1. Health Impacts of Climate Change:
Psychological, Physical, and Community
Dr. Susan Clayton
The College of Wooster

3. Why look at the effects of climate change on health?

4. Describing the impacts can personalize the issue
Health impacts transcend the partisan divide
Understanding impacts is critical to preparing for them
And make it less remote
And make it politically palatable
And make it more manageable

5. How can climate change affect human well-being?

6. Direct and indirect effects Acute and gradual changes
Experience and perception
Threat itself is a risk factor for psychological and emotional distress

7. Mental health and wellbeing Social relationships
Physical health
Mental health and wellbeing
Social relationships
Broader ways of thinking
And emphasize human consequences to attract attention and emphasize self-interest
Note interdependence among all of these aspects

8. Heat: higher average temperatures and more frequent heat waves
Precipitation: changing patterns and more intense storms as well as droughts
Rising sea levels: coastal flooding and storm surges
Wildfires
Air pollution: heat increases ground-level ozone and smog
Source:
EcoAmerica

9. Source:
EcoAmerica

10. Source:
EcoAmerica

11. Acute impacts from natural disasters
Death Injury Disease flooding increases water-borne disease Adverse birth outcomes preterm births low birth weight maternal complications

12. Indirect impacts
Disruptions in food, water, shelter Disruptions in delivery of health services Impaired immune system functioning Increase in domestic abuse

13. Mental health effects
PTSD Depression General anxiety Suicide and suicidal ideation Substance abuse -- all of which may last several years or longer

14. E.g., Hurricane Katrina
49% developed an anxiety or mood disorder 1 in 6 developed posttraumatic stress disorder Suicide and suicidal ideation more than doubled
Similar rates of PTSD have been found after other disasters

15. Gradual changes Increased temperatures
Changing patterns of precipitation
Sea level rise
Coffee, wine, chocolate
Heavy precipitation events have increased by 71% in the Northeast

16. Health impacts Increased ozone levels and airborne particulates
Asthma and respiratory effects
Dust storms
Associated with “valley fever,” a fungal pathogen
Allergens
Increased production of pollen
Indoor mold more likely

17. Assuming no change in regulatory controls or population characteristics, estimates from combined ozone and particle health effects range from 1,000 to 4,300 additional premature deaths nationally per year by 2050

18. Spread of infectious diseases Ticks and Lyme disease
Dengue, West Nile, Zika?
Clinical depression has been observed in patients with West Nile virus
Heat waves
Kidney, cardiovascular and respiratory impacts
In Australia, hospital admissions increased by 7% during heat waves
Decreased access to clean water
Algae blooms, Saltwater intrusion
Including for dementia; mood disorders; neurotic, stress related, and somatoform disorders.
And 1-2 billion at risk of inadequate water supply

20. Precipitation increases accidents Temperature increases fatalities
Hunger
Changes in agricultural potential of an area can lead to food insecurity.
A 2° C temperature increase will place million at risk of hunger, according to the World Bank
Traffic accidents
Precipitation increases accidents
Temperature increases fatalities
One study estimated an additional 603 deaths annually in the U.S.
Foods at risk include coffee and wine

21. Higher temperatures have psychological effects
Suicide rates go up Hospitalization for mental illness goes up Aggression goes up School performance goes down

22. Indirect effects Due to economic difficulties
damage to physical and social infrastructure
environmental degradation
Desertification due to climate change could create 50 million migrants in the next 10 years.

23. Effects on perceptions
Diminished sense of self loss of occupation loss of lifestyle and culture loss of autonomy Possibility of solastalgia loss of place and disruption of place bonds -- the loss of solace from valued places

24. “Our gardens have had to die because our house dam has been dry…
“Our gardens have had to die because our house dam has been dry…. It’s very depressing because a garden is an oasis…that’s all gone, so you’ve got dust at your back door” (Australian farmer coping with drought) “You think your house is permanent… When you lose your house and everything you own, you learn everything is temporary” (Hurricane Sandy survivor)

25. Anxiety about the future
Hopelessness Suicide
Note learned helplessness

26. Uncertainty about climate change
Individual responses lack of control, anxiety about unpredictability Intergroup tensions over meaning due to perceived inequity

27. Community impacts
Increases in violence and crime Increases in interpersonal aggression Decreased social cohesion
Associated with increased competition over resources, increased inequity, redirection of resources, breakdown of social infrastructure
iated with stress, lack of social buffer, heat
The loss of interpersonal and social networks can intensify responses to negative events

28. A threat to national security
The Syrian refugee crisis is linked to unusual drought in the area, associated with climate change
Jihadists are already blaming
the U.S. for climate change
Water conflicts

29. Threats to identity loss of occupation loss of place
loss of lifestyle and culture
loss of autonomy and control

30. Loss of occupational identity
“Ranching families across the country are now facing an existential threat to a way of life that has sustained them”
(New York Times on wildfires in the U.S.)
Farmers in drought-afflicted areas in Australia and India have suffered increased levels of mental distress.
Suicide rates are higher for agricultural workers in the U.S. than for any other occupational group.

31. Loss of cultural identity: Indigenous communities
Weakened social networks
Increased level of conflict
Increased drug and alcohol abuse

32. Indigenous cultures face a threat to their way of life

33. Loss of place identity identity
“The lake was our mother and father. Without the lake, where do we go?”
“Can the people of the lake exist without the lake?”
The Uru-Murato of Bolivia
Also evidence among Inuit and in Louisiana coastal community

34. Natural disasters in 2018 displaced 19 million people worldwide
This does not include the gradual changes, whose economic and social impact is probably greater.

35. Migration presents a health risk
Immigrants are more likely to develop psychosis
This is true even among second-generation immigrants, showing that it is the social context post-migration and not the pre-migration factors that matter.
Unlike survivors of discrete traumas, refugees experience stressors that accumulate over the pre- flight, flight, exile, and repatriation periods.

36. Who will be affected?

37. Not everyone will be affected equally
The poorest countries will suffer the greatest health impacts
Within the U.S., poor communities are likely to bear the greatest burden
Those with multiple stressors and/or fewer resources

38. Sources of vulnerability
Geographically vulnerable
Economically vulnerable
members of low-income communities and nations
Socially vulnerable
women, members of marginalized communities
Physiologically vulnerable
The elderly are particularly vulnerable to heat
Those already suffering from mental illness
Multiple stressors increase vulnerability
Thermoregulation is affected by some medications for schizophrenia, e.g.

39. Children are particularly vulnerable
Physical vulnerability: Immaturity can enhance the risk of disease, impact of persistent stress, vulnerability to pollutants, and effects of malnutrition. Stress itself, along with malnutrition and lack of clean water, makes the body more vulnerable.

40. Children are particularly vulnerable
Social vulnerability: Disruption to education Psychological vulnerability: Dependence on others Need for security Mental health of the caregiver can impact the child’s mental health Effects will depend on the child’s developmental stage as well as sources of resilience.
Some studies suggest higher rates of PTSD

41. Inequality itself is a threat to mental health through risk factors such as
Reduced personal autonomy
Negative self-perception
Stress
Social isolation
Insecurity

42. What can be done? Promoting resilience
More quotes from Sandy survivors

43. Most people do recover from trauma Post-traumatic growth is possible
Becoming actively involved in addressing climate change can help people to cope with the stress of worrying about it
“We learned first-hand that the best way for us to heal from our devastation and loss was to help others recover.” (Hurricane Sandy survivor)

44. Factors associated with resilience
Practical support Community ties Sense of optimism Active coping strategies
Practical support includes informational resources and mental health support
Coming together as a community can actually strengthen social ties and provide an occasion for personal growth.
Active coping was associated with cognitive performance among elementary school children after a disaster

45. Plan ahead Educate people about what to expect and how to adapt
Focus on local impacts
Conduct a vulnerability assessment
Establish the infrastructure to encourage adaptation
E.g., assess flooding potential and re-zone districts, plant wetlands, erect barriers, establish effective early warning systems for extreme weather, have backup plans for clean water.
After Milwaukee implemented a plan for extreme heat conditions, a subsequent heat wave resulted in only half the anticipated number of deaths. Enhanced tree canopies and fewer heat-absorbing surfaces could reduce heat-related mortality by a substantial amount.
Psychosocial support is a key component of an effective response to a natural disaster

46. Consider the social context
Strengthen social networks, work across multiple groups
Consider the most vulnerable; plan for mental health resources
Encourage optimism and sense of efficacy
Emphasize co-benefits
Events in a community can affect levels of engagement, trust, and reciprocity by supporting pro-social norms (or not)

47. Acting on climate change can protect health
Burning fossil fuels emits pollution that is associated with 4 of the 5 leading causes of death in the U.S.
Coal-burning plants are also the leading cause of mercury pollution, which affects the brain
3.2 million people a year die from factors related to physical inactivity. Choosing to walk or cycle instead of driving can have strong positive health impacts.
Eating less meat, especially red meat, would reduce risk of heart disease and death while reducing carbon emissions.

48. The environment can be a source of resilience
A view of nature through a window has been experimentally associated with more rapid recovery from surgery, reduced requests for painkillers
Time in the natural world has been associated with greater sense of purpose in life, reduced stress, positive emotions, vitality, awe,…
… and these positive emotions have in turn been associated with lower levels of pro-inflammatory cytokines, which are associated with a variety of health problems including heart disease and depression
Greatergood.berkeley

49. Health is not just the absence of disease
Climate change presents an opportunity
to examine the social and physical infrastructure of our communities
to consider opportunities of enhancing well-being

50. What you can do Inform yourself
Communicate about the health effects of climate change (especially to policymakers)
Get involved in disaster preparedness efforts
Coordinate and support with others involved in addressing climate change
Communication overcomes collective ignorance (Darley and Latane studies)

51. Change the social context
Lead by example Overcome collective ignorance

52. Acting on climate is acting on health!
“Countries will have to undergo a shift from understanding climate change solely as a threat, to embracing the response to climate change as an opportunity for human health and well-being”
The Lancet Countdown: Tracking progress on health and climate change. (2016)