1. Jonathan Patz, Professor Center for Sustainability and the Global Environment & Director, Global Health Institute University of Wisconsin - Madison Global Environment and Health WHO/PAHO Collaborating Centers Regional Meeting, RTP, Oct. 2011

2. OUTLINE Climate Change Risks Adaptation and Mitigation: Co-benefits and unintended consequences Land use & global ecological change

3. Barton & Grant, 2006 “Health Map” Sustainabilit y Commission

4. Bara Shigri Glacier, Himachal Pradesh Courtesy: Diana Liverman Losing 30 meters per year

5. Changes in sea ice extent September 1980: 7.8 million square kilometers Sept 1980 Alaska Siberia Greenland The Arctic sea ice cover Courtesy: Don Perovich

6. Changes in sea ice extent September 2007: 4.2 million square kilometers Sept 2007 Alaska Siberia Greenland Courtesy: Don Perovich

7. Changes in sea ice extent Reduction from 1980 to 2007 Huge decrease in ice extent Courtesy: Don Perovich

9. Understanding: predictions of ice extent Observationed decline is faster! Stroeve et al. 2007 Courtesy: Don Perovich

10. IPCC 2001scenarios to 2100 ---------------- 

11. CLIMATE CHANGE Temperature Rise 1 Sea level Rise 2 Hydrologic Extremes Urban Heat Island Effect Air Pollution & Aeroallergens Vector-borne Diseases Water-borne Diseases Water resources & food supply Mental Health & Environmental Refugees Heat Stress Cardiorespiratory failure Respiratory diseases, e.g., COPD & Asthma Malaria Dengue Encephalitis Hantavirus Rift Valley Fever Cholera Cyclospora Cryptosporidiosis Campylobacter Leptospirosis Malnutrition Diarrhea Toxic Red Tides Forced Migration Overcrowding Infectious diseases Human Conflicts 1 3°C by yr. 2100 2 40 cm “ “ IPCC estimates Patz, 1998 HEALTH EFFECTS OF CLIMATE CHANGE

12. Heatwave morbidity -Milwaukee Source: Li, et al. 2011

13. 50° C

14. Future summers warmer than warmest on record Today’s one billion at risk for hunger could double by mid-century. Battisi and Naylor, Science 2009

15. USA: Combined sewer overflows (CSOs) Courtesy: Kellogg Schwab 1.2 trillion gal of sewage & stormwater a year discharged during combined sewer overflows – would keep Niagara Falls roaring for 18 days Center for Water & Health, JHU Bloomberg School of Public Health

16. U.S. CCSP, 2008 Globally Averaged In Future, when it rains…it will pour.

17. Bradford Beach South Shore Beach Bradford and South Shore Beach on Lake Michigan E. coli CFU/100 ml 235-999 0-100 100-235 1000-9999 10,000-20,000 Rainfall Urban stormwater Sewage overflow Sandra McLellan Courtesy: Sandra McLellan UW-Milwaukee

18. New Orleans after Hurricane Katrina

19. Climate change Adaptation and Mitigation

20. Co-benefits from mitigating GHGs: opportunity for improving health We can reduce: 800,000 deaths/year from air pollution 1.9 million deaths from physical inactivity WHO, 2007

21. Friedman et al. 2001; UNEP 2009 Olympics: Natural experiments Atlanta 1996: Traffic Ozone Traffic was reduced by 23% Ozone air pollution fell by 28% Childhood Asthma dropped 42% Beijing 2008: China spent $17 Billion for a “Green Olympics” Nitrogen dioxide fell by 38%, Particulate matter by 20%

22. From transportation…to human health Grabow, et al (in press) 2011 Technology & Activity Scenarios What are the associated emissions? (CO 2, NO 2, SO 2, VOCs, PM, etc.). What are the health impacts of predicted pollution levels? How do these emissions impact air pollution? Ozone

23. WHAT IF, 20% fewer car trips, Midwest USA? Grabow et al. 2011 500 lives saved per year 500 lives saved per year 100,000s of illnesses avoided And if 50% of these short trips were by bicycle, the fitness benefit reaches 1,100 lives saved/yr.

24. Mitigating climate change could: 1)Enhance personal fitness; 2) reduce air pollution; 3) reduce greenhouse gases great health opportunity Co-benefits: fighting global warming is a great health opportunity

25. Adaptation to climate change may have unintended consequences; Need for full Health Impact Assessment approach

26. Millennium Ecosystem Assessment “Ecosystem Services”“Ecosystem Services” “Natural capital”“Natural capital” FREE services from nature

27. Identified Drivers of Disease Emergence Millennium Ecosystem Assessment From the Millennium Ecosystem Assessment Patz & Confalonieri, 2005

29. Deforestation & malaria risk, Peruvian Amazon Vittor et al. 2006

30. Biological Diversity Climate Change Desertification Nutritional changes Disease Regulation Medicinal products Water purification Extreme weather events Heat waves &air pollution Malnutrition Water- & Food-borne disease Vector-borne diseases Water scarcity and safety Agro-ecosystem productivity Food scarcity Droughts Health and the Rio Conventions Human health Human health Climate induced Biodiversity loss Deforestation effects on climate Land degradation, deforestation Desertification hastened by landcover change Precipitation changes leading to drought Source: Corvalan, WHO, 2006

31. Conclusion Global climate and ecological change pose significant risks to health Risks, Adaptation and Mitigation Policies should be studied together “Health in all Policies” approach required