1. National Institutes of Health U.S. Department of Health and Human Services John M. Balbus, MD, MPH Senior Advisor for Public Health National Institute of Environmental Health Sciences UK-US Climate Meeting Atlanta, GA February 7, 2014 Climate Change and Human Health: Mine the gaps

2. National Institutes of Health U.S. Department of Health and Human Services

3. National Institutes of Health U.S. Department of Health and Human Services Climate Change and Health Copyright restrictions may apply. Haines, A. et al. JAMA 2004;291:99-103. Potential Health Effects of Climate Variability and Change

4. National Institutes of Health U.S. Department of Health and Human Services

5. National Institutes of Health U.S. Department of Health and Human Services Draft National Climate Assessment Key Messages – Human Health 1.Climate change threatens human health – impacts already underway in the U.S. 2.Climate change will amplify existing health threats the nation faces, esp. for vulnerable communities & people. 3.Preparedness & prevention can protect people from some of these impacts; early action is most beneficial, because our ability to adapt to increasing threats may be limited in future. 4.Responding to climate change provides opportunities to improve health and well-being in sectors including energy, agriculture, and transportation; in ways that can protect people, combat climate change, and provide other benefits. 5

6. National Institutes of Health U.S. Department of Health and Human Services Key Health Threats Multiple Climate Stressors & Health –Climate change impacts add to the cumulative stresses currently faced by vulnerable populations: Societal System Failures During Extreme Events –Multiple system failures can occur during extreme weather events Large-Scale Environmental Change Favors Disease Emergence –Factors include shifting pest ranges, lack of immunity & preparedness, inadequate monitoring. 6

7. National Institutes of Health U.S. Department of Health and Human Services What are some of the questions “health folks” ask? How often/where will temperatures exceed health thresholds? How extreme will weather be in my area? What climate change and/or extreme weather threats face my facilities? How will CC-related ecosystem and human system changes affect my patients How will CC-related changes affect the essentials of health and well-being, like food and shelter?

8. National Institutes of Health U.S. Department of Health and Human Services What kinds of climate and other earth observations data help answer those questions? Future Averages and Extremes –Daily min and max temperature –Total precipitation per season –Length of freeze-free periods, droughts –Temperatures of hottest 1,3,5 day periods, etc. –Soil moisture, vegetative cover Future Variability –Annual and seasonal range of daily max and min temps, rainfall events, extreme events Threshold Exceedance –# and frequency of record-breaking seasons (hot summers, wet winters, etc.) –# of days/nights above set thresholds (e.g., days above 90, nights above 75)

9. National Institutes of Health U.S. Department of Health and Human Services What are the “gaps”? Knowledge Gap- historically inadequate investment in CCHH research means we don’t know the best climate and weather parameters Temporal Gap- public health programs operate on emergency to annual time scales Spatial Scale Gap- public health often operates on neighborhood spatial scale- microclimates are critical

10. National Institutes of Health U.S. Department of Health and Human Services Additional Challenges for Climate Change and Human Health Data Mining Paucity of health data- –Privacy issues complicate providing geospatial resolution –Fragmentation of US health system; private/local sources richest Large number of disciplines involved –Difficulty with data integration –Differing terminology, etc. –Limited research investment=limited research community Identifying and accessing data sources

11. National Institutes of Health U.S. Department of Health and Human Services

12. National Institutes of Health U.S. Department of Health and Human Services (REUTERS/Mario Anzuoni)

13. National Institutes of Health U.S. Department of Health and Human Services CCHHG Membership Co-chairs: National Institute of Environmental Health Sciences (NIEHS) Centers for Disease Control and Prevention (CDC) National Oceanographic and Atmospheric Administration (NOAA) Representatives: Department of Defense (DOD) Department of State (DOS) Environmental Protection Agency (EPA) National Aeronautics & Space Administration (NASA) National Science Foundation (NSF) U.S. Agency for International Development (USAID) U.S. Department of Agriculture (USDA) U.S. Geological Survey (USGS) 13

14. National Institutes of Health U.S. Department of Health and Human Services CCHHG Workstreams Adaptation – support for the Interagency Climate Change Adaptation Task Force Assessment and Indicators – technical input, stakeholder engagement, and sustained assessment activities for the National Climate Assessment Communication, Education, and Engagement – coordination with USGCRP on outreach to public health stakeholders Data Integration – development of Metadata Access Tool for Climate and Health (MATCH) International – review of international adaptation plans and assessments, and engagement with global health community Joint Research and Application – development of a climate change & human health research application community 14

15. National Institutes of Health U.S. Department of Health and Human Services Match.globalchange.gov

16. National Institutes of Health U.S. Department of Health and Human Services US Interim Assessment Report on Human Health More detailed assessment of existing climate and health research than was possible in the most recent draft NCA. Strong focus on quantifying impacts, and opportunities for public engagement and review During a Scoping Workshop held in November, CCHHG agencies agreed to focus on quantifying national-scale impacts in four areas: Extreme Heat Air Quality Vectorborne Disease (Lyme) Waterborne Disease (Vibrio) Advancing the science to foster development of datasets, models, scenarios 16

17. 1. Forecasting Climate Impacts and Assessing Vulnerabilities 2. Projecting the Disease Burden 3. Assessing Public Health Interventions 4. Developing and Implementing a Climate and Health Adaptation Plan 5. Evaluating Impact and Improving Quality of Activities Building Resilience Against Climate Effects Climate and Health Program, National Center for Environmental Health

18. National Institutes of Health U.S. Department of Health and Human Services Conclusions Climate change and health field is still in early days Challenges related to scales, disciplinary boundaries, data privacy concerns, etc. Opportunities now for advancing the science through development of models and conduct of assessments 18

19. National Institutes of Health U.S. Department of Health and Human Services Thank you! http://www.niehs.nih.gov/geh