Development) countries when consid-

ering countries with the same numbers of exposed persons. For example, Japan and

the Philippines are exposed to frequent tropical cyclones; Japan has a population

of 22.5 million and the Philippines has a population of 16 million. When hit by

tropical cyclones, the mortality rate in the Philippines is about 17 times higher than in

Japan (ISDR 2009b). Small Island States have much higher relative risks compared to

the size of their populations and economies. Vanuatu, for example, is the country with

highest mortality risk per million inhabitants for tropical cyclones.

At the global level, economic losses as measured by Gross Domestic Product

(GDP) mortality risk from disasters is nearly 200 times are higher in low-income

70 Climate Change, Extreme Weather and Climate Events, and Health Impacts 607

than OECD countries (when assessed in relation to their economies) as compared to

OECD countries, considering countries with the same numbers of exposed persons.

This also applies to economic losses in terms of Gross Domestic Product (GDP).

Latin America and the Caribbean suffer losses six times higher than OECD countries,

from floods, and South East Asia nearly 15 times higher in the case of floods. Risk

arises from a range of causal factors related with the socioeconomic development of

each country, not just the severity of the hazards or the level of exposure to them.

Governance is an important factor determining risk. Countries with solid institutions,

efficient early warning systems, plans for preparation and response to disasters, and

governments with a policy for risk management tend to have lower levels of risk

(ISDR 2009b).

The SREX author teams assigned confidence levels to the key findings in the

SREX report, where the confidence levels were based on three scales: evidence and

agreement, confidence, and likelihood (Mastrandrea et al. 2010) Table 70.1 lists the

high confidence key findings (where levels of confidence are on a five-point scale

including high and very high).

Table 70.1 High confidence key findings from the IPCC special report on managing the risks ofextreme events and disasters to advance climate change adaptation

Exposure and vulnerability

Exposure and vulnerability are dynamic, varying across temporal and spatial scales, and depend on

economic, social, geographic, demographic, cultural, institutional, governance, and environmental

factors

Settlement patterns, urbanization, and changes in socioeconomic conditions have all influenced

observed trends in exposure and vulnerability to climate extremes

Economic losses

Economic losses from weather- and climate-related disasters have increased, but with large spatial

and interannual variability

Economic, including insured, disaster losses associated with weather, climate, and geophysical

events are higher in developed countries. Fatality rates and economic losses expressed as a proportion

of gross domestic product (GDP) are higher in developing countries

Increasing exposure of people and economic assets has been the major cause of long-term

increases in economic losses from weather- and climate-related disasters

Disaster risk management

The severity of the impacts of climate extremes depends strongly on the level of the exposure and

vulnerability to these extremes

Trends in exposure and vulnerability are major drivers of changes in disaster risk

Development practice, policy, and outcomes are critical to shaping disaster risk, which may be

increased by shortcomings in development

Future climate extremes

Locations currently experiencing adverse impacts such as coastal erosion and inundationwill continue

to do so in the future due to increasing sea levels, all other contributing factors being equal

Changes in heat waves, glacial retreat, and/or permafrost degradation will affect high-mountain

phenomena such as slope instabilities, movements of mass, and glacial lake outburst floods

Changes in heavy precipitation will affect landslides in some regions

(continued)

608 A. Sena et al.

Health Impacts of Weather and Climate Extreme Events

According to the World Health Organization (WHO), around one quarter of the

global burden of disease and premature mortality is due to environmental factors,

including climate change. Currently, the health impacts of climate change are

relatively small, although the burden is likely to increase among vulnerable

populations and regions as the climate continues to change (Pruss-Ustun and

Corvalan 2006). The burden of disease attributable to climate change in the year

2000, compared with 1961–1990, from increases in temperature and changing

precipitation patterns was estimated to be more than 150,000 deaths (McMichael

et al. 2003). Flooding alone caused the loss of 192,000 healthy life years (measured

as Disability Adjusted Life Years, DALYs). The risk of death from floods could

increase fourfold by 2030.

Extreme weather and climate events can have negative effects on human health,

such as the 2003 European heat wave that caused tens of thousands excess deaths.

Floods can increase the incidence of infectious diseases, such as diarrheal diseases,

leptospirosis, and hepatitis A. The incidence and geographic range of climate-

sensitive vector-borne diseases and their reservoirs can be altered by changes in

temperature, rainfall, and humidity and changes in land use and vegetation. Exam-

ples include dengue fever, malaria, and leishmaniasis. Changes in temperature,

humidity, and rainfall patterns also are associated with asthma, other respiratory

diseases, and respiratory infections. Other impacts may be more long term, such as

changes in food availability leading to malnutrition. Climatic extremes also can

result in mental health problems (Confalonieri et al. 2007; PAHO/WHO 2008;

McMichael et al. 2003).

Figure 70.1 shows examples of the relationship between climate change,

climate disasters, and health outcomes, modulated by environmental vulnerability

Table 70.1 (continued)

Changes in climate have the potential to seriously affect water management systems

Increases in exposure will result in higher direct economic losses from tropical cyclones. Losses

will also depend on future changes in tropical cyclone frequency and intensity

Managing changing risks

Effective risk management generally involves a portfolio of actions to reduce and transfer risk and

to respond to events and disasters, as opposed to a singular focus on any one action or type of

action

Opportunities exist to create synergies in international finance for disaster risk management and

adaptation to climate change, but these have not yet been fully realized

Stronger efforts at the international level do not necessarily lead to substantive and rapid results at

the local level

Appropriate and timely risk communication is critical for effective adaptation and disaster risk

management

Adaptation efforts benefit from iterative risk management strategies because of the complexity,

uncertainties, and long time frame associated with climate change


(e.g., deforestation, housing in unsafe areas) and social vulnerability (e.g., poverty,

lack of information).

The pathways from extreme weather and climate events to their health impacts

are often complex and indirect. Non-climate environmental and social factors can

affect the dynamics of climate-sensitive health outcomes. Environmental vulnera-

bility factors, including those resulting from human intervention, can exacerbate the

impacts of extreme events through deforestation, land use change, water use

change, and unplanned urbanization. Social vulnerability factors that can influence

the severity of several health outcomes include demographic (e.g., age, migration,

and population density), level of poverty, biological (vectors and infectious agents

reproduction cycles and the immunological state of the population), effectiveness

of and access to public health and health-care systems, and development policies,

such as housing and basic sanitation services.

Table 70.2 gives examples of extreme events, the impact process, and their

health consequences.

Extreme Weather Events Require Global to Local Actions

The World Conference for Disaster Reduction, held in 2005 in Kobe (Hyogo),

Japan, approved the 2005–2015 Framework for Action with the theme of “building

the resilience of nations and communities to disasters (also known as the Hyogo

Framework for Action or HFA). The conference adopted 5 priorities of action:

1. Ensure that disaster risk reduction is a national and a local priority with a strong

institutional basis for implementation.

2. Identify, assess, and monitor disaster risks and enhance early warning.

3. Use knowledge, innovation, and education to build a culture of safety and

resilience at all levels.

4. Reduce the underlying risk factors.

5. Strengthen disaster preparedness for effective response at all levels.

Based on these priorities, the HFA made specific recommendations. Priority

action 4 made a special call to promote the goal of “hospitals safe from disasters”

Climatechange

Climate disasters: Health Impacts:

Injuries, traumas

SocialVulnerability

Infectious diseases(Vector, rodent,water and food-borne diseases)MalnutritionMental disordersCardiovascular,respiratory diseases

HurricanesStorms

Land slidesForest firesDroughtsHeat-wavesCold spells

Floods

EnvironmentalVulnerability

Fig. 70.1 Climate change,

extreme weather and climate

events, vulnerability, and

health impacts

610 A. Sena et al.

that could continue to function efficiently in case of disasters (ISDR 2005). It also

highlighted “the substantial reduction of disaster losses, in lives and in the social,

economic, and environmental assets of communities and countries.” It called for the

involvement and commitment of all concerned stakeholders including

Table 70.2 Extreme weather and climate events and their health impacts

Type of

event Impact process Health impact

Heat

waves

• Prolonged period of uncommon hot weather

• Higher than normal high temperature

• Higher than normal low (night) temperature

• Low hydration

• Susceptible population (e.g., the elderly,

children, impaired health)

• Underlying social conditions

• Heat stress

• Cardiovascular, cerebrovascular,

respiratory disease, and mortality

Cold

exposure

• Exposure to low temperature

• Preexisting cardiovascular disease

or respiratory conditions

• Susceptible population (the elderly,

children, preexisting health conditions

including heart and respiratory disease)


• Hypothermia, frostbite

• Falls and related injuries

• Acute respiratory conditions,

asthma

• Cardiovascular disease

(myocardial infarction)

Floods,

severe

storms

• Alteration of quality and contamination of

water and food (fungus, parasites, bacteria,

viruses)

• Changes in the development and behavior

of vectors

• Continued exposure to rain, water, and

humidity

• Changed behavior of poisonous animals

• Exposure to high intensity winds

• Exposure to electricity

• Changed human behavior

• Traumatic events, loss of family, and

economic means

• Changed food production and access


• Water- and food-borne diseases

(e.g., diarrheal diseases, cholera,

typhoid fever, leptospirosis,

hepatitis A, dermatoses)

• Vector-borne diseases (e.g.,

changes in malaria, dengue, dengue

hemorrhagic fever, yellow fever)

• Respiratory infections,hypothermia

• Drowning

• Injuries, electric shock

• Bites, including domestic and

poisonous animals, snakes, spiders,

scorpions

• Violence including sexual violence

• Psychosocial impacts; Post-

traumatic stress disorder

• Malnutrition

Droughts • Extended period between rainfalls

• Limited access to potable water (quality

and quantity)

• Increased contact with wild animals

• Limited water for hygiene

• Unsafe water storage

• Reduced or severely limited crop yields

• Reduced health of animals and livestock

• Drought-related wildfires

• Reduced air quality


• Increased water and food-borne

diseases, including diarrheal

disease

• Vector- and rodent-borne diseases

(e.g., dengue, West Nile virus,

Hantavirus)

• Malnutrition

• Mental diseases, suicides

• Respiratory diseases


governments, regional and international organizations, civil society, the private

sector, and the scientific community (ISDR 2005).

At the country level, reduction of vulnerabilities is key to protect populations

from weather and climate disasters. The impact of such disasters is dependent on

the local vulnerabilities. Countries and populations more likely to suffer the

highest health impacts are those that lack the means to protect themselves, often

the poor, elderly, children, and those suffering from ill health. It is therefore

essential to have national and local level contingency plans for disasters that

include consideration of how a changing climate could alter future hazards.

Planned actions must take into account exposure to extreme weather and climate

events and the capacity of communities to avoid, prepare for, cope with, and

recover from these events. It is necessary to implement actions to increase

population resilience (Keim 2008).

Well-defined policies at the national and subnational level promote effective

interventions. International agencies incentivize the preparation of such strategies

and policies at the national level, taking into account key geographical, social,

cultural, environmental, and economic characteristics. Decision-makers, key

professionals, and the affected population need to be included in developing

specific measures to ensure effective response to adverse events. Such policies

and measures should be key aspects of national adaptation plans to climate change.

Countries are making advances in attaining their targets for the Millennium

Development Goals. Climate change is a threat to maintaining their achievements.

Following the United Nations Conference on Sustainable Development held in Rio

de Janeiro in June 2012, countries agreed to the UN Outcome Document,

“The Future We Want” (UN 2012), where a section is dedicated to disaster risk

management. It calls for a better integration between strategies for disaster

risk management and climate change adaptation, and on climate change, the report

calls for adaptation as an immediate and urgent global priority. The report also

recommends the formulation of “sustainable development goals.” Climate change,

disasters, and health are important determinants of sustainable development;

therefore, actions to combat climate change, manage disaster risks, and improve

health promote alignment with global agreements.

References

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II to the fourth assessment report of the Intergovernmental Panel on Climate Change.

Cambridge University Press, Cambridge, UK

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International Strategy for Disaster Reduction (2009b) Global assessment report on disaster risk

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Geneva

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http://www.ipcc.ch/

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