1 / 36

Global Environmental Change & Health Paul R. Epstein, M.D., M.P.H. Center for Health and the Global Environment Harv

Global Environmental Change & Health Paul R. Epstein, M.D., M.P.H. Center for Health and the Global Environment Harvard Medical School http://med.harvard.edu/chge.

paul2
Download Presentation

Global Environmental Change & Health Paul R. Epstein, M.D., M.P.H. Center for Health and the Global Environment Harv

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Global Environmental Change &Health Paul R. Epstein, M.D., M.P.H. Center for Health and the Global Environment Harvard Medical School http://med.harvard.edu/chge

  2. The loss of forests, freshwater and biodiversity, inadequate and inefficient use of energy, and the explosive growth in the world’s urban centers undermine long-term economic growth and threaten ecological systems. They also endanger human health, and increase developing countries vulnerability to natural disasters and conflict. … Furthermore, increases in global greenhouse gas emissions, approximately fifty percent of which are produced in developing countries, threaten to disturb the delicate ecological balance, disproportionately affecting the world's poor who are the least able to adapt to these changes. Long-term economic growth depends upon managing a country’s natural resources base, using energy to increase human productivity, helping cities to provide services and markets, and having predictable seasonal and long-term climatic conditions. -- US Agency for International Development (2002)

  3. Traditional Epidemiological Framework Ecological Epidemiological Framework Agent Social SYSTEMS Ecological Global Environment Host Epidemics Disease

  4. Global Temperature: the Past 20,000 Years, & the Next 100 Years 3 Av. temp. over past 10,000 years =15 ºC Mesopotamia 2 flourishes Agriculture Vikings in 1 emerges Greenland 0 Temp. change (ºC) End of last ice age IPCC (2001) forecast: + 1.4-5.8oC, with band of uncertainty Black Death Holocene Optimum 21st century: rapid rise 1940 Medieval Warm Little Ice Age in Europe (15th-18th centuries) -2 -3 -4 Younger Dryas -5 20,000 10,000 2,000 1,000 300 100 Now +100

  5. 370 ppm VOSTOK ICE CORE 280 ppm CO2 T 180 ppm 420 kya Present

  6. Observed vs. modeled temperature rise since 1860

  7. Deep OceanWarming

  8. SST Anomalies May 2003

  9. Health Impacts of Climate Change

  10. HEATWAVES May 2003 Andhra Pradesh T 122•F >400 deaths HUMIDITY & HEAT INDICES TMINS

  11. AIR POLLUTION AND CLIMATE CHANGE Indoor pollutants SES/emotional factors Diesel (& pollen) ASTHMA 2-3x Since 1980s • Pollen Floods & Mold Ground-level Ozone (T-dependant) Droughts & Fires

  12. IPCC 2001: New Findings • Extreme Weather Events • Heatwaves, Droughts & Floods • Intensity & Frequency • (rains >2”/d) • Biological Systems • are Responding • Plant migrations • Insects & butterflies • Bird egglaying • Marine species

  13. Emerging Infectious Diseases • 30 DISEASES “NEW” TO MEDICINE SINCE 1976 • HIV/AIDS Ebola • Legionnaires’ E. coli O157:H7 • SARS Antibiotic-Resistant Agents • Hantavirus Pulmonary Syndrome • Lyme Disease Nipah Virus • Vibrio cholerae O139Arenaviruses • RESURGENT & REDISTRIBUTING • Malaria, Dengue Fever, West Nile Virus, Cholera VECTORS Mosquitoes Ticks Rodents Bats Tsetse Flies Fleas Lice Snails Algae

  14. INFECTIOUS DISEASE A DRIVING FORCE IN HISTORY The Bad News PLAGUE 541 AD 1346 AD The “Good” News Cholera, TB, Smallpox

  15. Climate Models and Potential Malaria Distribution T Average ~1ºC/C T MINIMUMS ~2ºC/C 1950 2000

  16. THE CRYOSPHERE

  17. PLANT COMMUNITIES

  18. Changes in the Cryosphere Geographic Shifts of Mosquitoes

  19. 450 ft. ~2•F warming 1970-1990 Diaz & Graham, Science: 19967

  20. LYME DISEASE PREDATORS OF DEER WARMER WINTERS 1980s 1990s TICK DISTRIBUTION IN SWEDEN Lindgren & Gustafson. Lancet 2001;358:16

  21. HURRICANE MITCH 1998 HURRICANE MITCH

  22. HURRICANE MITCH IMPACTS ON HEALTH AND DEVELOPMENT DISEASE CLUSTER -- Malaria (>30,000 cases) -- Dengue fever (>1,000) -- Cholera (>30,000) -- Leptospirosis

  23. 4161 cases 284 deaths WNV HUMAN CASES & DEATHS 62 66 21 BLOOD ORGAN TRANS IN-UTERO ? BREAST MILK ………………… POLIO-LIKE PRESENTATION & NEURO SEQUELAE • 2000 2001 2002 Science 2002:297:1988

  24. WNV: A DISEASE OF WILDLIFE • 230 SPECIES 44 STATES, DC, 5 CANADIAN PROVINCES • 138 Bird spp., RAPTORS • - 37 spp. of mosquitoes • HORSES • ZOOanimals • REPTILES AVIAN FLYWAYS

  25. INFECTIOUS DISEASES: FORCES OF GLOBAL CHANGE • SPECIES LOSSVECTORDISEASES • Raptors Rodents • Lyme, Hantaviruses, • Leptospirosis, Plague • Vulture die off • India • Feral DogsRabies

  26. Hantavirus Pulmonary Syndrome 1993 Drought, Then Early Rains 10X Explosion of Mice Populations

  27. Range Expansion of Soybean Cyst Nematode in North America Crop PestsGenerations/Year

  28. DISEASES OF TREES • US • West Coast fungi (Phytophthora) • Alaska spruce bark beetles • 2 generations/year • East Coast hemlock woolly adelgid • N w/ warm winters • Droughts vulnerability to pests. • Diseased trees susceptible to fire.

  29. Coral Diseases Color Variants on M. cavernosa Photo: Raymond Hayes Red Band Disease on M. annularis Photo: Laurie Richardson

  30. SARS Severe Acute Respiratory Syndrome CORONAVIRUS • Species X-over • Genetic reshuffling • Farming practices & • food handling $50-100 BILLION TRADE, TRAVEL, TOURISM Bio Economic Research Associates, Cambridge, MA

  31. HIV/AIDS • SOCIAL AND ENVIRONMENTAL DETERMINANTS • Transmission • Informal sector, Mining, Conflict • Viral Evolution • Coxsackie virus • Levander & Beck. Selenium and viral virulence. Br Med Bul 1999;55:528 Malnutrition & disease burden • Chandra RK. Nutrition and immunoregulation. J Nutr 1992;122:754 • Stress proteins & mutations • Immune surveillance system

  32. Costs of Extreme Weather Events Insurance & Reinsurance, FEMA, OFDA, NGOs, Nation States, Companies UNEP $150b/y w/in this decade

  33. Levels of Solutions • Surveillance and Response Capacity • Health Early Warning Systems • Environmental, Energy & Economic Policies

  34. CHALLENGES • CLEAN ENERGYHARMONIZING ADAPTATION & MITIGATION • MDGsHEALTH, NUTRITION, POVERTY • AGENDA 21FISHERIES, FORESTS, POPs • 0 • Solar-powered • clinics, homes, schools & enterprises • water purification, pumping & desalination

  35. CLEAN DEVELOPMENT Framework Reg THE ENGINE OF GROWTH for the 21st CENTURY Funds Inst • EE and RE • “Green Buildings” & Smart Growth • Rationalized Transport & Transit • Retrofitting Infrastructure • Ecological Reconstruction

More Related