HEALTHY PEOPLE = HEALTHY PLANETThe Public Health Benefits of Climate Solutions


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HEALTHY PEOPLE = HEALTHY PLANET The Public Health Benefits of Climate Solutions


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Impacts on N. America WILDFIRES INCREASED HEAT HEAVY RAIN, STORMS, FLOODS


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IPCC: Only one safe course of action


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Sam Moody Atlanta, GA


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We Over Me Farm Houston, TX


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Steve Groff Holtwood, PA


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CARMAGEDDON! Ultrafine Particulates down 83 % PM2.5 down 36 percent ER Visits UCLA down 23% ER Visits Mt Sinai down 13% 911 calls decreased 12% Los Angeles, CA 405 Freeway


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Jeffery Thompson MD Gundersen Lutheran Health System LaCrosse, WI


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$1 MILLION ANNUAL SAVINGS from improved EFFICIENCY


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Powered by 100% Clean Energy


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TOP 5 CAUSES OF DEATH IN US Heart Disease (diabetes) Cancer Chronic Lung Disease Stroke Unintentional Injury (mva)


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TOP 10 CAUSES OF THE CAUSES of death in developed countries 1) tobacco 2) high blood pressure 3) overweight and obesity 4) physical inactivity 5) high blood glucose 6) high cholesterol 7) low fruit and vegetable intake 8) urban outdoor air pollution 9) alcohol 10) occupational WHO 2009


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CAUSES OF THE CAUSES OF THE CAUSES Air pollution Car centric built environment Industrial agriculture and food system


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AIR POLLUTION AIR POLLUTION


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EPA Ozone Nonattainment Areas


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September in Central Texas: 1 out of 6 days with unhealthy air


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AIR POLLUTION AND CHILDHOOD ASTHMA Playing multiple outdoor sports in areas with poor air quality triples the risk of developing childhood asthma (McConnell, 2002) Childhood asthma incidence increased 16% per 10ug/m3 of fine particulate exposure, and 7% per 10ug/m3 of Nox. (Anderson, 2013) A 5-ppb increase in average NO2 during the first year of life was associated with an odds ratio of 1.17 for physician-diagnosed asthma. (Nishimura, 2013)


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AIR POLLUTION AND CVD CHRONIC EXPOSURE Rate of carotid intimal thickening is doubled in people who live within 100 m of busy roadway (Kinsli, 2010) ACUTE EXPOSURE Each 10ug/m3 PM2.5 4.5% increase in acute cardiac events 8-18% increase in CVD mortality (Pope, 2004, 2006, 2008)


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AIR POLLUTION AND DIABETES 10ug/m3 PM2.5 = 1% increase in prevalence DM2 (Pearson, 2010) Exposure to traffic and PM increased risk of new onset DM2 15-42% (Kramer, 2010) Highest quartile maternal exposure to NOx increased gestational DM 70% (Malmqvist, 2013) 2SD increase in childhood exposure NO2/ PM2.5 = 18% increase in insulin resistance. (Thiering, 2013)


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Prenatal PAH Exposure and Childhood Obesity Rrundle et al Am J Epidemiol. Jun 1, 2012; 175(11)- 1163–1172..


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AIR POLLUTION AND CHILD OBESITY Prenatal exposure to higher levels of PAH doubled risk of obesity at age 7 (Rundle, 2012) Residential proximity to traffic in childhood (controlling for other risk factors) associated with higher BMI at age 18 (Kramer, 2010) Kids in 90th percentile for traffic related air pollution have more rapid increase in BMI (Jerrett, 2014)


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AIR POLLUTION CARBON POLLUTION


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Ziska, Australian Journal of Plant Physiology, 2000. 27: 893? 898. CO2 and Noxious Plants RAGWEED POISON IVY


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CO2, MOLD and Asthma For each 10 U increase in home Environmental Relative Moldiness Index (ERMI) in infancy, risk of incident asthma by age 7 increased 80% (Reponen, 2011)


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Nox + VOCs + heat = Ozone


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Ozone Climate Penalty


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Climate-Related Ozone will Increase NY Pediatric ED Asthma Visits 5-10% by 2020 Sheffield PE,   SeAm J Prev Med.p;41(3):251-7


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PREMATURE DEATHS FROM OZONE will triple by 2030


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Valley Fever Endemic Area


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VALLEY FEVER Brown, Clin Epidemiol. 2013; 5(1) 185-197 Tenfold increase in incidence of Cocciciodomycosis Lubbock, TX


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WARMING & WILDFIRE SMOKE


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Wildfire Contribution to Ground Level Ozone Northwest Fire Season 2012 Jaffe et al | Environ. Sci. Technol. 2013, 47, 11065?11072


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A Kenward et al 2013 LOS ANGELES PM 2.5 2003


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DIOXINS, PAH and Wildfires Smoke from Idaho Fires 2013


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Clean energy


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US WIND POWER POTENTIAL


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US SOLAR POWER POTENTIAL


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100% CLEAN BY 2050 thesolutionsproject.org


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Total life cycle emissions Clean vs Fossil Fuel


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Intermittency not a problem up to 80%


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Percent renewable generation achieved with conventional technology


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POLICIES for CLEAN AIR Shift subsidies from fossil fuel to clean energy Strong National Renewable Electricity Standard 50% of electricity by 2030, 100% by 2050 Net metering (utilities pay for surplus power)


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LEVEL THE PLAYING FIELD STOP EXTERNALIZING HEALTH AND CLIMATE COST OF CARBON


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MORE EFFICIENT BUILDINGS


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PROGRESSIVE EFFICIENCY STANDARDS for New and Remodeled Buildings www.architecture2030.org


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COMPETITIVE FUEL ECONOMY


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POLICIES FOR ENERGY EFFICIENCY Stronger fuel economy standards National Energy Building Code National Retrofit Financing


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Decrease in O3 and PM 2.5 with 3 Climate Policy Options Clean Electricity Std Transportation Carbon Tax T Thompson, Nature Climate Change (July 2014)


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20,000 Heart Attacks PREVENTED 23,000-50,000 Deaths each year SAVED: OVER 100 BILLION DOLLARS PER YEAR EPA 2013


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Carbon Abatement Cost Curve


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CLEAN ENERGY=CLEAN AIR =HEALTH SAVINGS T. Thompson, Nature Climate Change 4, 917–923 (2014)


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Value of decreased mortality from air quality improvement exceeds cost of emissions reduction West et al, Nature Climate Change 3: 885-889 2013 HIGH VALUE LOW VALUE ABATEMENT COST / TON CO2


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EPA Carbon Rules Impact on Air Quality: 2020 OZONE FINE PARTICULATES


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Distribution of Lives saved by EPA Carbon Rule in 2020


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CAR CENTRIC BUILT ENVIRONMENT


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Texas Interurban Railway


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From Interurban to Automobile


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NEIGHBORHOODS


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HEART DISEASE,OBESITY, DIABETES; COLON CANCER ONE THIRD PROSTATE CANCER, AND RECURRENT BREAST CANCER ATTRIBUTABLE TO PHYSICAL INACTIVITY


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WALKABILITY, OBESITY, AND DIABETES TEN YEAR PROSPECTIVE STUDY Ontario Least walkable neighborhoods DM +6% Obesity/Overweight +13% Most walkable neighborhoods DM -7% Obesity/Overweight - 9% (Booth, 2014, presented at ADA)


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WALKABILITY DM, OBESITY, AND CVD Sprawl and disconnected street networks are associated with increased rates of obesity, diabetes, and CVD. (Marshall, 2014) Residents of “walkable” metro areas walk more & use more public transit, have lower BMI & BP, less DM, and 3 years longer life expectancy than people living with sprawl. (Ewing, 2014)


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Cost of Transportation Related Health Outcomes in US $300 billion per year


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WALKABILITY SCORES FOR TEXAS MAJOR CITIES Houston 44 San Antonio 34 Dallas 44 Austin 35 Ft Worth 32 El Paso 39


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TRANSIT ORIENTED DEVELOPMENT


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TRANSIT AND OBESITY Users of public transit are 45% less likely to be obese or overweight (Zheng, Y. 2008) Transit commuters walk twice as many minutes/day as car commuters, weigh an average of 6-7 lb less and have lower % body fat. (Flint, 2014) Increased use of public transit would cut the annual increase in obesity prevalence by 45%. (Edwards, 2008)


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TRANSIT DECREASES MVA DEATHS Urban Traffic Fatalities/100,000 by Cities' Transit Use by Smart Growth vs Sprawl


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Austin ranks 39th of 46 major metro areas in jobs available within 30 minute trip by public transit


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Per Capita Health Savings from Rapid Transit and TOD Average Urban Transit High Quality Urban Rail or Rapid Bus Transit Oriented Development


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US Emissions from Transportation


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POLICIES FOR ACTIVE/PUBLIC TRANSIT Smarth growth, Infrastructure Investment, Coordination (Health in All Policies)


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10,000 colon cancers 215,000 heart attacks 32,000 MVA fatalities PREVENTED 570,000 new diabetes cases each year ANNUAL SAVINGS SF BAY AREA Maizlish, N. Am J Public Health. 1.4-22 BILLION DOLLARS PER YEAR 2013 Apr;103(4):703-9.


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Good news: We're already on our way. Vehicle miles per capita decreasing


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INDUSTRIAL FOOD SYSTEM


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From family farm to agribusiness


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Increased consumption of high fructose corn syrup


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FOOD DESERTS


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Inadequate Intake of Fruits/Vegetables


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Increasing dependence on imported produce & associated outbreaks of foodborne infection 2013 – Cilantro from Mexico http://www.foodandwaterwatch.org/food/global-grocer/


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Adult Obesity Trend


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TEXAS TRENDS OBESITY RELATED DISEASES


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High Fructose Corn Syrup and Metabolic Syndrome Meta-analysis: Fructose consumption increases FBG, triglycerides, and systolic BP. (Kelishadi, 2014) Fructose sweetened beverages increase FBG and insulin levels, decrease insulin sensitivity (Stanhope, 2009) Fructose induced insulin resistance in rats is attenuated by lycopene (Yin, 2014)


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Red Meat, DM, Cancer, and CVD NIH-AARP Study: 20-50% increased mortality from cancer and CVD (Sinha, 2009) Womens' Health Study: 28% more incident DM over 8 years (Song, 2004) Nurses' Health Study/ Health Professionals Followup Study: 13% increase in mortality per serving (all cause, cancer, and CVD). (Pan, 2012) Extra daily half serving of meat raised risk of DM 48% for subsequent 4 years (Pan, 2013)


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OBESITY AND ASTHMA Numerous prospective studies in adults found obesity associated with increased risk of incident asthma with BMI “dose response” Weight loss, both surgical and non surgical, associated with resolution of asthma, decrease in asthma symptoms or increased FEV1 (Ford, E The Epidemiology of Obesity and Asthma J Allergy Clin Immunol 2005;115:897-909.)


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International Study of Asthma and Allergies in Childhood JUNK FOOD AND ASTHMA Nagel, Thorax. 2010 Jun;65(6):516-22.


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INDUSTRIAL AGRICULTURE AND GLOBAL WARMING METHANE POLLUTION (70 x warming power of CO2 )


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& MORE GLOBAL WARMING NITROGEN OXIDE from FERTILIZER (300 x warming power of CO2)


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DROUGHT AND WATER QUALITY Public Water Systems on Restriction


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Arsenic in Groundwater Arsenic concentration in wells Public water systems exceeding EPA std


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Arsenic alters gene expression, promotes lung, skin, bladder cancer Cancer risk from adult As in drinking water Altered gene expression in cord blood with maternal As exposure


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MATERNAL ARSENIC EXPOSURE AND DECREASED CHILD SURVIVAL (Rahman, 2013)


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CROP MYCOTOXINS


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Aflatoxin 2014 Fumonisin 2014 Texas State Chemist 2014 Hepatotoxic Nephrotoxic Teratogenic Carcinogenic Hepatotoxic Carcinogenic Immunosuppressive


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NHANES 2000 1% positive Age OR for + 12-39 1.49 40 + 1.00 Ethnicity OR Black 0.92 White 1.00 Mex American 2.71 Aflatoxin Biomarkers Bexar County 2010 20% of adults positive, associated with rice and tortillas


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ANNUAL INCIDENCE HCC 1995–2010 Ramirez AG, Munoz E, Holden AEC, Adeigbe RT, et al. (2014) Incidence of Hepatocellular Carcinoma in Texas Latinos, 1995–2010: An Update. PLoS ONE 9(6): e99365. doi:10.1371/journal.pone.0099365 US Latino Texas Latino South Texas Latino White, non-Hispanic


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Aflatoxin Biomarkers and Risk Factors for Hepatocellular Carcinoma RISK FACTORS OR for HCC Aflatoxin Biomarker Alone 7 Chronic Hepatitis B or C Alone 7-28 NAFLD alone 3-16 Aflatoxin + Chronic Hep B or C 60 Aflatoxin + NAFLD ?? 40% OF OBESE CHILDREN AND 40% OF ALL ADULTS HAVE NAFLD


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HEALTHY FOOD SYSTEM LOCAL DIVERSE SUSTAINABLE HEALTHY FOOD


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Mediterranean Diet


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Mediterranean vs Western diet Less: GHG, H2O, energy, land Saez-Almendros et al. Environmental Health 2013 12:118 doi:10.1186/1476-069X-12-118 MEDITERRANEAN 0 WESTERN


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Organic farming vs Conventional 30% lower GHG, higher profit, equal yields


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Mediterranean Diet & Asthma, Diabetes, and Cancer PROSPECTIVE STUDIES 14% lower risk asthma (Nagel, 2010) 80% lower risk DM (Martinez-Gonzales, 2008) 24% lower risk cancer (Benetou, 2008) 31% lower CVD mortality (Sofi, 2008) 22% lower cancer mortality (Sofi, 2008)


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INTERVENTION STUDIES Mediterranean Diet 60% decrease cardiac events (Ornish, 1998) 70% decrease CVD mortality (DeLogeri, 1994) 35- 48% decrease in metabolic syndrome (Esposito, 2004, Azadhbakt, 2005)


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ADVISE SUBSIDIZE Meat, Dairy 63% Grains 20% Sugar, Oil, Alcohol 15% Nuts, Legumes 2% Fruits, Vegetables 1%


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POLICIES FOR HEALTHY FOOD AND FARMS Subsidize fruits and vegetables Reward good stewardship Crop diversity Natural fertilizer Crop rotation Conservation set asides Donate excess food Harvest energy from waste


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300,000 Heart Attacks/Strokes PREVENTED 260,000 New Diabetes Cases 127,000 CVD Deaths each year 144,000 Cancer Deaths


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WE ARE HERE Temperature increase 1.4 degrees F


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AND HERE: 70% overweight or obese 34% CVD 12% diabetes 37% pre-diabetes 8% asthma 75 cents of every health dollar spent on preventable chronic disease


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Sustainable agriculture Active and public transportation Efficient buildings and vehicles Clean electricity


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BUSINESS AS USUAL 2030 40% Obese 40% CVD 20% Diabetic 10% Asthmatic 2050 50% Obese 50% CVD 30% Diabetic


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WHAT YOU CAN DO Sign up for action alerts climate911.org VOTE CLIMATE climatehawksvote.com Tell your congresspeople: Climate policy is essential to protect public health Speak out in your community


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Climate/Health Communication Workshop October 11: 5305 Turnabout Lane 10am-noon


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HEALTHY PEOPLE = HEALTHY PLANET www.climate911.org


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