1. Healthy People 2100: Scenarios of Demographic and Socioeconomic Change Kristie L. Ebi, Ph.D., MPH Krisebi@essllc.org NCAR Summer Colloquium July 2006

2. London All Cause Mortality by Mean Weekly Temperature Carson et al. 2006

4. Scenarios Coherent, internally consistent depictions of pathways to possible futures based on assumptions about economic, ecological, social, political, and technological development Scenarios include: –Qualitative storylines that describe assumptions about the initial state and the driving forces, events, and actions that lead to future conditions –Models that quantify the storyline –Outputs that explore possible future outcomes if assumptions are changed –Consideration of uncertainties

5. Global Regional Economic Social & Environmental A2 A1 B2 B1 IPCC/SRES Reference Scenarios Population Economy Technology Energy use Land use Environment

6. SRES: Population Complete Globalization Strong Regionalization Emphasis on material wealth Emphasis on sustainability and equity

7. World Population

8. Population 2050

9. SRES: Economic Growth Complete Globalization Strong Regionalization Emphasis on material wealth Emphasis on sustainability and equity

10. OECD Development Assistance Statistics 1987- 1988 average 1992- 1993 average 19992000200120022003 I. Official Development Assistance of which 43 83458 31853 23353 74952 435 58 292 69 029 Emergency and distress relief 7042 9184 4143 5743 2763 8695 874 Emergency & distress relief as % of total 1,615,008,296,656,256,648,51

11. Health In MA Scenarios ScenarioHealth Gap Possible Outcome High IncomeLow Income Global orchestration Low Continued improvements; new medical technology Malnutrition, infectious and chronic diseases Techno- garden Lower Improvements in population health New vaccines, increased food security Adapting mosaic Lowest Less diabetes, obesity, chronic disease Rapid improvement, elimination of hunger Order from Strength High Increased obesity and diabetes; better medical technology Epidemics, poor health care access, famine, conflict

12. Climate Change & Malaria: Analysis of the SRES Climate & Socio-Economic Scenarios Van Lieshout et al. 2004 MIASMA 2.2 HadCM3 with A1F1, A2, B1, B2 0.5° by 0.5° grid –Downscaled to national level –Re-aggregated by region Expert judgment of adaptive capacity (SES, current malaria control)

13. Results Malaria increases –Hot spots (due to confluence of climate and adaptive capacity) –Fringe of its current distribution –Where current control is poor –90 to 200 million by 2080s Malaria decreases where precipitation decreases Endemic areas largely not affected

14. Pitcher et al. in press

15. Thank You

16. Elderly (65+)