1. NYS Strategies to Address Climate Change and Protect Health Build Resilience, Protect Health Jan E. Storm PhD Center for Environmental Health jes19@health.state.ny.us

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3. Step 4 Develop Climate & Health Adaptation Plan Step 1 Forecast Impacts, Assess Vulnerabilities Step 2 Project Disease Burden Step 3 Assess Public Health Interventions Step 5 Evaluate Impact, Improve Quality of Activities STAKEHOLDERS (LOCAL, STATE) STAKEHOLDERS (LOCAL, STATE) IMPLEMENT CLIMATE & HEALTH ADAPTATION PLAN (LOCAL, STATE) IMPLEMENT CLIMATE & HEALTH ADAPTATION PLAN (LOCAL, STATE) Derived From: “Building Resilience Against Climate Effects” 3

4. http://www.dec.ny.gov/energy/67778.html http://www.dec.ny.gov/energy/80930.html http://www.nyserda.ny.gov/climaid 4

5. STATE-WIDE CLIMATE CHANGE REPORTS Health Impacts of Climate Change 5 Increasing temperature – Heat related mortality, morbidity Increased frequency, magnitude of extreme weather events, flooding, power outages – Increased stress, mental health impacts, respiratory & gastrointestinal disease, injuries; impaired provision of health services Worsening air quality – increased cardiovascular, respiratory morbidity, mortality Altered drinking and recreational water quality – Increased water-borne diseases Ecosystem changes – Increased vector, food-borne diseases Altered food production - food shortages Sea level rise, severe coastal flooding, storm damage, erosion – Risk to sewage and septic systems, transportation, water treatment infrastructure

6. STATE-WIDE CLIMATE CHANGE REPORTS CAP/CLIMAID - Recommended Public Health Adaptations Educate, empower engage policy makers (state and local), community leaders, businesses, institutions, health-care providers, general public (i.e., all New Yorker’s) about health impact of climate change Research and assess public health risks from climate change (including sea level rise), climate change and health indicators, and adaptation strategies; identify and address vulnerable populations Consider impacts of climate change (including sea level rise) on health in planning, programs, policies, regulations Increase resilience of communities by providing additional support for healthy built environment concepts, smart growth, green infrastructure, local/urban agriculture Assess, improve capacity of existing public health preparedness, response, recovery programs to respond and direct resource where needed 6

7. CDC-NYSDOH COOPERATIVE AGREEMENT “Developing Public Health Capacity and Adaptations to Reduce Human Health Effects of Climate Change” Assessment and Planning to Develop Climate Change Programs, 2010-2013 Building Resilience Against Climate Effects (BRACE), 2013-2016 Evaluating climate-health indicators for planning, monitoring Completed needs assessments and surveys −DOH leaders, program & surveillance managers, LHDs, stakeholders LHD survey key takeaways: −Climate change and health viewed as issue of huge scale and scope with need for direction (e.g., what to prioritize, where to begin) −Most-frequently cited barriers to addressing climate change were lack of funding, lack of staff, and lack of education/training −Partnership opportunities between NYSDOH and LHDs include educational efforts, and using local adaptation/mitigation activities as case studies NYSDOH Climate and Health Adaptation Plan process to begin May/June 2013; completion of plan in August 2013 7

8. Climate Variability/Change and the Risks for Under-Studied Adverse Health Outcomes (CDC) Identify diseases related to various weather factors/climate change indicators Assess public health implications (health care costs, absences from school, work) Evaluate interaction among weather factors, air pollutants, health outcomes Assess vulnerable populations Evaluate utility, efficacy of composite weather indicators Establish climate-health tracking system and develop public communication/education strategies (EPHT) NYS DOH RESEARCH Building Evidence to Support Planning, Adaptation, and Interventions 8 Citation: Lin S, Hsu WH, Van Zutphen AR, Saha S, Luber G, Hwang SA. Excessive heat and respiratory hospitalizations in New York State: estimating current and future public health burden related to climate change. Environ Health Perspect. 2012 Nov;120(11):1571-7.

9. Climate Change and Adverse Birth Outcomes (NIH) Assess associations between extreme weather indicators during pregnancy and adverse birth outcomes Evaluate geographic variation Evaluate modification by air pollution Assess associations with maternal vulnerability (chronic disease, medications, low SES, etc.) Map vulnerability Forecast birth outcome burden of climate change NYS DOH RESEARCH Building Evidence to Support Planning, Adaptation, and Interventions Citation: Van Zutphen AR, Lin S, Fletcher BA, Hwang SA. A population-based case-control study of extreme summer temperature and birth defects in New York State. Environmental Health Perspectives. Online ahead of print 27 Jun 2012 9

10. Population vulnerability to Climate Change in NYS and Adaptation Strategies (NYSERDA) Map vulnerabilities to heat; health risks, individual sensitivity and community characteristics Project future vulnerabilities Assess adequacy, accessibility of NYS cooling centers; public awareness of heat warning systems, cooling centers Develop adaptation strategies for vulnerable areas, populations NYS DOH RESEARCH Building Evidence to Support Planning, Adaptation, and Interventions 10

11. NYS PREVENTION AGENDA Promote a Healthy and Safe Environment http://www.health.ny.gov/prevention/prevention_agenda/2013-2017/ 11

12. Goal #1: Reduce exposure to outdoor air pollutants with a particular focus on burdened communities Objective 1d: Coordinate efforts to reduce emissions of harmful co-pollutants with efforts to reduce GHG or carbon emissions Example Interventions to be Considered Coordinate activities addressing climate change mitigation through reduction of GHG emissions with regulatory activities to reduce emissions of other harmful co-pollutants Incorporate information on vulnerability to climate change in identification of Environmental Justice communities for targeting climate adaptation measures PROMOTE A HEALTHY AND SAFE ENVIRONMENT Air Quality 12

13. Goal #2: Reduce potential public health risks associated with drinking and recreational water Objective 2b: Upgrade physical infrastructure (source, treatment, and delivery systems) in 15% of community water systems Objective 2d: Develop strategies to address water quantity and quality challenges posed by land use and climate change Example Interventions to be Considered Educate elected officials about need for asset management at community water systems to ensure long-term sustainability of infrastructure Fund infrastructure upgrades; create fiscal incentives for local governments to update aging infrastructure Promote or require long-range local planning for the long-term sustainability of water utilities infrastructure Perform research to quantify projected impacts of climate change on water quantity and quality PROMOTE A HEALTHY AND SAFE ENVIRONMENT Water Quality 13

14. Goal #1 – Improve design and maintenance of the built environment to promote healthy lifestyles, sustainability and adaptation to climate change Objective 1a: Increase percentage of the population that lives in a jurisdiction that adopted the Climate Smart Communities pledge Objective 1h: Reduce health impacts associated with extreme weather incidents, especially among vulnerable populations Example Interventions to be Considered Develop education, outreach materials on the impact of the built environment and climate change on health Provide expanded emergency services for vulnerable populations during extreme weather incidents provide accessible, neighborhood cooling centers provide incentives for sustainable and climate smart planning, zoning and development, including transportation promote progressive codes and incentives for ‘green buildings’ explore penalties for carbon-promoting, unsustainable building PROMOTE A HEALTHY AND SAFE ENVIRONMENT Built Environment 14

15. NYS DOH Coordinates with local responders, authorities, provides guidance; support for public health response Provides coordination, guidance, support to local health, healthcare to re-establish health care systems Helps to coordinate, support local evacuation of victims/residents Provides subject matter expertise Complies with NYS CEMP HEPRP IMS Annex I Appendix 7 – Extreme Weather Planning and Response Guide forecasts impacts, assesses vulnerabilities (heat waves, frequent/heavy precipitation, etc.) Identifies, assesses public health interventions Local Government, Emergency Services First line of defense in health emergencies Counties must have a Public Health Emergency Preparedness and Response Plan (PHEPRP) Extreme Weather Planning and Response Guide to be required as part of PHEPRP NYS DOH OFFICE OF HEALTH EMERGENCY PREPAREDNESS Health Emergency Preparedness & Response Plan (HEPRP) 15 Commissioner Office of Public Health Office of Health Emergency Preparedness

16. 16 NYS DEC OFFICE OF CLIMATE CHANGE Climate Smart Communities http://www.dec.ny.gov/energy/65494.html

17. 17 NYS DEC OFFICE OF CLIMATE CHANGE Climate Smart Communities

18. CSC Certification Program – under development Pledge Element 7: Plan for Adaptation to Unavoidable Climate Change Commit to Enhancing Resilience Conduct Vulnerability Assessment Establish an Ongoing Monitoring Program Develop a Climate Adaptation Plan Incorporate Climate Change Projections and Vulnerabilities into Local Plans and Projects Use Planning and Zoning tools to Manage Risks and Protect Vulnerable Areas Create a Climate Change Adaptation Education and Outreach Program Update Infrastructure and Design New Infrastructure to Increase Resilience to Climate Change Impacts 18 NYS DEC OFFICE OF CLIMATE CHANGE Climate Smart Communities

19. 19 NYSERDA Cleaner, Greener Communities Program Focus on resiliency Community-wide regional planning Phase 1 $10 million for comprehensive sustainability plans Led by a municipality in each Regional Economic Council region Phase 2 $90 million toward regional projects New York Climate Change Science Clearinghouse Underway Compilation of scientific data, literature to assist NYS in achieving climate change mitigation, adaptation goals

20. Emergency Preparedness Commissions http://www.governor.ny.gov/

21. NACCHO Climate Change Demonstration Sites Goal – Increase coordination and communication among local stakeholders to address public health impacts of climate change – 6 LHD’s – climate-focused strategic plan Outcomes – Convened stakeholder groups focused on climate change adaptation – Mapped vulnerable populations and areas – Created local climate change adaptation plans incorporating public health http://www.naccho.org/toolbox/ DO: – Connect with local stakeholders early – Focus on local climate change-related health effects – Tailor focus to stakeholder interests – Set short- and long-term goals to keep momentum going and stakeholders engaged DO NOT: – Plan alone or rely on one leader – Use technical jargon – Rely on national/global information – Confront resistance to or denial of climate change 21

22. Contact Information and Additional Resources NYS Climate Action Planning – http://www.dec.ny.gov/energy/80930.htmlhttp://www.dec.ny.gov/energy/80930.html NYSERDA Cleaner, Greener Communities – http://www.nyserda.ny.gov/Statewide-Initiatives/Cleaner-Greener-Communities.aspx http://www.nyserda.ny.gov/Statewide-Initiatives/Cleaner-Greener-Communities.aspx US EPA Climate Change – Northeast Impacts & Adaptation – http://www.epa.gov/climatechange/impacts-adaptation/northeast.html http://www.epa.gov/climatechange/impacts-adaptation/northeast.html NOAA National Climate Data Center – http://www.ncdc.noaa.gov/ http://www.ncdc.noaa.gov/ Northeast Regional Climate Center – http://www.nrcc.cornell.edu/page_climatelinks.html http://www.nrcc.cornell.edu/page_climatelinks.html Climate Access – http://www.climateaccess.org/ http://www.climateaccess.org/ Climate Adaptation Knowledge Exchange – http://www.cakex.org/ http://www.cakex.org/ NACCHO – http://www.naccho.org/topics/environmental/climatechange/ccdemosites.cfm http://www.naccho.org/topics/environmental/climatechange/ccdemosites.cfm 22 Jan E. Storm PhD Center for Environmental Health jes19@health.state.ny.us