Climate Justice and Public Health

John Balbus, MD, MPH
Senior Advisor for Public Health
Director, NIEHS-WHO Collaborating Centre for Environmental Health Sciences
National Institute of Environmental Health Sciences

National Environmental Justice Conference and Training Program
Washington, DC
March 13, 2015
National Institutes of Health • U.S. Department of Health and Human Services

In a warming world, if you’re cold, someone else is hot

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http://www.washingtonpost.com/blogs/wonkblog/wp/2015/02/19/a-beautiful-view-of-the-polar-vortex-from-18000-feet/

Opening thought: Great threat, great opportunity

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Climate justice through a public health lens….
• Overview of climate projections for the US
• Health impacts of climate change and the role of social
determinants
• What does climate justice through a public health lens
mean?
• How the federal government is responding

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U.S. Department of Health and Human Services

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U.S. Department of Health and Human Services

Projected Temperature Change of
Hottest Days

Projected Change in Heavy
Precipitation Events

Extreme events trend upwards in US since 1980

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U.S. Department of Health and Human Services

Slide courtesy of Dr. George Luber, CDC

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U.S. Department of Health and Human Services

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U.S. Department of Health and Human Services

Heat: mortality in NYC linked to lack of air conditioning

Klein Rosenthal et al., 2014

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U.S. Department of Health and Human Services

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U.S. Department of Health and Human Services

Race, Social Capital, and the Health Impacts of Katrina
• “Significant racial differences persist in specific Katrinainduced health symptoms with African Americans”

• Adeola, Francis O., and J. Steven Picou. "Race, social capital, and the health
impacts of Katrina: Evidence from the Louisiana and Mississippi Gulf
Coast."Human Ecology Review 19.1 (2012): 10-24.
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U.S. Department of Health and Human Services

Vulnerability of NYC neighborhoods to chemical
hazards and extreme events

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U.S. Department of Health and Human Services

So what does climate
justice through a
public health lens
really mean?
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U.S. Department of Health and Human Services

A public health lens on climate justice can mean…

Reducing health
disparities is a climate
justice imperative
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U.S. Department of Health and Human Services

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U.S. Department of Health and Human Services

Environmental regulations are part of the answer…

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U.S. Department of Health and Human Services
http://well.blogs.nytimes.com/2015/03/04/childrens-lung-health-improves-as-air-pollution-is-reduced-study-says/

A public health lens on climate justice can mean…

Sustainable, healthy
communities are the
foundation of
transformation
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U.S. Department of Health and Human Services

Transformation is coming… equity must be part of it

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U.S. Department of Health and Human Services

Green Jobs, Sustainable Communities

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U.S. Department of Health and Human Services

A public health lens on climate justice can mean…

Special attention to
those most at risk

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U.S. Department of Health and Human Services

Outdoor workers and heat stress- perfect heat storm?

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5724a1.htm
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U.S. Department of Health and Human Services

The President’s Climate Action Plan- June 2013

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U.S. Department of Health and Human Services

Sustainable and Climate Resilient Health Care Facilities Initiative

• 3 Part Background “Guide”
• 5 Element Framework for Healthcare Facility Resilience
– Diagram and Descriptions

• Compendium of Resources
• Matrix and Guide to Case Studies
• Bibliography
• Available at toolkit.climate.gov

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U.S. Department of Health and Human Services

The USGCRP Climate and Health
Assessment

Report on impacts of observed and projected climate change
on human health in the United States, with a strong focus on
impact quantification where possible.

Builds upon the current NCA and 2008 US CCSP climate and
health-focused report (SAP 4.6).

The USGCRP Climate and Health Assessment is a Highly
Influential Scientific Assessment.

26

Draft Outline
1. Introduction
2. Thermal Extremes
3. Air Quality Impacts
4. Vectorborne and Zoonotic Disease
5. Waterborne and Foodborne Disease
6. Food Safety, Nutrition, and Access
7. Extreme Weather and Climate Events
8. Mental Health and Stress-Related Disorders
9. Risk Factors and Populations of Concern

Internal 6

Draft Outline
Risk Factors
- Social Determinants of
1. Introduction
Health
- Biological Sensitivity
2. Thermal Extremes
- Exposure
- Resilience
3. Air Quality Impacts
Populations of Concern
- Minority, Low Income, EJ
4. Vectorborne and Zoonotic Disease
- Tribal Peoples
5. Waterborne and Foodborne Disease
- Children and Pregnant
Women
6. Food Safety, Nutrition, and Access
- Older Adults
groups
7. Extreme Weather and Climate -- Occupational
Persons with disabilities
Events
- Persons with chronic
diseases
8. Mental Health and Stress-Related
Disorders
9. Risk Factors and Populations of
Concern
Internal 11

Draft Timeline
The assessment is an “interim report”
with an estimated publication date in spring 2016 – between the
Third NCA (May 2014) and Fourth NCA (expected 2018).

Second
Order
Draft

Second Order Draft of all chapters to steering
committee

December, 2014

Draft delivered to USGCRP for SGCR Principals
Review

January 2015

Peer
Public Comment (Federal Register Notice)
Review
NRC Peer Review
Draft
Internal
Internal Agency Reviews and Clearance
Final Draft

March – May, 2015

Final
Release
Draft

Authors Revise and Prepare Final Release Draft

Nov 2015 – Feb
2016

Design and Production complete- Roll Out

March, 2016

March - June, 2015
Sept – Nov, 2015

29

Climate and Data Tools Initiative

National Institutes of Health
U.S. Department of Health and Human Services

Resources and activities for protecting health in a context of climate
change

• CDC’s BRACE framework and guidance
documents
– http://
www.cdc.gov/climateandhealth/default.htm

• 3rd National Climate Assessment
– http://
nca2014.globalchange.gov/report/sectors/human
-health

• USGCRP Climate Health Assessment
– http://www.globalchange.gov/health- assessment

• Climate Resilience Tool Kit- launching spring
2015
– http://toolkit.climate.gov/

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U.S. Department of Health and Human Services

Summary
• Climate justice, health disparities, sustainable
communities are all tightly linked
• Climate change brings significant threats but can also
force transformative positive change for health
• New tools, assessments, and data resources can help
communities protect and promote health

National Institutes of Health
U.S. Department of Health and Human Services

Thank you!

http://www.niehs.nih.gov/geh
http://www.globalchange.gov
/what-we-do/climate-change-health.html

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U.S. Department of Health and Human Services