Climate Change and Global Health

Storm Surge Flooding, Westport, Washington, November 2009

Climate Change and Global Health

Climate change poses a number of risks to global health.  These risks draw our attention to the fact that health issues operate on a scale that transcends our own individual concerns, extending well beyond local communities, state and national boundaries.  

I attended a lecture in February, 2011, by Dr Howard Frumkin, Dean of the University of Washington School of Public Health on the health risks of climate change.  It was an interesting talk, covering many areas where climate change impacts global health. These impacts may be associated with the increased frequency of extreme weather events. 

Extreme weather events discussed included increased heat, cold, melting, freezing, flooding and droughts.  Increased atmospheric instability may give rise to more frequent hurricanes and tornadoes. Extreme weather events can be viewed on various time scales, from 50 to 100 year storms, to events on a more geological time scale.

Heat stress is of particular concern to the elderly, the young and the immune-compromised. Extreme heat, especially in non or inadequately air-conditioned spaces may result in premature mortality during heat waves, in the vulnerable, especially in the city where paved areas draw heat.  Dr Frumkin was concerned about the "harvesting" effect of heat waves on elderly, urban, populations.

Cold, snow, ice and freezing also may become survivability issues, involving issues of heating and interruption of water and electrical service.  Storms may impact travel and thus food supply, transportation of vital supplies to population centers and medical facilities.  

Public health challenges may emerge with air or water quality issues, impacting respiratory, cardiovascular, and other associated systems.  Infectious diseases may spread via the air or water through vectors  such as tic or mosquitoes, or via zoonotic means through human to animal or animal to human spread).  Allergies may develop in response to climate changes, and new pathogens may emerge or spread to different areas.

Air pollution is a problem which affects more than just urban areas.  With experience working in the regulatory air quality sector, I realize the widespread impacts that pollutants such as ozone and other pollutants have.  Photochemical reactions involving products of combustion (e.g. auto exhaust) take place in the atmosphere resulting in ozone levels downwind of major urban areas. As the reactions involve sunlight and heat, the levels on sunny and hot days increase in the summer. In the fall and spring periods of extended air stagnation resulting from stalled high pressure weather systems may increase the respiratory and cardiovascular burden on the vulnerable patient group. Air pollution does not know boundaries, thus residential and industrial pollution from other countries may impact us, as ours impacts theirs.  Forest fires add to the impact.  Extreme weather may impact all these issues.

The impact of climate change, extreme weather events and public health challenges may impact food production, may result in civil conflict, dislocation of impacted people and may increase the expression of mental health issues .

The discussion of climate science drives the discussion on public health impacts as projections are made regarding the manner in which changes will take place in Earth's climate systems.  Modeling climate systems drives downstream weather and public health challenges. These challenges are studied in a variety of settings, including federal government institutions such as NOAA, NASA and the CDC, and at a variety of state and local governmental and, at private institutions.  The Intergovernmental Panel of Climate Change and the National Climate Assessment have comprehensive plans reflecting policy in this area.

Extreme weather events can result in significant mortality and morbidity, as well as impacts to property.  Tornadoes and Hurricanes and wind storms may result in death and injuries from flying objects, falling trees and power lines as well as medical emergencies secondary to the event.  Fires may result from damaged gas lines. 

Increased flooding and storm surge may result in drownings and damage to property. Flooding may increased the spread of infectious diseases, problems with sewage systems and interruptions in drinking supplies

Drought may bring about reductions in food supply.  This is a serious issue as crops may be challenged to grow in areas where they were previously able to.  Vegetation, vectors and pathogens may spread into other areas as a result of warming.  This impacts the latitude at which such impacts occur as well as the altitude above sea level, moving to cooler latitudes and elevations.

More weeds may develop in urban areas in response to climate change and global warming as vegetation adjusts to the changing environment.

Extreme weather events thus may have public health impacts relating to many systems, resulting in dislocation of people and mental health issues as citizens adjust to the events.

The challenge is how to address climate change issues in the context of these public health issues.

Trinity Nuclear Test

Bosque del Apache National Wildlife Refuge

near San Antonio, New Mexico

On July 16, 1945, the first atomic bomb test was performed at a site about 35 southeast of Soccorro, New Mexico.  The test was code named 'Trinity' by Dr Robert Oppenheimer, director of the Los Alamos Laboratory involved in the Manhattan Project.  It used a 20 kiloton Plutonium implosion device, of a similar design to what would ultimately be dropped over Nagasaki on August 9, 1945, less than a month later.  The Manhattan Project was a war-time effort to develop an atomic bomb, which occurred over a time period from 1942 to 1946.  The effort extended to a number of facilities, including Hanford, Washington and Oak Ridge, Tennessee in addition to the Los Alamos, New Mexico  site where major design work occurred.  Ultimately testing would be done in a number of areas, including Nevada and the Pacific Islands, including Bikini Atoll, after World War II.

The Trinity test differed in nature from that used on the first atomic blast at Hiroshima.  The Hiroshima blast used a gun type, or projectile type detonation of uranium while the Nagasaki and Trinity Blast involved implosion of a plutonium core.

The Trinity atomic bomb test followed a period of development of nuclear expertise in a number of areas, from study of the atom itself, to study of high energy collisions and the study of nuclear chain reactions. A key development was a letter by physicists Eugene Szilard  and Albert Einstein,   expressing their concern that Germany could develop an atomic bomb.  The result of their efforts, which included collaborations with other physicists such as Eugene Wigner and Edward Teller , was that President Franklin Delano Roosevelt accelerated scientific research with a new committee on June 28, 1941 and approved the atomic program on October 9, 1941.  The response to their letter came on October 19, 1941.

This timeline is interesting, taken in the context of the historical evolution, from World War I, in 1914-1918 to World War II and its aftermath in the nuclear arms race.  The historical context included the 1918 Flu Pandemic (Spanish Flu), aided by a World War I fought in the trenches, the Great Depression,  and the ever continuing battle between commercialization, globalization and nationalist interests.  The development of nuclear weapons ratcheted up the stakes, due to the wider implications of their use and the attendant risks.

Nuclear risks include the potential manufacture, storage, transportation, testing and potential use of nuclear weapons in conflict (including WWII).  These risks are in addition to risks arising from nuclear usages in other areas, such as power generation and medical usages.  We have seen impacts from the Three Mile Island, Chernobyl and Fukushima nuclear power plant incidents.  I've discussed some of these issues in other blog articles, including: Nuclear Balance of Risks, Chernobyl 25th Anniversary and Energy Choices and Risk.

Development, testing and use of nuclear weapons has left a long lasting radiological footprint on the landscape in areas such as Hanford and the Pacific Northwest, the Trinity Site and White Sands and the Southwest, the Pacific Islands, including Japan during WWII, and downwind (and water) areas.

The above photograph is taken at Bosque Del Apache National Wildlife Refuge, near San Antonio, New Mexico in February, 2009, about 20 -30 miles from the Trinity Test Site, some 63-64 years after the test.  Another image, taken at Valley of the Fires State Park, New Mexico, was taken near Carrizozo, New Mexico, one of the areas harder hit by the Trinity plume.

Externalities

Externalities


Refinery Exhaust Stacks, Anacortes, Washington (image on Photoshelter)

Air pollution from a fixed stack is a good example that can be used to explain the concept of an externality. I discussed the externalities previously in a blog article (Risk and Externalities) in the context of the BP oil spill and its widespread impact in the Gulf of Mexico.

On the production side, externalities come into play when the full cost of production is not reflected in the cost of the good.

Air pollution emissions may contain various pollutants, gaseous and particulate matter. The area impacted and the degree of impact will be affected by the pollutants released and the meteorological conditions.

For example, a temperature inversion will keep cold air close to the surface under a layer of warm air so that the air does not mix well vertically. The pollutants will be kept closer to the surface and their impact will be greater.

Sulfur dioxide emissions may impact lakes and fish (as acid rain), and thus ecosystems. Sulfur dioxide is a harmful pollutant for humans as well as fish. Sulfur dioxide can adhere to airborne suspended particulate matter. If the particulate matter is small, this may ease entry into the lung where the sulfur dioxide can do greater harm.

Air pollution is a direct result of the manufacturing process that extends from the stack into the community and beyond. It’s impact results in costs to others. Thus there are costs associated with air pollution that are not included in the production costs. To the extent that this is true, the product produced is under priced, and the public, an external entity, is paying those additional costs.

Costs include medical costs, as well as reduced life expectancy due to the pollution. Air pollution, in addition to being unhealthy, reduces visibility, may add odor, and adds quality of life issues. Pollution impacts maintenance of buildings and other structures.

Determing costs attributable to air pollution is a complex problem. There have been studies done to ascertain such costs. For example, a RAND study looked at health costs in California attributable to air pollution above state standards. That study would reflect air pollution due to a variety of causes, not just the point sources discussed in this blog article. California has a great deal of automobile pollution which contributes to carbon monoxide and ozone pollution problems.

Monitoring and regulation of air pollutants requires resources as well. Air pollution regulation and monitoring exists at the federal, state and local levels.

To reiterate, the producer’s price does not reflect these costs. Thus the price of the good is under priced with respect to other options because it does not include the cost of these “external” costs which others must bear.

When full external costs are brought into the mix, the producer’s price must necessarily increase. As it increases, other competing options may become more attractive and the producer may lose business. Alternatively, the producer may choose to upgrade the method of production to reduce the pollution, a cost they may not be willing to take if full external costs were included.

Air pollution is one example of an externality.

The situation becomes more complicated where the risk matrix considers low probability, high risk events. Such events may be difficult to estimate and to price for. Even assuming these low probability, high risk events could be reasonably priced for, it may be impossible for the producer to compete with prices reflecting such a risk margin. Competitors in the same field may refuse to include such a risk margin, thus driving the producer out of business. Competitors in other fields without such a risk margin will be at an advantage.

Where the risk margin for the low probability, high impact event is not priced for and is not included in the pricing there is the potential for considerable externality impacts should the low probability high impact risk event materialize.

As previous nuclear disasters have shown, the low probability, high risk event presents considerable externality issues in the nuclear arena, considering the serious impacts of radiation. (See my blog articles, Chernobyl 25th Anniversary and Energy Choices and Risk).