Protecting our Health from Professionals Climate Change:

a Training Course for Public Health

Chapter 15: What Makes Individuals and Populations Vulnerable to the

Effects of Climate Change on Health?

Overview: This Module

Defines terms Discusses the causes of vulnerability to

disease and injury resulting from climate change

Describes current and past examples of vulnerability to effects of heat, famine and storms

Points to opportunities to reduce vulnerability and improve population health

Definition of Vulnerability

“The degree to which a system is susceptible to, and unable to cope with, adverse effects of climate change”

Intergovernmental Panel on Climate Change, Fourth Assessment Report 2007

(IPCC AR4, 2007)

Definition of Vulnerability (cont.)

Determinants of Vulnerability

Character, magnitude, and rate of climate change

Sensitivity to climate change Coping capacity (adaptation)

Example of Vulnerability to Climate Change — Coral Reefs

Reasons Exposed to rapid ocean

warming Sensitive to small

increases in temperature

Limited adaptive capacity

Determinants of Health Vulnerability to Climate Change

Biological Physical Geographical Social Economical Political

Heat wave Heat wave —— Europe Europe

Heat index, Summer 2003

Heat-Related Deaths: Who Was at Greatest Risk? (England and Wales, 1993–2003)

Older people: age factor Women: gender factor People living in London: geographical factor

Those in nursing and care homes: social and political factor

Hajat et al., 2007

Fouillet et al., 2008

Adaptation: Heat Wave in France — 2006

Effects of 2006 Heat Wave in France

2,065 excess deaths (July 11–28) Number expected based on the rates seen

during the 2003 heat wave: 6,452 Possible explanations

– Model imperfections (over-estimate of expected deaths)

– Reduced vulnerability (e.g., heat warning system, better informed public, more responsive health services)

Climate Change and Pacific Ocean Sea Level Rise

Sea level rise 28–43 cm

Increase in tropical storm intensity likely

Vulnerability of Pacific Islands to Sea Level Rise

Woodward et al.,

1998

Typhoon Impacts by Classification: a Preparedness Evaluation

Loss of life due to typhoons is decreasing owing to better preparedness(Fukuma,1993)

Cartogram: Greenhouse Gas Emissions in 2002

Cartogram: Climate Change Health Impacts

Note: Uses only data on deaths from malaria and dengue fever, diarrhoea, malnutrition, drowning (and heatstroke for OECD countries)

Vulnerability to the Future Effects of Climate Change

“The rich will find their world to be more expensive, inconvenient, uncomfortable, disrupted and colorless — in general, more unpleasant and unpredictable, perhaps greatly so. The poor will die.”

Kirk R. Smith, 2008Professor: Environmental Health Sciences University of California, Berkeley

Hurricane Katrina Crossing the Gulf of Mexico

Hurricane CategoryPeople

evacuatedHomes

damaged Deaths

George 1998 3–4 818,000 40,000 6

Irene 1999 1 162,000 3,000 4

Michelle 2001 4 712,000 90,000 5

Isidore 2002 2 280,000 51,000 0

Lili 2002 2 165,000 51,000 1

Oxfam America, 2004

Diminishing Number of Death Due to Hurricanes Striking Cuba, 1998–2002

Oxfam America, 2004

Foundation of Low Storm Mortality in Cuba

1. Tangible preparedness assets — stockpiles, plans, equipment, early warning systems

2. Infrastructure — high levels of literacy, rural development, access to reliable health care

3. Social capital — engagement of local communities, high levels of participation, commitment to reconstruction and recovery

Vulnerability and Climate Variability: The Case of India 1876–1878

“The more one hears about this famine, the more one feels that such a hideous record of human suffering and destruction the world has never seen before.”

Florence Nightingale, 1877

Effect of El Niño on Rainfall

June–August40 years of data to 2000

Red dots — drier than usual during El NiñoBlue dots — more rainfall

Size of circle — size of effect

KNMI, 2009

El Niño events associated with weakening easterlies, warming of the western Pacific, and shift in rainfall patterns

The 1877 El Niño Was Not Particularly Severe …

Davis, 2000

… But it Resulted in Intense Famine

Davis, 2000

Famine in Relation to Food Production, India 1875–1878

Mid-1876 — monsoon fails, drought begins in SW IndiaLate 1876 — price of food rises steeply, migrations begin Mid-1877 — famine deaths begin: total between 6 and 10 million

1877 record grain exports to UK

Davis, 2000No. Deaths

Central India 1860–1890: Wheat Boom Made Mass Hunger More Likely

Aggressive promotion of wheat (for export) instead of millet and gram (for local consumption)

Production subsidised by destructive soil mining and high levels of household debt

Community-controlled reserves replaced by remote stockpiles with no moral or regulatory restraint on speculation

Neglect of public works (irrigation especially)

Pacific: Does Modern Agriculture Reduce Vulnerability to Climate Variability?

Traditional Agriculture Crop diversity Drought-resistant

staples (e.g., taro, yam) Robust methods of food

preservation Strong social networks Inter-island trade

systems

Modern Agriculture Cash cropping Reliance on imported

staples (e.g., rice) Unreliable methods of

food preservation (e.g., refrigerators)

Attenuated social networks

Trade systems global, not local

Conclusions

Vulnerability = susceptibility to adverse effects + inability to adapt

Causes of vulnerability include biological characteristics, the physical environment, social circumstances, and national and international politics

Opportunities to reduce vulnerability cover a correspondingly wide range

Reducing vulnerability to damage resulting from climate change will bring other substantial benefits, earlier