Human Health Impacts & Adaptation

Climate Impacts on Alaska

Sun setting over a city on a hot day. Source: EPA (2010)

Weather and climate play a significant role in people's health. Changes in climate affect the average weather conditions that we are accustomed to. Warmer average temperatures will likely lead to hotter days and more frequent and longer heat waves. This could increase the number of heat-related illnesses and deaths. Increases in the frequency or severity of extreme weather events such as storms could increase the risk of dangerous flooding, high winds, and other direct threats to people and property. Warmer temperatures could increase the concentrations of unhealthy air and water pollutants. Changes in temperature, precipitation patterns, and extreme events could enhance the spread of some diseases.

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The number of 100-degree days per year is projected to increase.
Source: USGCRP (2009)

The impacts of climate change on health will depend on many factors. These factors include the effectiveness of a community's public health and safety systems to address or prepare for the risk and the behavior, age, gender, and economic status of individuals affected. Impacts will likely vary by region, the sensitivity of populations, the extent and length of exposure to climate change impacts, and society's ability to adapt to change.

Although the United States has well-developed public health systems (compared with those of many developing countries), climate change will still likely affect many Americans. In addition, the impacts of climate change on public health around the globe could have important consequences for the United States. For example, more frequent and intense storms may require more disaster relief and declines in agriculture may increase food shortages.

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Impacts from Heat Waves

Heat waves can lead to heat stroke and dehydration, and are the most common cause of weather-related deaths. ^{[1] [2]} Excessive heat is more likely to impact populations in northern latitudes where people are less prepared to cope with excessive temperatures. Young children, older adults, people with medical conditions, and the poor are more vulnerable than others to heat-related illness. The share of the U.S. population composed of adults over age 65 is currently 12%, but is projected to grow to 21% by 2050, leading to a larger vulnerable population. ^[1]

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The "urban heat island" refers to the fact that the local temperature in urban areas is a few degrees higher than the surrounding area. Source: USGCRP (2009)

Climate change will likely lead to more frequent, more severe, and longer heat waves in the summer (see 100-degree-days figure), as well as less severe cold spells in the winter. A recent assessment of the science suggests that increases in heat-related deaths due to climate change would outweigh decreases in deaths from cold-snaps. ^[1]

Urban areas are typically warmer than their rural surroundings. Climate change could lead to even warmer temperatures in cities. This would increase the demand for electricity in the summer to run air conditioning, which in turn would increase air pollution and greenhouse gas emissions from power plants. The impacts of future heat waves could be especially severe in large metropolitan areas. For example, in Los Angeles, annual heat-related deaths are projected to increase two- to seven-fold by the end of the 21st century, depending on the future growth of greenhouse gas emissions. ^[1] Heat waves are also often accompanied by periods of stagnant air, leading to increases in air pollution and the associated health effects

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Impacts from Extreme Weather Events

The frequency and intensity of extreme precipitation events is projected to increase in some locations, as is the severity (wind speeds and rain) of tropical storms. ^[1] These extreme weather events could cause injuries and, in some cases, death. As with heat waves, the people most at risk include young children, older adults, people with medical conditions, and the poor. Extreme events can also indirectly threaten human health in a number of ways. For example, extreme events can:

Flooded streets in New Orleans after Hurricane Katrina in 2005. Source: FEMA (2005)

• Reduce the availability of fresh food and water. ^[2]
• Interrupt communication, utility, and health care services. ^[2]
• Contribute to carbon monoxide poisoning from portable electric generators used during and after storms. ^[2]
• Increase stomach and intestinal illness among evacuees. ^[1]
• Contribute to mental health impacts such as depression and post-traumatic stress disorder (PTSD). ^[1]

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Impacts from Reduced Air Quality

Despite significant improvements in U.S. air quality since the 1970s, as of 2008 more than 126 million Americans lived in counties that did not meet national air quality standards. ^[3]

Increases in Ozone

Scientists project that warmer temperatures from climate change will increase the frequency of days with unhealthy levels of ground-level ozone, a harmful air pollutant, and a component in smog. ^{[2] [3]}

Smog in Los Angeles decreases visibility and can be harmful to human health. Source: California Air Resources Board (2011)

Ozone chemistry. Source: NASA (2012)

• Ground-level ozone can damage lung tissue and can reduce lung function and inflame airways. This can increase respiratory symptoms and aggravate asthma or other lung diseases. It is especially harmful to children, older adults, outdoor workers, and those with asthma and other chronic lung diseases. ^[4]
• Ozone exposure also has been associated with increased susceptibility to respiratory infections, medication use, doctor visits, and emergency department visits and hospital admissions for individuals with lung disease. Some studies suggest that ozone may increase the risk of premature mortality, and possibly even the development of asthma. ^{[1] [2] [3] [5]}
• Ground-level ozone is formed when certain air pollutants, such as carbon monoxide, oxides of nitrogen (also called NO_X), and volatile organic compounds, are exposed to each other in sunlight. Ground-level ozone is one of the pollutants in smog. ^{[2] [3]}
• Because warm, stagnant air tends to increase the formation of ozone, climate change is likely to increase levels of ground-level ozone in already-polluted areas of the United States and increase the number of days with poor air quality. ^[1] If emissions of air pollutants remain fixed at today's levels until 2050, warming from climate change alone could increase the number of Red Ozone Alert Days (when the air is unhealthy for everyone) by 68% in the 50 largest eastern U.S. cities. ^[1] (See Box below "EPA Report on Air Quality and Climate Change.")

Changes in Fine Particulate Matter

Particulate matter is the term for a category of extremely small particles and liquid droplets suspended in the atmosphere. Fine particles include particles smaller than 2.5 micrometers (about one ten-thousandth of an inch). These particles may be emitted directly or may be formed in the atmosphere from chemical reactions of gases such as sulfur dioxide, nitrogen dioxide, and volatile organic compounds.

• Inhaling fine particles can lead to a broad range of adverse health effects, including premature mortality, aggravation of cardiovascular and respiratory disease, development of chronic lung disease, exacerbation of asthma, and decreased lung function growth in children. ^[6]
• Sources of fine particle pollution include power plants, gasoline and diesel engines, wood combustion, high-temperature industrial processes such as smelters and steel mills, and forest fires. ^[6]

Due to the variety of sources and components of fine particulate matter, scientists do not yet know whether climate change will increase or decrease particulate matter concentrations across the United States. ^{[7] [8]} A lot of particulate matter is cleaned from the air by rainfall, so increases in precipitation could have a beneficial effect. At the same time, other climate-related changes in stagnant air episodes, wind patterns, emissions from vegetation and the chemistry of atmospheric pollutants will likely affect particulate matter levels. ^[2] Climate change will also affect particulates through changes in wildfires, which are expected to become more frequent and intense in a warmer climate. ^[7]

Changes in Allergens

Climate change may affect allergies and respiratory health. ^[4] The spring pollen season is already occurring earlier in the United States due to climate change. The length of the season may also have increased. In addition, climate change may facilitate the spread of ragweed, an invasive plant with very allergenic pollen. Tests on ragweed show that increasing carbon dioxide concentrations and temperatures would increase the amount and timing of ragweed pollen production. ^{[1] [2] [9]}

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Impacts from Climate-Sensitive Diseases

Changes in climate may enhance the spread of some diseases. ^[1] Disease-causing agents, called pathogens, can be transmitted through food, water, and animals such as deer, birds, mice, and insects. Climate change could affect all of these transmitters.

Food-borne Diseases

• Higher air temperatures can increase cases of salmonella and other bacteria-related food poisoning because bacteria grow more rapidly in warm environments. These diseases can cause gastrointestinal distress and, in severe cases, death. ^[1]
• Flooding and heavy rainfall can cause overflows from sewage treatment plants into fresh water sources. Overflows could contaminate certain food crops with pathogen-containing feces. ^[1]

Water-borne Diseases

• Heavy rainfall or flooding can increase water-borne parasites such as Cryptosporidium and Giardia that are sometimes found in drinking water. ^[1] These parasites can cause gastrointestinal distress and in severe cases, death.
• Heavy rainfall events cause stormwater runoff that may contaminate water bodies used for recreation (such as lakes and beaches) with other bacteria. ^[9] The most common illness contracted from contamination at beaches is gastroenteritis, an inflammation of the stomach and the intestines that can cause symptoms such as vomiting, headaches, and fever. Other minor illnesses include ear, eye, nose, and throat infections. ^[2]

Animal-borne Diseases

Mosquitoes favor warm, wet climates and can spread diseases such as West Nile virus.

• The geographic range of ticks that carry Lyme disease is limited by temperature. As air temperatures rise, the range of these ticks is likely to continue to expand northward. ^[9] Typical symptoms of Lyme disease include fever, headache, fatigue, and a characteristic skin rash.
• In 2002, a new strain of West Nile virus, which can cause serious, life-altering disease, emerged in the United States. Higher temperatures are favorable to the survival of this new strain. ^[1]

The spread of climate-sensitive diseases will depend on both climate and non-climate factors. The United States has public health infrastructure and programs to monitor, manage, and prevent the spread of many diseases. The risks for climate-sensitive diseases can be much higher in poorer countries that have less capacity to prevent and treat illness. ^[9] For more information, please visit the International Impacts & Adaptation page.

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Other Heath Linkages

Other linkages exist between climate change and human health. For example, changes in temperature and precipitation, as well as droughts and floods, will likely affect agricultural yields and production. In some regions of the world, these impacts may compromise food security and threaten human health through malnutrition, the spread of infectious diseases, and food poisoning. The worst of these effects are projected to occur in developing countries, among vulnerable populations. ^[9] Declines in human health in other countries might affect the United States through trade, migration and immigration and have implications for national security. ^{[1] [2]}

Although the impacts of climate change have the potential to affect human health in the United States and around the world, there is a lot we can do to prepare for and adapt to these changes. Learn about how we can adapt to climate impacts on health.

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References

1. USGCRP (2009). Global Climate Change Impacts in the United States . Karl, T.R., J.M. Melillo, and T.C. Peterson (eds.). United States Global Change Research Program. Cambridge University Press, New York, NY, USA.

2. CCSP (2008). Analyses of the effects of global change on human health and welfare and human systems . A Report by the U.S. Climate Change Science Program and the Subcommittee on Global Change Research. Gamble, J.L. (ed.), K.L. Ebi, F.G. Sussman, T.J. Wilbanks, (Authors). U.S. Environmental Protection Agency, Washington, DC, USA.

3. EPA (2010). Our Nation's Air: Status and Trends Through 2008 (PDF). U.S. Environmental Protection Agency. EPA -454/R -09-002.

4. NRC (2010). Adapting to the Impacts of Climate Change . National Research Council. The National Academies Press, Washington, DC, USA.

5. EPA (2006). Air Quality Criteria for Ozone and Related Photochemical Oxidants (2006 Final) . U.S. Environmental Protection Agency, Washington, DC, USA.

6. EPA (2009). Integrated Science Assessment for Particulate Matter: Final Report . U.S. Environmental Protection Agency, Washington, DC, USA.

7. NRC (2010). Advancing the Science of Climate Change . National Research Council. The National Academies Press, Washington, DC, USA.

8. EPA (2009). Assessment of the Impacts of Global Change on Regional U.S. Air Quality: A Synthesis of Climate Change Impacts on Ground-Level Ozone (An Interim Report of the U.S. EPA Global Change Research Program) . U.S. Environmental Protection Agency, Washington, DC, USA.

9. Confalonieri, U., B. Menne, R. Akhtar, K.L. Ebi, M. Hauengue, R.S. Kovats, B. Revich and A. Woodward (2007). Human health. In: Climate Change 2007: Impacts, Adaptation and Vulnerability . Contribution of Working Group II to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change Parry, M.L., O.F. Canziani, J.P. Palutikof, P.J. van der Linden and C.E. Hanson, (eds.), Cambridge University Press, Cambridge, United Kingdom.

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Adaptation Examples in Health

Climate change poses a threat to public health. Extreme weather events, heat waves, expanded habitats for disease transmitters, and climate-induced air and water quality degradation can impact human health, particularly in sensitive groups. For more information about the climate change impacts on health, please visit the Health Impacts section.

State and local officials across the country are collaborating with federal agencies, including the Centers for Disease Control and Prevention (CDC) and the Federal Emergency Management Agency (FEMA), to support development of healthy cities that are prepared for climate change. Many ongoing adaptation efforts relate to preparing for heat waves. Specific health adaptation approaches include:

• Monitoring emerging health risks
• Planning urban adaptation strategies, such as planting trees to minimize heat buildup in cities and manage storm water, or promoting the use of cool roofs to reduce energy needs and improve air quality
• Preparing emergency response plans, which include providing cooling centers for extreme heat events
• Improving public communication during specific health risks such as extreme heat events or low air quality days

The following case studies, examples, and related links are illustrative and not intended to be comprehensive.

EPA Excessive Heat Events Guidebook helps officials prepare

In 2006, EPA developed the Excessive Heat Events Guidebook (PDF) to help cities take steps to protect sensitive populations during heat waves. The guidebook provides background information and actionable recommendations for public health and safety officials.

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Cities combat heat waves

Residents stay out of the heat at a cooling center in Wisconsin. Source: Ready Wisconsin

As the climate warms, the frequency and severity of heat waves will likely increase. Public health officials and service providers in many cities are taking a variety of steps to reduce heat-related illnesses and deaths during heat waves. For example:

• Philadelphia encourages residents to stay hydrated, seek air conditioning, and stay indoors on hot days to avoid exposure to poor air quality. ^[1] The city designated many public buildings, such as libraries, senior centers, and shopping malls, as cooling centers.
• Chicago encourages residents to check on friends, family, and neighbors who are particularly sensitive to extreme heat.

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Public health officials prepare for new challenges

With the assistance of CDC's Climate-Ready States & Cities Initiative, cities and states are improving their ability to anticipate, prepare for, and respond to the expansion of the ranges of disease-carrying pests. Among ongoing activities, the Minnesota Department of Health (PDF) is identifying populations that may be particularly sensitive to diseases not previously present in the state and is enhancing monitoring efforts in order to track these diseases. ^[2]  Michigan is developing communications plans such as its Michigan Climate and Health Adaptation Plan (PDF) , aimed at better informing the public about the health impacts of climate change, including emerging diseases and extreme weather. ^[3]

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Cool roofs reduce energy demand and cool cities

NYC °CoolRoofs installs reflective coverings that reduce the local temperatures and energy requirements for New York City buildings. Source: NYC °CoolRoofs

People living in cities are particularly susceptible to heat waves because urban infrastructure absorbs heat, making it warmer than surrounding areas. Additionally, during extreme heat events, demand for air conditioning and energy increases. This increased use of energy further reduces air quality and may lead to power outages. To combat these effects, cities and federal agencies install cool roofs, which decrease local temperatures and reduce energy demands.

• New York City's NYC °CoolRoofs program uses building design to keep the city cooler and reduce demand for air conditioning. Since 2008, New York City Building Codes have required at least 75 percent of the roof surface of new buildings to be white-coated, or "highly reflective."
• The U.S. Department of Energy is installing cool-roof technologies on new and retrofitted roofs.

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References

1. City of Philadelphia Public Health. Accessed 03/26/2012.

2. Minnesota Department of Health (2010). Draft Minnesota Department of Health Strategic Plan to Adapt to Climate Change (PDF).

3. Michigan Department of Community Health (2011). Michigan Climate and Health Adaptation Plan: 2010-2015 Strategic Plan .

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