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Tuesday, October 9, 2018

Global warming: the ultimate health issue?

"THIS REPORT responds to the invitation for IPCC ‘... to provide a Special Report in 2018 on the impacts of global warming of 1.5°C above pre-industrial levels and related global greenhouse gas emission pathways’ contained in the Decision of the 21st Conference of Parties of the United Nations Framework Convention on Climate Change to adopt the Paris Agreement.

The IPCC accepted the invitation in April 2016, deciding to prepare this Special Report on the impacts of global warming of 1.5°C above pre-industrial levels and related global greenhouse gas emission pathways, in the context of strengthening the global response to the threat of climate change, sustainable development, and efforts to eradicate poverty.

This Summary for Policy Makers (SPM) presents the key findings of the Special Report, based on the assessment of the available scientific, technical and socio-economic literature relevant to global warming of 1.5°C and for the comparison between global warming of 1.5°C and 2°C above pre- industrial levels. The level of confidence associated with each key finding is reported using the IPCC calibrated language. The underlying scientific basis of each key finding is indicated by references provided to chapter elements…"
President Trump (who admits, unsurprisingly, to not having read the IPCC report) has repeatedly dismissed global warming as "a hoax, a money-making industry."

"Trump suggests the climate may actually be 'fabulous' after an ominous UN report on looming disaster"

Right. Google "IPCC global warming report findings" to see extensive reporting and analysis of the 2018 IPCC findings. I am particularly interested in the IPCC findings regarding likely human health impacts (and the impacts on all life more broadly). 

Stay tuned. According to the IPCC, time for averting large-scale prolonged calamities is getting very short. According to our President, we need to burn more coal.

As I post the first cut of this, we're less than a day away from the Florida panhandle landfall the rapidly strengthening of Hurricane Michael. Recall my prior post on Hurricane Florence. "Anthropocene Era," anyone?

Below, a sculpture/statue in Berlin entitled "Politicians discussing Global Warming."


Not much on "health" in the Report, with one exception (Chapter 3):
3.4.7 Human health
Climate change adversely affects human health by increasing exposure and vulnerability to climate-related stresses, and decreasing the capacity of health systems to manage changes in the magnitude and pattern of climate-sensitive health outcomes (Cramer et al., 2014; Hales et al., 2014). Changing weather patterns are associated with shifts in the geographic range, seasonality, and intensity of transmission of selected climate- sensitive infectious diseases (e.g., Semenza and Menne, 2009), and increasing morbidity and mortality are associated with extreme weather and climate events (e.g., K.R. Smith et al., 2014). Health detection and attribution studies conducted since the AR5 provided evidence using multi-step attribution that climate change is negatively affecting adverse health outcomes associated with heatwaves; Lyme disease in Canada; and Vibrio emergence in northern Europe (Mitchell, 2016; Mitchell et al., 2016; Ebi et al., 2017). The IPCC AR5 concluded there is high to very high confidence that climate change will lead to greater risks of injuries, disease and death due to more intense heatwaves and fires; increased risks of undernutrition; and consequences of reduced labor productivity in vulnerable populations (K.R. Smith et al., 2014)…
This paragraph is followed by several pages of topical "detail." That's about it. There's one brief allusion to "Population Health," but lacking any ensuing illustrative particulars (see my prior post).

Notwithstanding that accelerated and serious health adversities will surely result from the various other characteristics of global warming -- e.g., air and water pollution, heat waves, persistent droughts, increased poverty, food shortages, climate-induced migration, political instabilities, etc. -- I was hoping for a more substantive discussion of health impacts per se.


CNN just published an article addressing the foregoing:
How climate change will affect your health
By Arman Azad, CNN

A new report from the UN Intergovernmental Panel on Climate Change warns of dire consequences if governments don't make "rapid, far-reaching, and unprecedented changes in all aspects of society" to stem global warming. But the planet isn't the only thing at risk as temperatures rise; your health might be in danger, too…

An increase in disease-carrying mosquitoes and ticks 

Hot and humid climates provide a perfect breeding ground for critters, and experts say that a warming world might put us at greater risk for vector-borne diseases, which are those transmitted by ticks, mosquitoes or other organisms…

Contaminated water sources and dangerous bacterial infections
Extreme weather and rainfall have contributed to the spread of bacterial infections through contaminated water, especially in summer. Warmer temperatures will only make those storms worse…

An increase in mental health issues
Even a modest rise in temperatures is associated with an increase in mental health issues, according to a study published this year that surveyed nearly 2 million US residents. The research, in the journal PNAS, looked at individual cities and found that warming of just 1 degree over five years was linked to a 2% increase in mental health issues…

An increase in Type 2 diabetes
Rising temperatures are associated with an increase in Type 2 diabetes, according to a 2017 study published in the journal BMJ Open Diabetes Research & Care. However, researchers looked only at the correlation between temperatures and diabetes, so the study didn't establish that temperatures necessarily caused the disease…

Respiratory problems and stroke

Most scientists agree that greenhouse gases like carbon dioxide are contributing to global warming, but those emissions aren't just hurting the planet. Fossil fuel pollutants can also generate a mixture of solid particles and liquid droplets in the atmosphere that can enter your lungs and even your bloodstream…

More car crashes and fewer food inspections
Even small changes in climate can impact human behavior, leading to an increase in fatal car accidents and a decrease in food safety inspections, according to a study published this year in PNAS…

…the MIT Media Lab research scientist who co-authored the study, noted that "hot temperatures are basically bad for human functioning." The crux of the idea, he said, was that "weather affects how we perform our duties and how we go about our daily lives and the risks that we experience."
Read all of it.
One thing that will be centrally important will be the applied "Data Science" elements of large scale public health "big data" disparate-source collation and analytics. Moreover, at the primary care outpatient clinic level, we will have to finally get beyond all of the endless "interoperability" happy talk and derive appropriate and effective means of EHR data sharing for epidemiological "early warning" sentinel purposes.

Per the IPCC report, I found this interesting (Chapter 5):
Well-being for all (Dearing et al., 2014; Raworth, 2017) is at the core of an ecologically safe and socially just space for humanity, including health and housing to peace and justice, social equity, gender equality, and political voices (Raworth, 2017). It is in alignment with transformative social development (UNRISD, 2016) and the 2030 Agenda of ‘leaving no one behind’. The social conditions to enable well-being for all are to reduce entrenched inequalities within and between countries (Klinsky and Winkler, 2018), rethink prevailing values, ethics and behaviours (Holden et al., 2017), allow people to live a life in dignity while avoiding actions that undermine capabilities (Klinsky and Golub, 2016), transform economies (Popescu and Ciurlau, 2016; Tàbara et al., 2018), overcome uneven consumption and production patterns (Dearing et al., 2014; Häyhä et al., 2016; Raworth, 2017) and conceptualise development as well-being rather than mere economic growth (Gupta and Pouw, 2017) (medium evidence, high agreement). 
Trump and his kleptocrats will simply scoff. I am reminded of Peter Frase's "Quadrant IV" -
Hierarchy and Scarcity: Exterminism
But if we do not arrive as equals, and environmental limits continue to press against us, we come to the fourth and most disturbing of our possible futures. In a way, it resembles the communism that we began with — but it is a communism for the few.

A paradoxical truth about that global elite we have learned to call the “one percent” is that, while they are defined by their control of a huge swathe of the world’s monetary wealth, they are at the same time the fragment of humanity whose daily lives are least dominated by money. As Charles Stross has written, the very richest inhabit an existence in which most worldly goods are, in effect, free. That is, their wealth is so great relative to the cost of food, housing, travel, and other amenities that they rarely have to consider the cost of anything. Whatever they want, they can have…

…In Tropic of Chaos, Christian Parenti makes the case that we are already constructing this new [exterminism] order, as climate change brings about what he calls the “catastrophic convergence” of ecological disruption, economic inequality, and state failure. The legacy of colonialism and neoliberalism is that the rich countries, along with the elites of the poorer ones, have facilitated a disintegration into anarchic violence, as various tribal and political factions fight over the diminishing bounty of damaged ecosystems. Faced with this bleak reality, many of the rich — which, in global terms, includes many workers in the rich countries as well — have resigned themselves to barricading themselves into their fortresses, to be protected by unmanned drones and private military contractors. Guard labor, which we encountered in the rentist society, reappears in an even more malevolent form, as a lucky few are employed as enforcers and protectors for the rich…
 The online article is fine. The book is better. Much more in-depth.

"As things stand now, even if every country met the commitment it made in the Paris Agreement, the temperature would still increase to three degrees Celsius above pre-industrial levels by the end of the century. If the world continues burning fossil fuels and emitting greenhouse gases at the current rate, it could rise by four degrees—a fact that the Trump Administration, which withdrew the United States from the Paris Agreement, in June, 2017, acknowledged with language buried deep in an August draft report issued in support of eliminating Obama-era fuel-economy rules. Representatives from the Trump Administration were in Incheon and had to approve the conclusions of the report. Whether President Trump will respond to its findings remains to be seen…" [From The New Yorker]
In my email inbox
"...if a smoke alarm rings in the kitchen and everyone’s watching “Fox & Friends” in the den, does it make a sound? Asked about the report last week, Donald Trump said, “I want to look at who drew it—you know, which group drew it.” The answer seemed to indicate that the President had never heard of the I.P.C.C., a level of cluelessness that, while hardly a surprise, was nevertheless dismaying. The next day, as a devastating hurricane hit Florida—one made that much more destructive by the warming that’s already occurred—the President flew to Pennsylvania to campaign for Lou Barletta, a climate-change-denying Republican congressman running for the Senate..."
WaPo OpEd
As the climate worsens, wealth inequality will, too
David M. Lodge is Francis J. DiSalvo director of the Atkinson Center for a Sustainable Future at Cornell University.

Disasters often bring out the best in Americans — cooperation, kindness and dogged perseverance supersede political and provincial ideologies. One need only look back to the warm greeting between President Barack Obama, a Democrat, and Republican New Jersey Gov. Chris Christie two days after Superstorm Sandy devastated the Garden State in 2012.

But these disasters also serve to separate Americans, widening the gap between the “haves” and the “have-nots” and increasing wealth disparities. Fortunately, environmental policy changes can help close that gap…

Without changes in federal and state policies, the economic divide will grow even faster as climate-induced flooding ravages our country. A host of federal and state environmental and development policies exacerbates this disparity, including Environmental Protection Agency policies that allow increased greenhouse-gas emissions and state regulations such as those in North Carolina that allow development in locations increasingly prone to flooding.

…Let’s hope political amity in the aftermath of this season’s hurricanes will last long enough for lawmakers to pass meaningful reforms. By allowing current science to inform policy, legislators would also be protecting the most vulnerable in our country and reducing the growth of the wealth gap.
Yeah, but the breadth of focus of the Trumptocracy is on that of the margins separating the "haves and the have-yachts." Again, Frase's "Quadrant IV."

On a brighter note, see the Atkinson Center "FOCUS: ONE HEALTH" page:
"Human health, animal health, and ecosystem health are inextricably linked. One Health or planetary health research emphasizes the connections between these elements to promote, improve, and defend the health and well-being of all species. This research focus often involves collaboration among clinicians, natural scientists, and social scientists working in universities, health institutions, and environmental organizations. Cornell boasts a top-ranked vet college, medical school, and environmental sciences across several colleges. Project teams have demonstrated success in working together in innovative combinations to tackle the complex, interlinked issues of species health, sustainable populations, and ecosystem functioning..."


I cited him once before (his book The Madhouse Effect) in my post "Update on the March for Science."
"By 2030, it is estimated, climate change will cause as many as 700,000 additional deaths a year worldwide.14 By comparison, each year 443,000 people currently die prematurely from smoking or exposure to secondhand smoke. One could well argue, from this standpoint, that the industry-funded campaign to deny the effects of human-caused climate change has and will cost even more lives and constitutes an even greater crime against humanity than the tobacco industry’s campaign to deny the health effects of tobacco.

Malnutrition kills more than 7 million people a year, many of them children. More than 2 million people a year die from complications arising from lack of access to clean drinking water, such as diarrhea and waterborne diseases. The vast majority, again, are children. The adverse impacts of climate change on food and water will magnify the fatalities. The developing world, with its weak health-care infrastructure, will be least able to cope.

A warmer Earth means more extreme, dangerous heat and more fatalities from heat stroke and heat exhaustion. In the United States, there has been a doubling of record daily high temperatures in the past half-century, and this increase has taken a toll. As many as 10,000 people perished in the Chicago heat wave of 1988, which affected a very large portion of those most vulnerable: the elderly and infants. Fortunately, with increasingly widespread air-conditioning in homes, buildings, and vehicles, we in the United States are insulated from the full impacts of heat extremes, and fatalities from complications related to intense heat are limited to fewer than 1,000 a year. (But, of course, the down side of air-conditioning is that it requires large amounts of electricity, which in turn require the burning of more fossil fuels.)

Other countries that have less of this infrastructure aren’t as fortunate. The record heat wave in Europe in 2003 took a toll of 70,000 human lives, and the record heat in Russia in 2010 took another 56,000. The heat wave in India and Pakistan in 2015 claimed several thousand more. The elderly, the very young, outdoor workers, and those who lack access to shelter are most vulnerable…

Climate change brings not only death but pestilence, too. We can expect to see infectious diseases such as Dengue fever and malaria spread into the extratropics as the globe continues to warm. West Nile virus was first detected in New York City following the record warm year of 1998, and dangerous Hantavirus appears to be spreading north in the western United States.

Then there’s the issue of air quality, allergies, and asthma. Higher atmospheric CO2 favors weeds such as ragweed, whose pollen triggers allergies and worsens asthma. Rising temperatures increase ground-level ozone smog, which also worsens asthma. The number of pollen allergy and asthma sufferers appears to be increasing in recent decades as the globe continues to warm..."
Mann, Michael E. The Madhouse Effect: How Climate Change Denial Is Threatening Our Planet, Destroying Our Politics, and Driving Us Crazy (pp. 40-42). Columbia University Press. Kindle Edition.

From NBC News:
…The international panel charged with reining in climate change said this week that the world needs to take "unprecedented" steps to remake its energy, transportation and agriculture systems to avoid the worst effects of global warming.

What the Intergovernmental Panel on Climate Change did not discuss was an even more radical potential response — one that would re-engineer Earth’s stratosphere to create a massive heat shield by effectively duplicating the fallout that follows a volcanic eruption.

This kind of revolutionary “solar geoengineering” — known by some as the “Pinatubo Strategy,” after a volcano whose 1991 eruption shrouded the planet in a sulfurous cloud — was once relegated to a far corner of academia. But a number of scientists and environmental advocates said this week that the IPCC report — punctuated by Hurricane Michael, which hit the Florida panhandle and may have been intensified by global warming — argues for speeding up the study of the once unthinkable…
Planet-wide "geo-engineering?" Good luck getting world-wide international political agreement on that.

GOP senators from hurricane-ravaged states mock UN’s climate change warning
Trump says climate change may be 'fabulous'. Dire UN report says otherwise.
Mexico Beach FL after Hurricane Michael

Good material here via this organization:

Climate Change Is Harming Our Health

Yet another resource.

Website link.

BTW, I've touched on the climate change stuff before:
The ultimate population health "Upstream" issue? (2014)
 Upstream, downstream; what happens to health when there IS no more stream? (2015)
As I Google around searching out activity and further resources, it's becoming clear that there will have to be a follow-on post.

And, the hits just keep on comin'...

Climate-driven declines in arthropod abundance restructure a rainforest food web
Bradford C. Lister and Andres Garcia

Arthropods, invertebrates including insects that have external skeletons, are declining at an alarming rate. While the tropics harbor the majority of arthropod species, little is known about trends in their abundance. We compared arthropod biomass in Puerto Rico’s Luquillo rainforest with data taken during the 1970s and found that biomass had fallen 10 to 60 times. Our analyses revealed synchronous declines in the lizards, frogs, and birds that eat arthropods. Over the past 30 years, forest temperatures have risen 2.0 °C, and our study indicates that climate warming is the driving force behind the collapse of the forest’s food web. If supported by further research, the impact of climate change on tropical ecosystems may be much greater than currently anticipated…
 Hat tip to the Naked Capitalism blog for the heads-up. "6th Extinction," anyone? (Scroll down in linked post.)


This book is scheduled for an October 30th release. I read a review in my latest Science Magazine.

"America's leading nutritionist exposes how the food industry corrupts scientific research for profit."
I'd like to see the folks at Science Based Medicine review this one.
_____________ AnthropoceneDenial

More to come...

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