OCTOBER 2009 PREVENTING EPIDEMICS. PROTECTING PEOPLE. ISSUE REPORT Health Problems Heat Up: CLIMATE CHANGE AND THE PUBLIC’S HEALTH TFAH BOARD OF DIRECTORS Lowell Weicker, Jr. President Former 3-term U.S. Senator and Governor of Connecticut Cynthia M. Harris, PhD, DABT Vice President Director and Associate Professor Institute of Public Health, Florida A&M University Patricia Baumann, MS, JD Treasurer President and CEO Bauman Foundation Gail Christopher, DN Vice President for Health WK Kellogg Foundation John W. Everets David Fleming, MD Director of Public Health Seattle King County, Washington Arthur Garson, Jr., MD, MPH Executive Vice President and Provost and the Robert C. Taylor Professor of Health Science and Public Policy University of Virginia Robert T. Harris, MD Former Chief Medical Officer and Senior Vice President for Healthcare BlueCross BlueShield of North Carolina Alonzo Plough, MA, MPH, PhD Director, Emergency Preparedness and Response Program Los Angeles County Department of Public Health Theodore Spencer Project Manager Natural Resources Defense Council REPORT AUTHORS Jeffrey Levi, PhD Executive Director Trust for America’s Health and Associate Professor in the Department of Health Policy The George Washington University School of Public Health and Health Services Serena Vinter, MHS Senior Research Associate Trust for America’s Health Daniella Gratale, MA Government Relations Manager Trust for America’s Health Chrissie Juliano, MPP Policy Development Manager Trust for America’s Health Laura M. Segal, MA Director of Public Affairs Trust for America’s Health PEER REVIEWERS TFAH thanks the reviewers for their time, expertise, and insights. The opinions expressed in the report do not necessarily represent the views of the individuals or the organization with which they are associated. Georges Benjamin, MD Executive Director American Public Health Association Cynthia M. Harris, PhD, DABT Vice President Director and Associate Professor Institute of Public Health, Florida A&M University Kim Knowlton, DrPH Senior Scientist, Health & Environment Program Natural Resources Defense Council Jennifer Li, MHS Director, Environmental Health National Association of County and City Health Officials Gino Marinucci, MPH Senior Director, Environmental Health Policy Association of State and Territorial Health Officials This report is supported by the Pew Environment Group, the conservation arm of the Pew Charitable Trusts. The opinions expressed in this report are those of the authors and do not necessary reflect the views of the foundation. ACKNOWLEDGEMENTS T RUST FOR AMERICA’S HEALTH IS A NON-PROFIT, NON-PARTISAN ORGANIZATION DEDICATED TO SAVING LIVES BY PROTECTING THE HEALTH OF EVERY COMMUNITY AND WORKING TO MAKE DISEASE PREVENTION A NATIONAL PRIORITY . The Pew Environment Group is the conservation arm of the Pew Charitable Trusts, a nongovernmental organization headquartered in the United States that applies a rigorous, analytical approach to improving public policy, informing the public and stimulating civic life. TABLE OF CONTENTS Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3 SECTION 1: Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7 SECTION 2: Why Climate Change Requires a Public Health Response . . . . . . . . . . . . . . . . . . . .11 A. Needs Assessments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12 B. Development of a Strategic Response Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13 1. Surveillance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14 2. Communication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15 3. Workforce . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16 4. Emergency Response and Long-Term Public Health Capacity . . . . . . . . . . . . . . . .17 5. Research and Accountability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20 SECTION 3: Special Concerns for Communities at High Risk for Health Consequences of Climate Change . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25 A. The Poor and Racial and Ethnic Minorities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26 B. Climate Change Puts Children at Risk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27 C. Special Needs of the Elderly and Obese Individuals . . . . . . . . . . . . . . . . . . . . . . . . . . .29 D. Communities in Action: Plans to Combat the Health Effects of Climate Change . . . . . .30 SECTION 4: State Indicators of Climate Change . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33 A. Planning Indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35 B. Funding Indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37 SECTION 5: Policy Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41 A. Federal Government . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41 B. State and Local Health Departments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .44 Appendix A: The Influence of Climate Change on Health and the Role for Public Health . . . . .47 1 [...]... cap -and- trade climate bill the American Clean Energy and Security Act of 2009 (H.R 2454) includes funding for the Climate Change Health Protection and Promotion Fund and directs the Health and Human Services (HHS) Secretary to develop a plan on climate and health The bill would provide an estimated $90 million for activities related to climate change and human health However, at the present time and. .. the impact of climate change on their patients’ health may also serve as better early warning systems of new public health problems posed by climate change health and what steps can be taken to prevent and prepare for climate change 3 WORKFORCE From first responders to scientists researching the health effects of climate change, the public health workforce is vital to protecting Americans’ health The. .. prevent, prepare for, and respond to climate change, they must be educated and informed about the associated health risks Educating people about the health impacts of climate change can persuade them to take steps to prepare themselves and their families for dangerous climate- related weather events, such as heat waves or hurricanes It can also motivate them to take steps to reduce their household’s environmental... for the health consequences of climate change; 3 A review of state-specific capacities; and 4 Policy recommendations for strengthening the ability of federal, state, and local public health departments to respond to climate change- associated events Table 1: Health Effects of Climate Change in the United States Weather Event Heat waves Health Effects I Premature death I Heat- related illnesses such as heat. .. Impacts in the United States New York, NY: Cambridge University Press, 2009, p 89-98 9 For more details on the human health effects of climate change and what public health departments can to do prevent these adverse out- comes, please see Appendix A: The Influence of Climate Change on Health and the Role for Public Health EXTREME WEATHER THREATS WITH HEALTH CONSEQUENCES IN THE UNITED STATES The United... developed to improve U.S readiness for the health consequences of climate change This paper outlines the role for the public health community in responding to climate change, including: 1 Examining how climate change is a public health issue, including exploring the capacities health departments need to prepare, respond, and recover from the health impact of climate change- associated events; 2 Highlighting... climate change, the public health response must be broadened to include all who should be aware of and responding to the public health implications of climate change Thus everyone from meteorologists (who can educate the public about the health threats of weather events) to architects and city planners (who can adjust the built environment to mitigate the impact of climate change) must be part of the. .. ability to prepare and respond to climate change will vary by individual and community L Assessment of the built environment; and NATIONAL HEALTH IMPACT ASSESSMENTS OF CLIMATE CHANGE Sixteen countries around the world have carried out national climate change health impact assessments since 2001: Australia, Bolivia, Bhutan, Canada, Finland, Germany, India, Japan, The Netherlands, New Zealand, Panama, Portugal,... territorial health officials said their health agency did not possess ample expertise to assess the threats from climate change. 45 State and local health departments conducting climate change needs assessment should: L Analysis of what segments of the population are most at risk for health impacts; and I Examine staff readiness to engage with partners on the issue of climate change and highlight the co-benefits... (formerly the U.S Climate Change Science Program) identified gaps in human health research and made specific suggestions for research on climate change and human health, including the following:79 I The ability to identify exposure thresholds for climate- sensitive health outcomes, such as heat stress, particularly for at-risk populations; I The development of modeling that looks at the health impacts of climate . inform them of the risks climate change poses to their employees’ health and what steps can be taken to prevent and prepare for climate change. From first responders to scientists researching the health. weather events and other adverse effects of climate change. Already, public health depart- ments are tasked with all-hazards and pandemic preparedness. Climate change- related events and the. prevent and prepare for climate change. At the state level, public health officials often are absent from climate change commissions and have not contributed to state climate change planning. These