1. The Impact of Climate Change and Sea Level Rise on Public Health Muge Akpinar-Elci, MD, MPH Director and Associate Professor Center for Global Health Old Dominion University, VA

2. Global Injustice Overall human vulnerability index for Climate Change UN Office for Coordination of Humanitarian Affairs Report, 2008, http://www.careclimatechange.org/files/reports/Human_Implications_TechnologyBrief.pdf

3. Possible Effects of Sea Level Rise on Human Health Injury Infrastructure damage Food and water insecurity Release of chemicals, sewage, and pollutants Food and water contamination Vector born diseases Impacts on chronic diseases and mental health Population displacement

4. Vulnerability “Vulnerability is the degree to which a system is susceptible to, and unable to cope with, adverse effects of climate change, including climate variability and extremes.” Vulnerable groups – Sick – Old and young – Physically or mentally challenged – Disadvantaged groups minorities, less educated, non-English speakers – Women the single mother household IPCC Fourth Assessment Report (AR4), 2007

5. Cases from the Caribbean; Guyana and Flood Young Population Flood date Affected (#people) 1988No data 199638,000 2005274,000 200635,000 2008100,000 EM-DAT: The OFDA/CRED International Disaster Database, http://www.emdat.be/ http://globalvoicesonline.org/2007/08/23/guyana-georgetown-is-flooded/

6. The health problems and Flooding: The case of COVE & JOHN, GUYANA To evaluate the prevalence of respiratory symptoms among occupants of water-damaged houses after the 2008 floods in Guyana Flooded houses 76.1% – Mould inside the home 37.3% (questionnaire) – Dampness and mould 32.8% (direct observation) A statistically significant association was found between flooded houses and “Fever and Chills” (p<0.05) A statistically significant association was also found between the presence of mould and runny nose, bronchitis (p<0.05) S. Rose, M. Akpinar-Elci. ISCOM, 2010

7. Adaptation A ongoing process – learning – analyzing – planning – adjusting Response to the problem and change risks

8. Community-Based Adaptation CARE, 2011, http://www.careclimatechange.org/files/adaptation/CARE_Understanding_Vulnerability.pdf

9. Role of Public Health in Sea Level Rise Adaptation Planning Forecasting Climate Impacts and Assessing Vulnerabilities Projecting the Disease Burden Assessing Public Health Interventions Developing and Implementing a Climate and Health Adaptation Plan Evaluating Impact and Improving Quality CDC: Building Resilience Against Climate Effects (BRACE) – a framework for public health agencies

10. Are we ready? Think the unthinkable Synergies between development and adaptation – improved housing, living conditions, and infrastructure will reduce poverty and, – at the same time, adapt to climate change

11. THANK YOU “When we were children, we used to think that when we were grown-up we would no longer be vulnerable. But to grow up is to accept vulnerability…” Madeleine L’Engle