1. Climate Change and Human Health Lesley Jantarasami EPA Office of Air and Radiation Office of Atmospheric Programs May 21, 2015 Presentation to the National Tribal Forum

2. For public health, climate change is the defining issue for the 21st century. Margaret Chan: Director General of World Health Organization Climate change is a public health issue and is one of the greatest threats to human health. Lynn Goldman, Testimony to Subcommittee on Energy and Power, Representing American Public Health Association Few Americans are aware of the current or projected future health impacts of global warming [for the U.S. or worldwide]. Public Perceptions of the Health Consequences of Global Warming, Yale Project on Climate Change Communication

3. US Global Change Research Program (USGCRP)  Mission: To build a knowledge base that informs human responses to climate and global change through coordinated and integrated federal programs of research, education, communication, and decision support

4. Motivation Purpose Audience USGCRP Climate and Health Assessment

5. The cast = lots of acronyms  Product of USGCRP  Part of NCA  Driven by CCHHG  Coordinated by EPA  Written by HHS (NIH, CDC, NIOSH, ASPR, FDA, SAMHSA, USUHS, VA), NOAA, EPA, USDA, NASA, USGS, DOD…

6. What’s in 1.Climate Change and Human Health (Intro) 2.Temperature-Related Death and Illness 3.Air Quality Impacts 4.Vectorborne Disease 5.Water-Related Illnesses 6.Food Safety, Nutrition, and Distribution 7.Extreme Weather 8.Mental Health and Well-Being 9.Risk Factors and Populations of Concern

7. What’s out  Mitigation, adaptation, or economic valuation  Policy recommendations  Most compounding, secondary, or cumulative climate and health effects  Assessment of research needs

8. Informing other Federal Climate and Health Initiatives Climate Data Initiative (climate.data.gov) Over 150 Federal climate and health datasets that are freely accessible to researchers and data innovators to produce new tools and applications. Climate Resilience Toolkit (toolkit.climate.gov) Provides scientific tools, information, and expertise to help people manage their climate-related risks and improve resiliency to extreme events. Sustainable Climate Resilience Healthcare Facilities Initiative Best Practices Guide and Toolkit to improve healthcare resiliency to extreme events.

9. An “interim report” To be published between the Third and Fourth National Climate Assessments Current plan for release is Spring 2016 – After National Research Council (NRC) peer review – After interagency review and clearance

10. Strengthens and expands our understanding of health impacts Updated Findings Stronger Evidence New analyses Broader Scope Identifies Risks and Vulnerabilities

11. www.globalchange.gov/health-assessment

12. Climate change is a significant threat to the health of the American people exposes more people in more places to public health threats exacerbates and accelerates some existing health threats and creates new public health challenges Draft Findings

13. NON-CLIMATE STRESSORS Land-use change Ecosystem degradation Infrastructure condition Geography Agricultural production & livestock use NON-CLIMATE STRESSORS Land-use change Ecosystem degradation Infrastructure condition Geography Agricultural production & livestock use CLIMATE DRIVERS Increased temperature Precipitation extremes Extreme weather events Sea level rise CLIMATE DRIVERS Increased temperature Precipitation extremes Extreme weather events Sea level rise EXPOSURE PATHWAYS Extreme heat Poor air quality Reduced food & water quality Changes in infectious agents Population displacement EXPOSURE PATHWAYS Extreme heat Poor air quality Reduced food & water quality Changes in infectious agents Population displacement HEALTH OUTCOMES Heat-related illness Cardiopulmonary illness Food-, water-, & vectorborne disease Mental health consequences & stress HEALTH OUTCOMES Heat-related illness Cardiopulmonary illness Food-, water-, & vectorborne disease Mental health consequences & stress SOCIAL DETERMINANTS Age & gender Race & Ethnicity Poverty Housing & infrastructure Education Discrimination Access to care & community health infrastructure SOCIAL DETERMINANTS Age & gender Race & Ethnicity Poverty Housing & infrastructure Education Discrimination Access to care & community health infrastructure Draft Findings

14. Temperature-Related Death and Illness Increasing concentrations of greenhouse gases lead to a warming of both average and extreme temperatures. This is expected to lead to a decrease in deaths from cold and an increase in deaths and illness from heat, particularly for a number of communities especially vulnerable to these changes, such as children, the elderly, and disadvantaged groups. Draft Findings

15. Air Quality Impacts Changes in the climate affect the air we breathe both indoors and outdoors. The changing climate has modified weather patterns, which in turn have influenced the levels and location of outdoor air pollutants such as ground-level ozone and fine particulate matter. Increasing CO 2 levels will also promote the growth of plants that release airborne allergens. Draft Findings

16. Vectorborne Diseases The seasonality, distribution, and prevalence of vectorborne diseases are influenced significantly by climate factors, primarily high and low temperature extremes and precipitation patterns. Climate change is likely to have both short- and long- term effects on vectorborne disease transmission and infection patterns, affecting both seasonal risk and broad geographic changes in disease occurrence over decades. Draft Findings

17. Water-Related Illness Across most of the United States, climate change is expected to affect fresh and marine water sources in ways that will increase people’s exposure to contaminants that cause illness. Certain climate and weather factors enhance the growth, survival, spread, and virulence, or toxicity, of water-related pathogens and toxins, which make them more likely to cause disease. Draft Findings

18. Food Safety, Nutrition, and Distribution Draft Findings

19. Extreme Weather Climate change has already resulted in a shift in the frequency, intensity, and duration of certain extreme events. Health hazards associated with extreme events can result in death, injury, disease, and other negative effects on human physical, mental, and social well-being. Draft Findings

20. Mental Health and Well-Being Draft Findings

21. Climate-Health Risk Factors & Populations of Concern Populations of concern include those with low income, communities of color, those with limited English proficiency and immigrant groups, Indigenous peoples, children and pregnant women, older adults, certain occupational groups, persons with functional disabilities, and persons with biologically determined vulnerability, such as pre-existing or chronic medical conditions. Draft Findings

22. Climate-Health Risk Factors & Populations of Concern Spotlight on Indigenous Peoples Section of Chapter – Food Safety and Security – Water Security – Loss of Cultural Identity – Degraded infrastructure and other impacts Photos: Mark Henle/The Arizona Republic Photo: US DOI Draft Findings

23. Demonstration of the USGCRP Public Review and Comment System Submit Comments: April 7 – June 8 (by noon EDT) https://review.globalchange.gov

24. Thank You! Contact me at: jantarasami.lesley@epa.govjantarasami.lesley@epa.gov www.globalchange.gov/health-assessment review.globalchange.gov