2. Climate change – reducing the risks to health Andy Haines

4. Carbon dioxide measurements since 1957 Mauna Loa, Hawaii The rise in carbon dioxide is due to our emissions For every 100t of CO 2 emitted now, 15-40t will remain in the atmosphere in1000y Other long-lived GHGs (methane, nitrous oxide, FCs..) give the equivalent of 20% more CO2

5. West Antarctic ice sheet Arctic ice sheets East Antarctic ice sheet 60myr 50myr 40myr 30myr 20myr 10myr Now Millions of Years Before Present 12 8 4 0 Temp o C (vs 1961-90 av temp) +3 o C +5 o C Earth’s Temperature Chart, since Dinosaur Extinction 65m yrs ago ? Sea level 25-40 metres higher than today Tripati et al Science 2009 Paleocene +1.5 o C last 2m yr = ice-age

6. A warming climate IPCC 2013 Surface temperature change 1901-2012 Global average sea level change September Arctic sea ice area

7. Projections of globally averaged surface temperature change from 1986-2005 IPCC 2013 +0.6C for change from pre-industrial

8. Projections of regional surface temperature change 1986-2005 to 2081-2100 for high emission scenario (RCP8.5) IPCC 2013 Temperature Precipitation

9. Projections for other quantities Global Ocean surface pH IPCC 2013 +0.2m for change from 1900

10. An adaptability limit to climate change due to heat stress Steven C. Sherwood and Matthew Huber PNAS 2010 Exceeding peak heat stress for extended periods should induce hyperthermia in humans ‘....It would begin to occur with global-mean warming of about on 7 °C, calling the habitability of some regions into question’ D.S.Battisti and R.L. Naylor. Science 2009

11. France, August 2003 ~15000 deaths (~70,000 in Europe) Robine et al 2007 Temperature distribution across Europe on 10 August 2003 at 1500hrs

13. Baseline 2000 Climate Change and Malaria Potential transmission in Zimbabwe Climate suitability: red = high; blue/green = low Highlands Source: Ebi et al., 2005

14. 2025 Climate Change and Malaria - Potential transmission in Zimbabwe Climate suitability: red = high; blue/green = low

15. Diarrheal disease and rainfall Global overview of 36 published reports from LMICs from 1954-2000 (Lloyd, Kovats, Armstrong. Climate Res 2007) 4% (1-7%) increase in diarrhoea incidence in children aged <5 per 10 mm /month decrease in rainfall Reduced effect of hand washing where rainfall is low?

16. 64 36 20 80 Percentage change in yields to 2050 -50 -20 0 +20 +50 +100 UN Devt Prog, 2009 Plus climate-related: Flood/storm/fire damage Droughts – range, severity Pests (climate-sensitive) Infectious diseases (ditto) CLIMATE CHANGE: Poor Countries Projected to Fare Worst MODELLED CHANGES IN CEREAL GRAIN YIELDS, TO 2050

17. Impacts on malnutrition Increased numbers of stunted children Region Millions of additional children with stunting in 2050 due to climate change NCAR climate scenario CSIRO climate scenario South Asia76 Sub-Saharan Africa99 Lloyd S, Kovats RS, Chalabi Z (2011)

18. Many millions more people are projected to be flooded every year due to sea-level rise by the 2080s Source: IPCC Wg II, TSI 2007.

19. 2010 – a harbinger of things to come? Pakistan floods ~ 20 m affected Chinese floods ~ 12m displaced Russian drought and fires –wheat harvest down ~ 30% 56,000 extra deaths in Moscow and Western Russia (Munich Re estimate) Record temperatures in 17 countries.

20. Deaths Attributable to Climate Change in Year 2000 14 WHO statistical regions are, here, scaled by estimated annual mortality (in 2000) due to change in climate since ~1970. Selected causes of death. (Patz, Gibbs et al, 2007: based on McMichael, Campbell-Lendrum, et al, 2004) Estimated annual deaths due to climate change from: malnutrition (~80K), diarrhoea (~50K), malaria (~20K), flooding (~3K)

21.  Physical limits: small low lying islands e.g. Cayman Islands  Behavioural limits: influence where we live and why, e.g. New Orleans  Technological limits: e.g. to the flood defences such as Thames Barrier, London There are physical, behavioural and technological limits to how much we can adapt

22. Fossil fuel emissions for the scenarios IPCC 2013

23. Health co-benefits from the ‘low- carbon’ economy Through policies in several sectors e.g. Housing Transport Food and agriculture Electricity generation

26. lignite coal oil biomass gas nuclear 0 10 20 30 40 Deaths from air pollution and accidents/TWh 050010001500 A lignite coal oil biomass gas nuclear 100 200 30 0 Cases of serious illness from air pollution /TWh 050010001500 B Equivalent CO 2 emissions g/kW.hr -1 0 Air pollution impacts vs CO 2 emissions Source: Markandya A, Wilkinson P. Lancet 2007

27. GBD estimates for air pollution deaths ( Lim et al LANCET 2012 ;380;) Ambient particulates ~3.2m deaths p.a. Household from solid fuels ~3.5 m p.a. Tropospheric Ozone ~ 150 k deaths p.a.

28. ImpactsReduced exposures e.g. to fine particles, radon, cold, mould, tobacco smoke Premature deaths averted~ 5400/ year Mt-CO 2 saved (vs 1990)55 Benefits of household energy efficiency in the UK (combined insulation and ventilation control improvements) ( Wilkinson et al 2009

29. Modelled health benefits of active travel and low emission vehicles: London and Delhi ( Woodcock et al 2009)

30. Change in disease burden Change in premature deaths Ischaemic heart disease 10-19%1443-2207 Cerebrovascular disease 10-18%866-1271 Dementia 7-8%195-250 Breast cancer 12-13%203-211 Road traffic crashes 19-39%47-86 Increased active travel in London--- Health effects ( also diabetes, depression, cancer of the breast and bowel)

31. Food and Agriculture Sector Food and Agriculture Sector 80% of total emissions in sector from livestock production Reducing animal source saturated fat by 30 % and replacing it with polyunsaturates could reduce heart disease deaths by ~ 15% (~ 18,000 premature deaths) in the UK

32. New technologies for clean energy New technologies for clean energy

33. Building a low carbon,accessible and resilient health system Design to reduce energy use and GHG emissions. Increase resilience to floods and heatwaves Provide care closer to home Reduce hospital vehicle emissions Encourage use of public transportation and bicycles Use locally sourced food and reduce animal product consumption 33 Photos: HCWH, Practice Greenhealth

34. Climate change has far reaching and potentially catastrophic impacts but many low carbon policies can improve health and the economy.