healthy people = healthy planet: texas version
DESCRIPTION
how fossil fuel based systems of power generation, transportation and food are driving our epidemic of chronic disease and why climate policy will make a differenceTRANSCRIPT
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HEALTHY PEOPLE = HEALTHY PLANETThe Public Health Benefits of Climate Solutions
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Impacts on N. America
WILDFIRES
INCREASED HEAT
HEAVY RAIN,STORMS, FLOODS
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IPCC: Only one safe course of action
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Sam Moody Atlanta, GA
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We Over Me Farm Houston, TX
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CARMAGEDDON!
Ultrafine Particulates down 83 % PM2.5 down 36 percent
ER Visits UCLA down 23%ER Visits Mt Sinai down 13%911 calls decreased 12%
Los Angeles, CA 405 Freeway
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Jeffery Thompson MDGundersen Lutheran Health System
LaCrosse, WI
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$1 MILLION ANNUAL SAVINGS from improved EFFICIENCY
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Powered by 100% Clean Energy
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TOP 5 CAUSES OF DEATH IN US
Heart Disease (diabetes)
Cancer
Chronic Lung Disease
Stroke
Unintentional Injury (mva)
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TOP 10 CAUSES OF THE CAUSESof death in developed countries
1) tobacco
2) high blood pressure
3) overweight and
obesity
4) physical inactivity
5) high blood glucose
6) high cholesterol
7) low fruit and vegetable intake
8) urban outdoor air pollution
9) alcohol
10) occupational
WHO 2009
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CAUSES OF THE CAUSES
OF THE CAUSES
Air pollution
Car centric built environment
Industrial agriculture and food system
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AIR POLLUTIONAIR POLLUTION
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EPA Ozone Nonattainment Areas
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September in Central Texas:1 out of 6 days with unhealthy air
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AIR POLLUTION AND CHILDHOOD ASTHMA
Playing multiple outdoor sports in areas with poor air quality triples the risk of developing childhood asthma (McConnell, 2002)
Childhood asthma incidence increased 16% per 10ug/m3 of fine particulate exposure, and 7% per 10ug/m3 of Nox. (Anderson, 2013)
A 5-ppb increase in average NO2 during the first year of life was associated with an odds ratio of 1.17 for physician-diagnosed asthma. (Nishimura, 2013)
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AIR POLLUTION AND CVD
CHRONIC EXPOSURE
Rate of carotid intimal thickening is doubled in people who live within 100 m of busy roadway
(Kinsli, 2010)
ACUTE EXPOSURE Each 10ug/m3 PM2.5
4.5% increase in acute cardiac events
8-18% increase in CVD mortality
(Pope, 2004, 2006, 2008)
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AIR POLLUTION AND DIABETES10ug/m3 PM2.5 = 1% increase in prevalence DM2(Pearson, 2010)
Exposure to traffic and PM increased risk of new onset DM2 15-42% (Kramer, 2010)
Highest quartile maternal exposure to NOx increased gestational DM 70% (Malmqvist, 2013)
2SD increase in childhood exposure NO2/ PM2.5 = 18% increase in insulin resistance. (Thiering, 2013)
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Prenatal PAH Exposure and Childhood Obesity
Rrundle et al Am J Epidemiol. Jun 1, 2012; 175(11)- 1163–1172..
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AIR POLLUTION AND CHILD OBESITY
Prenatal exposure to higher levels of PAH doubled risk of obesity at age 7 (Rundle, 2012)
Residential proximity to traffic in childhood (controlling for other risk factors) associated with higher BMI at age 18
(Kramer, 2010)
Kids in 90th percentile for traffic related air pollution have more rapid increase in BMI (Jerrett, 2014)
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AIR POLLUTION CARBON POLLUTION
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Ziska, Australian Journal of Plant Physiology, 2000. 27: 893− 898.
CO2 and Noxious Plants
RAGWEED POISON IVY
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CO2, MOLD and Asthma
For each 10 U increase in home Environmental Relative Moldiness Index (ERMI) in infancy, risk of incident asthma by age 7 increased 80% (Reponen, 2011)
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Nox + VOCs + heat = Ozone
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Ozone Climate Penalty
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Climate-Related Ozone will Increase NY Pediatric ED Asthma Visits 5-10% by 2020
Sheffield PE, SeAm J Prev Med.p;41(3):251-7
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PREMATURE DEATHS FROM OZONE will triple by 2030
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Valley Fever Endemic Area
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VALLEY FEVER
Brown, Clin Epidemiol. 2013; 5(1) 185-197
Tenfold increase in incidence of Cocciciodomycosis
Lubbock, TX
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WARMING & WILDFIRE SMOKE
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Wildfire Contribution to Ground Level Ozone
Northwest Fire Season 2012
Jaffe et al | Environ. Sci. Technol. 2013, 47, 11065−11072
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A Kenward et al 2013
LOS ANGELESPM 2.5 2003
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DIOXINS, PAH and WildfiresSmoke from Idaho Fires
2013
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Clean energy
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US WIND POWER POTENTIAL
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US SOLAR POWER POTENTIAL
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100% CLEAN BY 2050thesolutionsproject.org
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Total life cycle emissions Clean vs Fossil Fuel
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Intermittency not a problem up to 80%
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Percent renewable generation achieved with conventional technology
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POLICIES for CLEAN AIR
Shift subsidies from fossil fuel to clean energy Strong National Renewable Electricity Standard
50% of electricity by 2030, 100% by 2050
Net metering (utilities pay for surplus power)
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LEVEL THE PLAYING FIELD
STOP EXTERNALIZING HEALTH AND CLIMATE COST OF CARBON
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MORE EFFICIENT BUILDINGS
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PROGRESSIVE EFFICIENCY STANDARDS for New and Remodeled Buildings
www.architecture2030.org
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COMPETITIVE FUEL ECONOMY
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POLICIES FOR ENERGY EFFICIENCY
Stronger fuel economy standards National Energy Building Code National Retrofit Financing
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Decrease in O3 and PM 2.5 with 3 Climate Policy Options
Clean Electricity Std Transportation Carbon Tax
T Thompson, Nature Climate Change (July 2014)
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20,000 Heart Attacks PREVENTED23,000-50,000 Deaths each year
SAVED: OVER 100 BILLION DOLLARS PER YEAREPA 2013
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Carbon Abatement Cost Curve
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CLEAN ENERGY=CLEAN AIR=HEALTH SAVINGS
T. Thompson, Nature Climate Change 4, 917–923 (2014)
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Value of decreased mortality from air quality improvement exceeds cost of emissions reduction
West et al, Nature Climate Change 3: 885-889 2013
HIGH VALUE LOW VALUE ABATEMENT COST / TON CO2
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EPA Carbon Rules Impact on Air Quality: 2020
OZONE FINE PARTICULATES
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Distribution of Lives saved by EPA Carbon Rule in 2020
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CAR CENTRIC BUILT ENVIRONMENT
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Texas Interurban Railway
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From Interurban to Automobile
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NEIGHBORHOODS
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HEART DISEASE,OBESITY, DIABETES; COLON CANCER ONE THIRD PROSTATE CANCER, AND
RECURRENT BREAST CANCER ATTRIBUTABLE TO PHYSICAL INACTIVITY
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WALKABILITY, OBESITY, AND DIABETES
TEN YEAR PROSPECTIVE STUDY Ontario
Least walkable neighborhoods
DM +6%
Obesity/Overweight +13%
Most walkable neighborhoods
DM -7%
Obesity/Overweight - 9%
(Booth, 2014, presented at ADA)
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WALKABILITY DM, OBESITY, AND CVD
Sprawl and disconnected street networks are associated with increased rates of obesity, diabetes, and CVD. (Marshall, 2014)
Residents of “walkable” metro areas walk more & use more public transit, have lower BMI & BP, less DM, and 3 years longer life expectancy than people living with sprawl. (Ewing, 2014)
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Cost of Transportation Related Health Outcomes in US
$300 billion per year
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WALKABILITY SCORES FOR TEXAS MAJOR CITIES
Houston 44
San Antonio 34
Dallas 44
Austin 35
Ft Worth 32
El Paso 39
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TRANSIT ORIENTED DEVELOPMENT
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TRANSIT AND OBESITYUsers of public transit are 45% less likely to be
obese or overweight (Zheng, Y. 2008)
Transit commuters walk twice as many minutes/day as car commuters, weigh an average of 6-7 lb less and have lower % body fat. (Flint, 2014)
Increased use of public transit would cut the annual increase in obesity prevalence by 45%.
(Edwards, 2008)
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TRANSIT DECREASES MVA DEATHSUrban Traffic Fatalities/100,000
by Cities' Transit Use by Smart Growth vs Sprawl
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Austin ranks 39th of 46 major metro areas in jobs available within 30
minute trip by public transit
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Per Capita Health Savings from Rapid Transit and TOD
AverageUrban Transit
High Quality Urban Rail or Rapid Bus
Transit Oriented Development
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US Emissions from Transportation
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POLICIES FOR ACTIVE/PUBLIC TRANSITSmarth growth, Infrastructure Investment,
Coordination (Health in All Policies)
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10,000 colon cancers215,000 heart attacks
32,000 MVA fatalities PREVENTED570,000 new diabetes cases each year
ANNUAL SAVINGS SF BAY AREA Maizlish, N. Am J Public Health. 1.4-22 BILLION DOLLARS PER YEAR 2013 Apr;103(4):703-9.
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Good news: We're already on our way. Vehicle miles per capita decreasing
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INDUSTRIAL FOOD SYSTEM
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From family farm to agribusiness
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Increased consumption of high fructose corn syrup
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FOOD DESERTS
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Inadequate Intake of Fruits/Vegetables
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Increasing dependence on imported produce & associated outbreaks of foodborne infection
2013 – Cilantro from Mexicohttp://www.foodandwaterwatch.org/food/global-grocer/
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Adult Obesity Trend
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TEXAS TRENDSOBESITY RELATED DISEASES
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High Fructose Corn Syrup and Metabolic Syndrome
Meta-analysis: Fructose consumption increases FBG, triglycerides, and systolic BP. (Kelishadi, 2014)
Fructose sweetened beverages increase FBG and insulin levels, decrease insulin sensitivity (Stanhope, 2009)
Fructose induced insulin resistance in rats is attenuated by lycopene (Yin, 2014)
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Red Meat, DM, Cancer, and CVDNIH-AARP Study: 20-50% increased mortality from
cancer and CVD (Sinha, 2009)
Womens' Health Study:
28% more incident DM over 8 years (Song, 2004)
Nurses' Health Study/ Health Professionals Followup Study: 13% increase in mortality per serving (all cause, cancer, and CVD). (Pan, 2012)
Extra daily half serving of meat raised risk of DM 48% for subsequent 4 years (Pan, 2013)
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OBESITY AND ASTHMANumerous prospective studies in adults found
obesity associated with increased risk of incident asthma with BMI “dose response”
Weight loss, both surgical and non surgical, associated with resolution of asthma, decrease in asthma symptoms or increased FEV1
(Ford, E The Epidemiology of Obesity and Asthma
J Allergy Clin Immunol 2005;115:897-909.)
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International Study of Asthma and Allergies in Childhood
JUNK FOOD AND ASTHMA
Nagel, Thorax. 2010 Jun;65(6):516-22.
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INDUSTRIAL AGRICULTURE AND GLOBAL WARMING
METHANE POLLUTION(70 x warming power of CO2 )
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& MORE GLOBAL WARMINGNITROGEN OXIDE from FERTILIZER
(300 x warming power of CO2)
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DROUGHT AND WATER QUALITYPublic Water Systems on Restriction
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Arsenic in Groundwater
Arsenic concentration in wells Public water systems exceeding EPA std
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Arsenic alters gene expression, promotes lung, skin, bladder cancer
Cancer risk from adult As in drinking water
Altered gene expression in cord blood with maternal As exposure
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MATERNAL ARSENIC EXPOSUREAND DECREASED CHILD SURVIVAL
(Rahman, 2013)
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CROP MYCOTOXINS
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Aflatoxin 2014 Fumonisin 2014
Texas State Chemist 2014
Hepatotoxic
Nephrotoxic
Teratogenic
Carcinogenic
Hepatotoxic
Carcinogenic
Immunosuppressive
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NHANES 2000
1% positive
Age OR for +
12-39 1.49
40 + 1.00
Ethnicity OR
Black 0.92
White 1.00
Mex American 2.71
Aflatoxin Biomarkers
Bexar County 2010
20% of adults positive, associated with rice and tortillas
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ANNUAL INCIDENCE HCC 1995–2010
Ramirez AG, Munoz E, Holden AEC, Adeigbe RT, et al. (2014) Incidence of Hepatocellular Carcinoma in Texas Latinos, 1995–2010: An Update. PLoS ONE 9(6): e99365. doi:10.1371/journal.pone.0099365
US Latino
Texas Latino
South Texas Latino
White, non-Hispanic
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Aflatoxin Biomarkers and Risk Factors for Hepatocellular Carcinoma
RISK FACTORS OR for HCC
Aflatoxin Biomarker Alone 7
Chronic Hepatitis B or C Alone 7-28
NAFLD alone 3-16
Aflatoxin + Chronic Hep B or C 60
Aflatoxin + NAFLD ??
40% OF OBESE CHILDREN AND 40% OF ALL ADULTS HAVE NAFLD
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HEALTHY FOOD SYSTEM
LOCALDIVERSE
SUSTAINABLEHEALTHY FOOD
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Mediterranean Diet
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Mediterranean vs Western dietLess: GHG, H2O, energy, land
Sáez-Almendros et al. Environmental Health 2013 12:118 doi:10.1186/1476-069X-12-118
MEDITERRANEAN 0 WESTERN
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Organic farming vs Conventional 30% lower GHG, higher profit, equal yields
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Mediterranean Diet & Asthma, Diabetes, and Cancer
PROSPECTIVE STUDIES
14% lower risk asthma (Nagel, 2010)
80% lower risk DM (Martinez-Gonzales, 2008)
24% lower risk cancer (Benetou, 2008)
31% lower CVD mortality (Sofi, 2008)
22% lower cancer mortality (Sofi, 2008)
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INTERVENTION STUDIESMediterranean Diet
60% decrease cardiac events (Ornish, 1998)
70% decrease CVD mortality (DeLogeri, 1994)
35- 48% decrease in metabolic syndrome
(Esposito, 2004, Azadhbakt, 2005)
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ADVISE SUBSIDIZE
Meat, Dairy 63%
Grains20%
Sugar,Oil, Alcohol 15%
Nuts, Legumes 2%
Fruits, Vegetables 1%
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POLICIES FOR HEALTHY FOOD AND FARMS
Subsidize fruits and vegetables
Reward good stewardship
Crop diversity
Natural fertilizer
Crop rotation
Conservation set asides
Donate excess food
Harvest energy from waste
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300,000 Heart Attacks/Strokes PREVENTED260,000 New Diabetes Cases127,000 CVD Deaths each year144,000 Cancer Deaths
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WE ARE HERE
Temperature increase 1.4 degrees F
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AND HERE:
70% overweight or obese
34% CVD
12% diabetes
37% pre-diabetes
8% asthma
75 cents of every health dollar spent on preventable chronic disease
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Sustainable agricultureActive and public transportationEfficient buildings and vehicles
Clean electricity
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BUSINESS AS USUAL
2030
40% Obese
40% CVD
20% Diabetic
10% Asthmatic
2050
50% Obese
50% CVD
30% Diabetic
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WHAT YOU CAN DO
Sign up for action alerts climate911.org
VOTE CLIMATE climatehawksvote.com
Tell your congresspeople: Climate policy is essential to protect public health
Speak out in your community
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Climate/Health Communication Workshop
October 11: 5305 Turnabout Lane 10am-noon
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HEALTHY PEOPLE = HEALTHY PLANET
www.climate911.org