1. George Luber, PhD Associate Director for Climate Change Climate and Health Program National Center for Environmental Health Climate Change Adaptation: Priority Actions for Public Health PHI Side Event at UN High Level Meeting on Non-Communicable Diseases, New York, September 19, 2011.

2. First the bad news… Despite existing breadth of organizations and sectors with initiatives on climate change Despite existing breadth of organizations and sectors with initiatives on climate change Despite the likelihood of anticipated health effects of climate change Despite the likelihood of anticipated health effects of climate change Public health effects of climate change remain largely unaddressed

3. Potential Health Effects of Climate Change Climate Change : Temperature rise Sea level rise Hydrologic extremes HEAT  Heat stress, cardiovascular failure SEVERE WEATHER  Injuries, fatalities AIR POLLUTION  Asthma, cardiovascular disease ALLERGIES  Respiratory allergies, poison ivy VECTOR-BORNE DISEASES  Malaria, dengue, encephalitis, hantavirus, Rift Valley fever WATER-BORNE DISEASES  Cholera, cryptosporidiosis, campylobacter, leptospirosis WATER AND FOOD SUPPLY  Malnutrition, diarrhea, harmful algal blooms MENTAL HEALTH  Anxiety, despair, depression, post-traumatic stress ENVIRONMENTAL REFUGEES  Forced migration, civil conflict Adapted from J. Patz

4. CDC’s Priority actions for Climate Change A set of “priority actions” that guide the public health approach Emerged from recommendations to the CDC Climate Change Workgroup during the January2007 meeting Forms the cornerstone for CDC’s policy on Climate Change http://www.cdc.gov/nceh/climatechange/

5. Environmental Justice, poverty and disempowerment as critical vulnerability factors “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, 2008 Professor, Environmental Health Sciences, UC- Berkeley Priority Action: Focus on the Most Vulnerable Focus on the Most Vulnerable in Our Communities

6. Carbon Emissions (Density-Equalizing Cartogram) The United States emits one quarter of the worlds gases that cause global warming. Mark Newman, University of Michigan │ www.worldmapper.org

7. Climate-Related Mortality Those who are most affected are least responsible for the greenhouse gas emissions that cause the problem Mark Newman, University of Michigan │ www.worldmapper.org

8. September 22, 20092009 NASA Public Health Review Team Meeting

9. Efforts to mitigate or adapt to the effects of climate change frequently yield other health benefits. Efforts to mitigate or adapt to the effects of climate change frequently yield other health benefits. Priority Action: Identify and Leverage Climate and Health Co-benefits and Synergies in Climate Change Mitigation and Adaptation Policies

10.  Physical activity  Air pollution And by the way…  Infrastructure costs  Social capital  CO 2 emissions  Depression  Injuries  Osteoporosis Slide courtesy of H. Frumkin

11. Hold On! There is a problem with this approach Policies that promote healthy, low-carbon lifestyles are necessary, but insufficient. These policies must be tied to evidence to support their continued use. Enhanced Public Health Surveillance is Critical!

12. Central Texas Climate Change Environmental Public Health Indicators Tracking Tool  Partnering with the City of Austin Climate Protection Program to create health indicators related to local Climate Change mitigation strategies Priority Action: Inform Policy

13. Area with High Flash Flood Vulnerability containing an EPA Impaired Stream/Water body Flash Flood Vulnerability Index overlaid onto EPA impaired streams. Census Block Groups with Parks Where Trees Have Been Planted, High Surface Temperature and High Rates of 65+ Cardiovascular Mortality (1999- 2005) Park Plantings (1999-2003) overlaid onto Average Surface Temperature and Baseline Age Adjusted Cardiovascular Mortality Rate among the Elderly (65+) in Travis County, TX (1999- 2005)

14. Adaptation Strategies for Climate Change Develop data-driven approaches that identify spatially-specific vulnerable populations and places Develop data-driven approaches that identify spatially-specific vulnerable populations and places Enhance surveillance by integrating environmental, meteorological and health data Enhance surveillance by integrating environmental, meteorological and health data Identify co-benefits for health of mitigation and adaptation strategies Identify co-benefits for health of mitigation and adaptation strategies

15. Re-Framing the Climate Change Dialogue

16. Thank You Contact: George Luber, PhD Associate Director for Global Climate Change National Center for Environmental Health gluber@cdc.gov Tel: 770-488-3429