maizlish: climate change, heat and health
TRANSCRIPT
Climate Change, Heat, and Health
Neil Maizlish, PhDOffice of Health Equity
California Department of Public Health
Presented at Understanding the Health Impacts of Climate ChangePublic Health Institute, Oakland, November 12, 2014
1
2
Heat-Related Health Impacts
• Extreme heat and heat waves
Heat illness
Heat–related exacerbation of existing chronic
disease (cardio-vascular, respiratory, etc.)
Existing burden of chronic disease
increases baseline vulnerability
• Incremental heat
Heat–related exacerbation of existing chronic
disease
• Temperature variability
• Heat as a co-factor for ozone/PM formation 3
Historical Heat vs.Climate and Heat (modeled from Cal Adapt)
Extreme Heat
incident Deaths
Philadelphia heat
wave, 1993
118
Chicago heat wave,
1995
739
European heat
wave, 2003
70,000
California heat
wave, 2006
650
Russian heat wave,
2010
11,000-
50,000
City 2050 2099
Bakersfield 48 93
El Centro 60 101
Fresno 46 90
Los Angeles 78 110
Redding 35 75
Sacramento 44 85
San Diego 76 129
San Francisco 39 126
San Jose 71 111
Truckee 41 83
Model Estimated Extreme Heat Days
May 1 to Oct 1 in Selected California
Cities, 2050 and 2099
4
Mortality and Illness in Heat Waves
• Europe, 2003: nine day heat wave with > 70,000 deaths
Could it happen here?
• California, 2006
650 excess deaths
16,166 excess emergency room visits
and 1,182 excess hospitalizations
$133 million in health-care related costs
5
Surveillance of Heat Deaths and Illnesses, California
• Current capacity to do statewide retrospective analysis of trends by race, ethnicity and gender We can also do near real-time surveillance (within 1 month) on
heat deaths with Electronic Death registry data
• Current capacity to do real time syndromic surveillance on heat exists at county level only by local health depts. (e.g. LA and San Diego)
• Exploring other options such as statewide emergency response calls for heat; heat deaths reportable condition (Cal REDIE)
0
1
2
3
41
99
9
200
0
200
1
200
2
200
3
200
4
200
5
200
6
200
7
200
8
rate
Rate of Hospitalizations and Deaths Due to Excessive Heat, California, 1999-2008
nonfatal hospitalizations per 100,000 deaths per millionSource: California Environmental
Health Tracking Program
6
Shift in Mean Warm Season Temperatures Tied to Increased Death Rates
7
Temperature Variability Tied to Shorter Life Expectancy
• 1 C° increase in summer temperature variability = 2.8 and 4.0 percent increase in the death rate for elderly people with chronic conditions
• The mortality risk was 1 to 2 percent greater for those living in poverty and for African-Americans
• Many California communities are living in the highest tiersof temperature variability in the United States
8
Climate change will impact all Californians but
the most vulnerable will suffer the most
• Climate change will magnify existing health inequities rooted
in social determinants of health; adaptation draws on many of
the same resources
• In LA County, more African-Americans and Latinos live in high
risk areas compared to whites and average incomes are
about 40% lower
9
Focus on Extreme Heat• CDPH’s existing work on heat illness
Environmental Health Tracking Program
Emergency Preparedness Office
Other research on heat illness and death
• Preparing California for Extreme Heat: Guidance and Recommendations (Climate guidance)
Many jurisdictions have heat response plans - but don’t currently address climate change and heat
Multi-agency heat work group developed strategies and recommendations to reduce risk and promote heat resiliency to protect health
10
Preparing California for Extreme Heat: Guidance and Recommendations
• Heat Resilient and Cooler Communities
Buildings, land use
Urban heat island effects
Cool/porous pavements
Urban greening
• Preparedness and Response to Extreme Heat
Incorporation of heat/climate change into existing hazard/mitigation plans
Heat warnings/alerts
Health & social service delivery to vulnerable populations, social cohesion, risk communication
Cooling strategies (air conditioning/cooling center access)
• Public Health and Health Care Sector Readiness
Health care providers
Public health surveillance
• Workers at Risk of Extreme Heat
Assessment of adequacy and effectiveness of existing standards
Training, education, engineering solutions
11
