Climate Change and Health Seminar Series: "When Data Isn’t Enough: Health, Science, and Climate Advocacy"

March 31, 2022

Information

Dr. Kim Knowlton joined the Center on Climate Change and Health to discuss her work on science and advocacy with the NRDC.

February 28, 2022

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00:00<v ->Everyone I think we can get started.</v>
00:02Today it's a very special day because today
00:06the Intergovernmental Panel on Climate in the House
00:09just released a Working Group II report,
00:12which is focused on climate change.
00:16So today we are very, very pleased
00:17to have Dr. Kim Knowlton joining us.
00:21Dr. Knowlton is a Senior Scientist
00:24at the National Resource Defense Council.
00:27She's also Assistant Professor at the Columbia University's
00:30Mailman School of Public Health,
00:31the department of Environmental Health Science.
00:34And she has been a senior member for
00:36one of the first climate health program in the country.
00:40So Dr. Knowlton specialize in the
00:43Human Health impact of climate change.
00:46She served as the co-convening lead author
00:49for the Human Health chapter
00:50of the US Third National Climate Assessment,
00:55as a member of the second and fourth
00:57New York City Panels on Climate Change.
01:00And participated in the IIPCC's fourth analytics reports.
01:05Her work with the New York's Climate and Health project,
01:08which you will hear about later,
01:10describe some of the very first down skilled
01:14global to regional climate
01:15and health access modeling in the US
01:18which to me is also one my,
01:21the kind which inspires me
01:25to do my PhD thesis on this topic.
01:30So I'm very pleased to welcome Dr. Kim Knowlton.
01:35<v ->Thank you, Kai.</v>
01:36You are so kind and thanks to you and Mauro
01:39for helping with the technology
01:43and just for the invitation
01:44and really everyone in the room
01:46on such an auspicious news day.
01:48As Kai said, it's just huge.
01:51I am really honored that you are taking some time
01:53to be here with me and us talking about
01:57climate change and how it affects people's health,
01:59certainly a topic near and dear to my heart.
02:02And this is gonna be, I think a pretty personal
02:07conversation with you.
02:09I'm not representing, you know,
02:10NRDC or Columbia University officially.
02:14I'm gonna tell you some things about my personal experiences
02:17in this field as Kai said.
02:21From some pretty early days in the climate and
02:24health world and to where I am now as a scientist advocate,
02:29still at the Natural Resources Defense Council,
02:32most of my time and still at Columbia,
02:34but I hope that I'll talk a little bit,
02:37give you a sense of my slow conversion
02:39from someone who probably somewhat idealistically
02:43and blindly thought data.
02:45It's all about data.
02:47Once I can do, or someone can do a great study
02:51and just bring forward those connections
02:53between climate change and health that'll be it.
02:55Then we'll just march into, you know,
02:57climate policy and health protections and all will be well.
03:00Well, I'm a firm believer but it takes a lot more than that
03:05as we all see from our experience
03:07and I'm gonna try and save time at the end for
03:11a lot of discussion time between us too.
03:13So thank you, Mauro and Kai for keeping me honest on that.
03:18So I'll give you a tidbits about what I've experienced
03:21along the way as we go.
03:25Most of my time now
03:27is spent at the Natural Resources Defense Council,
03:30an environmental not for profit
03:32that was established more than 50 years ago
03:35by a group of young attorneys who had the idea
03:39that they would use the environment as their client.
03:43Environmental law didn't even exist as a field then.
03:46And we have since that time,
03:47pretty much kept the same mission statement.
03:50And it's a big one.
03:51It's a little bit ambitious to protect the earth,
03:53the wild places, the people,
03:56the health of all those systems,
03:57and to ensure people's right to clean and healthy air,
04:01water, land and the wild.
04:03So, climate change and climate policy is really...
04:07If one had to pick one,
04:09it would be overarching, you know, theme that we work on.
04:15So, it has sure been a challenge,
04:17but I'm so happy, satisfied, learn something,
04:22many things every day at this advocacy organization
04:27working as I do in the health frame.
04:30So let's get started.
04:31Next slide please.
04:32So this is a representation of me
04:35connecting the dots between climate change and health.
04:39I started actually as a geologist, I like those big systems.
04:43I loved earth systems and learning about
04:46how human activities affect the earth
04:50and the environment and vice versa.
04:52How environmental change affects our health.
04:56I was very influenced by some work I did on
05:00radioactive waste management.
05:02I worked at a group that was
05:04kind of the counterpart of the nuclear industry.
05:06We would try and find potential areas of concern
05:10and license applications that
05:12proposed radioactive waste sites.
05:14And there were a group of activists
05:17at a site we were working with in West Texas
05:20who impressed me mightily with their ability to
05:24link this environmental change to local health.
05:28We can't have this rad waste facility here
05:32because the groundwater will bring it into our town,
05:34you know, the radionuclides.
05:37Contamination and no, we can't have it.
05:40And they were successful and powerful, small but mighty
05:43and I thought that's quite interesting.
05:46I would like to study that.
05:47So I ended up going back to school
05:51to City University in New York City
05:54and then to Columbia University
05:57where I got so many lucky breaks.
06:01I was lucky enough to be part of the
06:03New York Climate and Health Project.
06:05Next slide, please.
06:06I'll tell you a little bit about that.
06:08This was funded by the Environmental Protection Agency's,
06:13STAR grants Science To Achieve Results.
06:16It was really one of the first big US-based
06:20integrated assessment modeling projects
06:23and kind of funding proposals.
06:25So, we had global climate modelers
06:28who fed their information to regional climate modelers
06:31who worked with land use modelers.
06:33Then there was an atmosphere chemistry model
06:36that sort of used all those inputs
06:38and kind of at the end of this interconnected chain
06:42was the health risk assessment.
06:44Dr. Patrick Kinney who was my research mentor,
06:48he's now at Boston University.
06:50He has been continues to be a leading light
06:54in the climate and health field.
06:56And he gave me lots of opportunities,
06:59including when he shattered across the classroom.
07:00"Hey Kim, are you still looking for a dissertation topic?"
07:03I said, "Yes, I am."
07:05The one that I had in mind about radioactive waste
07:08was not taking shape.
07:10So I jumped on board,
07:12the climate and health train,
07:14which in 2000 was kind of new and I jumped on forward
07:18and off we went.
07:20Next slide, please.
07:23That job of connecting the dots between
07:25climate change and our health was...
07:27I mean, in the research community,
07:29it was starting to grow,
07:30but kind of in the community at large,
07:32it was an absolutely new idea.
07:34And I have to say,
07:3620 years later, it still is a constant conversation,
07:40not only does climate change affect the environment
07:42and the Arctic and polar bears and like non-human faces.
07:48It also affects people
07:49and some people far, far more than others.
07:52So, this is an old chestnut
07:55something from a article from the "New York Times" in 2003,
07:59the introduced this project that looked at the
08:03New York City Tri-state area,
08:0531 counties in New York, New Jersey, Connecticut,
08:09and the novel thing then
08:12about the New York Climate and Health project
08:13was health was the driver.
08:16At the end of that cascade,
08:17who was going to estimate the impacts
08:20to the health of people in New York city?
08:23Who was gonna be specific to New York?
08:25Who was gonna look into the future?
08:26At the time, these were new ideas.
08:28In this image you see Dr. Cynthia Rosenzweig
08:32who worked at NASA GISS,
08:35with Jim Hansen, who was one of the, you know,
08:38like the pioneers of this whole impacts
08:41in climate change field.
08:44At the table you see yours truly
08:45on the left and Pat Kinney
08:47Cynthia again Joyce Rosenthal, who is a urban planner,
08:52worked in public health.
08:53So, this was like the beginning,
08:55the blossoming of a really interdisciplinary team
08:58or transdisciplinary.
09:00Next slide, please.
09:03And it was, and it still remained somewhat challenging
09:06to find the space, to find the funding,
09:09to find the journals,
09:11to find the academic appointments.
09:14That kind of foster and feed interdisciplinary work.
09:17But there's been, you know,
09:19lots of progress in the years in between.
09:22It's been a challenge, but a good one.
09:24We would meet every week for three years
09:27that was the term of the NYCHP as we call it
09:31every week to learn each other's jargon and language.
09:35And how do you do your modeling?
09:37We really had to come up with
09:39over that time a shared language, a shared vocabulary,
09:43so that we could put together link these models.
09:46And these are some of the images from the
09:50more than a dozen peer review journal papers,
09:53eventually that came out of the project.
09:56So it was a very rich project
09:59and you can see here kind of the,
10:01some of the images that represent those different sectors
10:05whose climate impacts are being modeled.
10:08In the upper left is I believe that's looks like from the
10:15model resolution global climate change
10:18that was dynamically down-scaled
10:21to regional climate model temperature.
10:25On the upper right you see the results
10:27of the atmospheric chemistry modeling component
10:31that Christian Hogrefe at the University of Albany
10:34did beautiful work with his colleagues there.
10:38Sort of below that the lower right is
10:41a figure from a paper that I was lucky enough
10:45to leave the team...
10:46This is all teamwork.
10:47You know, none of it is singular.
10:49But it was really one of the first times
10:51that people who live in a region in the US
10:55could look at their county.
10:56Those are counties that are kind of at outlined and say,
10:59"Hey, in some future year there's gonna be
11:02"an increase in premature mortality here."
11:05It's gonna be how much hotter.
11:06I think that this was kind of the beginning of that
11:09geographic specificity that has become
11:12quite a powerful way to use data.
11:15And in the lower left here is some land use change modeling.
11:19We look forward to the 2020s, 2050s and 2080s.
11:24Next slide, please.
11:25This is just a little bit of a zoom in.
11:28And I know Kai that
11:30you like this paper and wanted me to talk about it.
11:32So here we are.
11:33These show, the estimates of percent increases in summer
11:38ozone related premature mortality
11:41look into the 2050s relative to the 1990s baseline.
11:45So here again, you just get the sense of the,
11:48kind of the original in my backyard.
11:51Hey, that's my county.
11:52Hey, that's where my aunt Sharon lives
11:54that came out of New York Climate and Health Project,
11:56which I think was part of why
11:59it created a foundation for other papers.
12:02What we found that was that overall
12:05there was a median 4.5% increased region-wide
12:09by the 2050s in that ozone related pre-mature mortality.
12:13Next slide, please.
12:16Kai created this.
12:17Thank you very much for that.
12:19But it gives a sense of how the work
12:24of the New York Climate Health Project
12:25was useful in other papers
12:28that since have gone on to go much further
12:31looking at how climate change
12:33affects air quality and then mortality.
12:35We know that ground level ozone
12:38it's a temperature and sunlight sensitive
12:41formation chemistry reaction.
12:43So that's part of why climate change in particular
12:46will serve to, you know, other things held constant,
12:50make it more challenging to meet ozone regulations
12:55and will tend to increase ozone concentrations.
12:58Actually, the work of Michelle Bell
13:00who's one of the faculty members at Yale
13:03was also really instrumental in understanding
13:06this kind of regional and super regional effect.
13:09She was lead author on a paper and climatic change
13:13that found estimated that there will be a 68% increase
13:17in ozone exceeded days by the 2050s.
13:21That is days that don't meet the eight hour standard.
13:24So this was some of the first times that we,
13:26people really got a chance to like vibe that,
13:31"Hey, in my backyard where I live
13:33"climate change could affect my health."
13:35Because as we know, there's 25 million people,
13:37adults and children in the US that have asthma
13:41ozone can be a trigger for asthma attack.
13:44There's all kinds of reasons why this is important.
13:47There was also a companion paper on heat.
13:52And heat related premature mortality that came out
13:55of the New York Climate and Health Project
13:57that gave a view to, you know,
13:59increases by the 2050s,
14:01like a 70% increase in premature heat related mortality.
14:06By the 2080s, a tripling in the New York Metro region.
14:10So in a lot of ways,
14:11it put ozone and air quality and heat on the
14:15New York Metro, I think, you know, sites for future work.
14:20Next slide, please.
14:22I'm gonna transition a little bit to
14:26the storytelling aspect,
14:28which has been a big feature of my work at NRDC.
14:34As Cynthia Rosenzweig
14:37from climate and health projects said wisely,
14:40she called it the four Ps at the time,
14:43which meant for her that proposals, you know,
14:46research proposals, lead to projects
14:49which lead to papers,
14:51but then they very much influence policy.
14:53And I would add people
14:56that you can't have those influences on policy
15:00kind of flowing from the data without people
15:02to make it happen.
15:04And then for better or worse,
15:05the another P kind of the six P is politics.
15:09These are all issues of some science and health science
15:13that have become as we know, so politicized
15:16in the years since and to this very day.
15:19So, local stories help fuel advocacy.
15:22And next slide, please.
15:24It's my hope, my belief that
15:29with health climate change becomes very personal
15:31and that it can help motivate
15:33that kind of health protective advocacy.
15:35I'm showing this because
15:37this was a study conducted with the
15:39California Department of Public Health
15:41and some NRDC scientists, myself included
15:45that was published in 2009
15:47in Environmental Health Perspectives.
15:49It was really one of the first US-based studies
15:52that looked at a big heat wave and its impact,
15:55not a premature mortality,
15:57but a morbidity on different illnesses,
16:00emergency room visits, hospitalizations in a big state.
16:04This is California.
16:06You can see the counties on there,
16:07but these are kind of climatic zones in California.
16:12There was a two week heat wave in 2006.
16:15That was really intense,
16:17had a really large geographic extent.
16:20And what this work found was to our surprise somewhat.
16:24There was a huge...
16:25I mean, you expect that there would be
16:27an increase in excess emergency room visits,
16:31but it was enormous.
16:32It was over 16,000 additional excess ER visits
16:37beyond what would typically be expected
16:40at that season of the year.
16:43There were almost 1200 excess hospitalizations,
16:47and you can see from this figure that
16:50the Central Coast region was just on the Western
16:52and Central Coast includes
16:54the San Francisco Bay Area.
16:56Well the temperatures there were not in an absolute sense,
16:59the hottest temperatures on the state,
17:01the relative risk was very high.
17:05And that is because the population there,
17:08the infrastructure, the residents
17:09are not a climatized are not prepared for intense heat.
17:13There's a lot of resident that don't have air conditioning.
17:16So, this was an interesting study.
17:19Another one that's been helpful to other people doing
17:22heat morbidity work.
17:24But it was also interesting because our partnership
17:28with the State Department of Health was really fruitful.
17:32We, as an NGO, as a nonprofit,
17:35as an advocacy organization could be kinda more forward
17:39and more direct with some of the messaging
17:42coming out of this
17:43and they had the, you know, the de-identified data,
17:48the statistical analysts,
17:51it was a great kind of marriage of skills
17:53and I think that that is part of,
17:57I mean, my message to us.
17:59We all have a role in what we're trying to achieve
18:01in the way of both learning and taking our learnings
18:04to a wider audience both public and policy making
18:08to get the heck on board
18:10with more health protective climate policy.
18:14Government agencies have a critical role
18:17and geoscientists have a critical role,
18:19you academic scientists have a critical role
18:22as do lots of other people,
18:24artists, writers, musicians,
18:27the people, children, elders, you know, community groups,
18:30we're all in this thing together.
18:32So a little bit of my pitch for it takes a village,
18:35but next slide please.
18:38To continue on that theme of
18:41like making global climate change,
18:43which can be sometimes rather abstract
18:46or rather, let's say abstract now
18:49after the last 10 years, that for sure.
18:51But it can seem rather large scale
18:54and I have found in my time at NRDC
18:58and working with partners there in particular,
19:01that making that global story local is hugely important.
19:06It brings it closer to home.
19:08It reflects people's lived experience
19:10from media point of view
19:12because working with the media successfully
19:15is important to get our science and our data
19:18out into the public sphere.
19:20Is great because if I do,
19:22as I have with, you know, my partners and colleagues,
19:24you see here in the map below,
19:26which I'll talk about a little bit more,
19:28we typically at NRDC use existing data sets,
19:32but try to put them together in novel ways
19:36that tell a health relevant story.
19:38And when we do that on a national scale,
19:42like the map you see here,
19:44it means that news outlets and people
19:47and local newspapers in every one of those counties
19:50can look at the map and say,
19:51"Hey, what's this story?"
19:53And we work with them to try and
19:55bring that local story to the fore.
19:57These are two URLs for some of the websites that NRDC
20:04still has that combine not only mapping tools like this,
20:09but also some of the information on
20:11the impacts writ large for people.
20:13And there's a lot of people who haven't been introduced
20:17to the connection between climate change and health.
20:20We also try to show preparedness and adaptation
20:24and action steps that are happening locally at the state,
20:29even at the local level,
20:31to give people a sense of what can do
20:34and see themselves in a kind of
20:35action frame in this story.
20:37Next slide please.
20:39While those two URLs are still current,
20:42I just wanted to take a little spin down memory lane
20:45for me at least and show you how the online maps evolve.
20:52We've gotten a lot of very positive feedback
20:54through the years.
20:55It was like 2011.
20:56It's been a decade little bit more.
20:58Yeah, a little bit more than decades
21:00since those maps first came out.
21:03And this is the URL for the original site climate maps.
21:08We made a large effort to bring together that statewide
21:12and then county level information.
21:14In that original site, we had more maps actually.
21:18We had showed air quality,
21:20how climate change affects environmental change
21:24and then related to health outcomes for air quality,
21:28extreme weather events, drought, flooding,
21:32extreme heat, one infectious disease, dengue fever.
21:37So we tried to put the information there.
21:39Next slide please.
21:41And we gave people a way to not only see the threat
21:46that shows what it used to look like.
21:48Our website has been streamlined by much better designers.
21:52Well, you know, better designers let's say
21:54certainly better than me.
21:56We also blog a lot.
21:57Our scientists, our policy experts blog.
22:01So they were all collected on the pages.
22:03Next slide please.
22:05And we felt it was important to give people
22:08that sense of what they can do, like preparedness actions.
22:12It's just frustrating
22:13and, you know, frankly can lead to a sense of,
22:16you know, a lack of agency
22:18to give people somewhat alarming
22:21health concerning news
22:22and not, you know, show a way to move their concern
22:25into action and movement.
22:27So we did try to do that.
22:28So this is just kind of sharing with you
22:32our thought process.
22:33It began the map series as a poster session,
22:37internal to NRDC.
22:38We got a lot of feedback from our colleagues
22:41and we took some time and we turned it into
22:44these online maps.
22:45Have since kind of maintained and sustained themselves
22:49as one of the most popular of NRDCS web pages.
22:52And we've gotten great feedback that they're great screening
22:55tools for local planners.
22:58Students have used them to inform their local work.
23:01So we're glad that they met with success.
23:04Next slide please.
23:06And this just gives a little view
23:08spin through these real fast.
23:10It shows in this case,
23:13this is kind of collocates ozone exceedance days.
23:18Days the year that this was mapped,
23:20it was 2007 when this first came out,
23:23but where there's ozone exceedance days and where ragweed,
23:28which is a plant that produces an arrow allogenic pollen
23:32and tends to produce it in late summer, early fall.
23:36Exactly the same time in much the US
23:38when ozone exceedance days in the hot
23:41and often still days of late summer
23:44can exacerbate ozone concentrations
23:46and the two conditions present a double whammy to health.
23:50The more sepia-toned areas in the map
23:55show where ozone exceedance days and ragweed
24:00are co-located and found kind of a map of relative risks.
24:05This map kind of survived through the years,
24:08had a real evergreen kind of lifespan
24:12because every year in the spring it's tree pollen.
24:15In the summer, it's grass pollen.
24:17In the fall, its ragweed,
24:18and there's a lot of pollen sufferers in the country.
24:22So we find that this gives us an opportunity
24:25to bring up those interconnections year after year.
24:28Next slide please.
24:30And this is just one other example of those
24:33national maps that take data sets and put them together
24:36in a novel way.
24:37This is the dengue fever.
24:39It maps where the two mosquito species,
24:43Aedes aegypti and Aedes albopictus
24:45were at the time found in the US
24:48using ArboNET dataset to map the vector.
24:52And it combined that with
24:54centers for disease control and prevention
24:56reports of dengue fever cases.
24:59Most of those admittedly were imported cases
25:03from people traveling outside the US
25:06becoming infected back to home
25:09and developing infection and symptoms.
25:11But that said,
25:13it is feasible that a mosquito vector
25:16could come into contact by a infected person,
25:21and it could become a local transmission source.
25:23And there, there is local transmission of dengue fever
25:28in some areas of Texas, of Florida of Hawaii.
25:32So this again was just a mapping example
25:35that began a series of discussions
25:38that has had a long lifetime.
25:39Interestingly, the year after this came out,
25:42this came out in 2009 and in 2010,
25:45CDC made dengue fever a reproval illness.
25:48We have to take credit for that,
25:50but it's kind of indicative that the national dialogue
25:54was amped up for a lot of reasons
25:55around that infectious disease.
25:57Next slide please.
25:59So just some more URLs,
26:01'cause I want you to have resources
26:02when I'm here and when we're done.
26:06We at NRDC put together weather detailed
26:10climate health fact sheets,
26:11or I think seven states.
26:13Michigan is shown here.
26:15We also have California, Colorado,
26:17Illinois, Virginia, Washington, and Pennsylvania.
26:22A lot of detail, a lot of citations
26:24for people that may be doing
26:25climate health work in those areas.
26:28And the last link is our current URL
26:33that tries to put together in one place,
26:35the climate and health work.
26:36And we'll be updating this soon.
26:38Next slide please.
26:39Okay.
26:41Checking my time.
26:42I'm in the bend to two other huge opportunities.
26:48Huge learning experiences for me,
26:51and I'll talk about them a little bit.
26:53But first NCA3 National Climate Assessment.
26:56The third US National Climate Assessment.
26:59I was fortunate enough to work on this effort
27:02as one of the co-convening lead authors
27:05for the Human Health chapter.
27:07This was back in kind of 2011 through 2014.
27:11There has since been a fourth iteration
27:14of The national Climate Assessment
27:16and right now work on the fifth assessment is underway.
27:20But this was a huge learning opportunity for me,
27:23I'd like to network with amazing scientists
27:26and see how the NCA reports come out.
27:29But it was very gratifying and interesting
27:32that this was the vintage of NCA
27:34when the here and now message
27:37really came to the fore.
27:39The climate impacts on health
27:40are happening here and now in the US.
27:43Probably the first time
27:44that's been so loud and clear.
27:46Translation.
27:47The whole effort was aimed to make
27:50all the information in all the chapters
27:52entirely digestible, not just to, you know,
27:55academics or scientists working in the field,
27:58but to everyone to the, you know, the public.
28:01And I really respect that
28:02and learned a lot from that effort.
28:04And third vulnerability.
28:05It was one of the first times that the differential,
28:09the disparate, the inequitable vulnerability
28:12of some places and people and communities,
28:15the climate change really was emphasized.
28:17Next slide, please.
28:19This is just some reflection on that here and now
28:23in the years, since that effort.
28:27Sadly year after year,
28:28it seems like we, you know,
28:29just get more of the lived experience of climate change.
28:33Years 2013 to the present, all of them
28:36in the top 10 warmest years globally ever recorded.
28:41The two gentlemen in the upper left
28:43are members of the National Medical Association.
28:46They surveyed their members down
28:4886% of their survey members said
28:50climate change is directly relevant to patient care.
28:55I mean, the physicians, the both the public health
28:57and medical communities and more and more people
29:00are learning about climate change from life,
29:03from experience and less so from reports
29:05and academic efforts.
29:07Next slide, please.
29:09Something else that NCA3 and other reports
29:12certainly have done is this.
29:14The view on the left is under a relatively lower
29:18greenhouse gas emissions scenario.
29:21The one on the right under a relatively higher
29:24emission scenario and kind of painting the difference
29:28in this case here.
29:30If you could just go back advance, that happens.
29:33Thank you, thank you.
29:34Giving a sense of the difference between
29:37the low emission scenario
29:39like three degrees Fahrenheit
29:42difference between now and the hottest days of the 2090s
29:46versus on the right higher emissions
29:49more like a 10 degrees Fahrenheit difference
29:51on the highest temperature on the hottest days.
29:54Giving a sense of what we can accomplish
29:56and what we can avoid by moving
29:59with all haste toward cleaner energy.
30:02Now, next slide please.
30:04And I bet you in this course and in your work,
30:09you talk a lot and we're all cognizant of, you know,
30:13the elderly, the very young, economically disadvantaged,
30:18many communities of color,
30:20people with preexisting conditions,
30:22certain locations, not equally vulnerable
30:26to climate health effects.
30:27The IPCC report that Kai mentioned that came out today,
30:32estimates that basically half of the world's population
30:36like 3.6 billion live in what they're calling hot spots.
30:40You have to wonder if half of the world's lives in a hotspot
30:44kind of changes the meaning of hotspot.
30:47In other words,
30:48billions of us are highly vulnerable and highly exposed.
30:53Next slide, please.
30:55I wanna mention kind of in this transition of data is great.
31:00It's very rich, but what can we do with it?
31:03Partnerships.
31:05Taking your findings, your work, your projects,
31:09your papers, your knowledge,
31:12and using it to learn about the lived experience
31:15about local knowledge, local expertise
31:18in partnership with people, communities and groups
31:22who live in some of those highly exposed
31:24and vulnerable areas it's what makes the work real.
31:27It can really turn the data that we have into action.
31:31And I wanna share with you a story,
31:33you know, my again, great fortune...
31:36Next slide, please,
31:37in working with NRDC and partners in Ahmedabad India,
31:42a city in Western India in Gujarat state.
31:45I actually see one of my dear colleagues
31:48and partners from that work is here today.
31:50I'm very glad Dr. Pavian.
31:54In 2010, this city experienced
31:57what was for Ahmedabad's historic heat wave.
32:00This is a news report that there were
32:02over 50 people who had died but...
32:05Next slide please.
32:06It turns out that upon further investigation
32:10among this partner team with the local experts
32:13and health scientists and researchers and NRDC researchers,
32:18it was more like over 1300 excess deaths
32:22in the month that the heat wave occurred.
32:25This graphic became known as the graph
32:27because it told a story graphically
32:30that had great meaning and motivated
32:36the Ahmedabad municipal corporation leadership,
32:39fantastic leadership from the city, just who said no more.
32:43This peak that one can see in the red,
32:47upper line of a peak with maximum temperature,
32:52that's maximum temperature peak,
32:54right below a daily death counts.
32:57Then Mayor said no more.
32:58I do not want this to happen again to,
33:01you know, the people of Ahmedabad.
33:02So next slide, please.
33:05The city, the leadership at our great partners,
33:08Indian Institute of Public Health in Gandhinagar,
33:12NRDC other experts help the city put together
33:15a heat action plan.
33:16Then first, all of South Asia
33:19with an early warning system with outreach
33:21to the most heat vulnerable communities
33:24with extra like dialogue with health professionals,
33:28with outreach to the media,
33:30and it really changed the whole kind of equation,
33:33dynamic appreciation of heat.
33:36Extreme heat as an approachable public health issue
33:39that and we can do something about it.
33:41Next slide, please.
33:44The people of Ahmedabad as well as city leadership
33:47took this issue and made it their own.
33:49This shows women and people having a parade
33:53to the streets of the city to raise awareness.
33:57On the right you see city leaders putting rooftops white
34:03to be more reflective and reduce indoor temperatures.
34:05Next slide please.
34:07And actually we were able to conduct an evaluation
34:10of the work in Ahmedabad and found that there were
34:13in the years after the launch
34:15of the heat action plan in 2013.
34:18And the years after the city avoided 1100 premature deaths.
34:24Not strictly heat related,
34:26but the deaths in there in the summer heat season
34:29were reduced dramatically.
34:32Could be a host of different reasons,
34:35but surely the heat action plan factored into that
34:38and that was published in journal environmental
34:42and public health. Dr. Jeremy Hess
34:45was the lead author on that.
34:48Next slide please.
34:49I'm rounding the bend.
34:51And I want to say thank you to Ahmedabad as always
34:56our partners there
34:58for that amazing work which continues
35:00both in terms of extreme heat
35:02and now we're working on air pollution as well.
35:05But to bring our climate and health work
35:08and data back home,
35:09this is an appreciation of the health related costs
35:12of climate change.
35:13You could definitely say
35:14we're already paying for climate change with our health.
35:16Next slide, please.
35:18In 2011, NRDC lucky to work on this work,
35:23took the first look from already published reports papers
35:28on kinds of events that are
35:32going to increase in the future
35:33in intensity and duration and frequency
35:36with climate change, climate sensitive events
35:39and health outcomes related to them.
35:41Heat wave, wildfire seasons, hurricane seasons.
35:46You can see kind of the array across the US.
35:49And in that first study, we found,
35:52we were surprised to find $14 billion
35:54in health-related costs, just from six
35:57those events that were documented.
35:59Surely those are not the only six
36:01such events that occurred in that time,
36:04but we lack integrated databases
36:07that give an ability to discern the whole fabric
36:11of climate sensitive events.
36:12Next slide please.
36:14But this interest in valuation continued strongly
36:18with this report and the Fourth National Climate Assessment.
36:22Next slide please.
36:23And my NRDC colleague, Dr. Vijay Limaye
36:28just advance it a couple times, if you don't mind please.
36:31And we will see that Dr. Limaye looked at
36:35just one year, 2012.
36:37Again, looked through the literature to document events.
36:40This was 10 different events and came up with
36:44$10 billion in health related costs typically unassigned.
36:49Health costs are not included when you hear
36:51about Noah's billion dollar disaster tally.
36:55Next slide.
36:57This is really important information
36:58for us to keep in mind
37:00that there will be over 37,000 encounters
37:05related to those climate sensitive events
37:07with these kind of costs.
37:09And 2/3 of the illness costs being paid
37:12for Medicare and Medicaid encounters.
37:14These kind of realities need to be factored in
37:17when at least for me when I hear people say
37:20it's gonna be so expensive to make that leap
37:23to greener and cleaner energy.
37:25We have to put health into the picture.
37:28Next slide, please.
37:29I know I'm a little over, but we're almost done.
37:32I don't know if you've had Dr. Ed Maibach
37:36from George Mason University come and speak with you,
37:39but he is a real leader and has been
37:43for a while in this climate and health messaging.
37:46Along with that your colleagues
37:48at Yale University, for sure.
37:49But Ed Maibach has a way of putting it like this.
37:52It's, you know, five messages,
37:55experts agree, climate change it's real, it's us
37:59it's anthropogenic, it bad yes.
38:02The more we learn, the more sobered we are
38:05by the impacts and their effects on people's health.
38:10But these are solvable issues.
38:13Next slide please.
38:15But they're solvable when we take our knowledge
38:19and our outrage perhaps the knowledge we learn,
38:23and we determine that we're gonna protect the people,
38:27the places that we care about and the people and places
38:31that we can't even see perhaps
38:35because it is, we are a global community.
38:38There is no doubt.
38:40And when we protect the most vulnerable,
38:43those who are on the front lines of, you know,
38:45suffering the worst impacts, when we go first to them,
38:49we learn a great deal.
38:51We help them, you know, most imminently
38:54we help ourselves to build that healthier
38:56and more secure future.
38:59That data is really about
39:00because if data doesn't help us connect with each other
39:04and connect to the, like the last doc,
39:07which is, I don't want my children,
39:10my grandchildren to live in a science fiction.
39:13I wanna give them like a future, you know,
39:15in my small part that's worth living
39:19and a current day that is, you know, worth fighting for.
39:24And we're gonna do that.
39:25So with that...
39:26Next slide or two.
39:28Thank you.
39:31We'll keep our eyes open our hearts open
39:34and our data streams open to learn about
39:36the differential impacts of climate change
39:38on our health around the globe
39:40with all humility and respect and that's me.
39:44And that's where you can find me
39:46at that at the NRDC email.
39:48I'm at Columbia, but I pick up emails
39:51mostly from NRDC.
39:54And we blog.
39:55And now lucky me, I get a chance hopefully,
39:57to listen to you and your experiences, concerns, questions.
40:02So the last slide is just, you know, the question
40:06but if you wanna leave the contact info up there Kai,
40:09that would be fine.
40:10Thank you everyone.
40:11Thanks for giving me a chance
40:12to talk with you and tell you my story.
40:16<v ->Thank you Kim.</v>
40:17Thanks for the wonderful story from your research
40:21to the community engagement and to the policy.
40:24So I think we can first give a round of applaud for...
40:27(indistinct)
40:31Well all those joining online
40:33if you do have questions,
40:34please feel free to post your question in the chat box.
40:38But Yiqun has already gathered
40:41a lot of question from our students.
40:44Our students read some of the readings materials you sent,
40:47and I think I summarize some into big categories.
40:51So the very first question many students are having is that
40:56you showed your 2011 paper on the cost
40:59of the health impact climate change,
41:02and also Dr.
41:03One at the 2019 GeoHealth paper.
41:09<v ->Yeah.</v>
41:10<v ->And the students are wondering, like,</v>
41:11we know this message is important,
41:15but have you been surprised at all
41:20with how your data has been used
41:23or by who has been citing it?
41:25And do you see any impact from using your paper
41:29in politics or in implementation?
41:36<v ->I will give a few examples.</v>
41:38And I think that the headline is yes.
41:43Yes it's starting.
41:46I could tell.
41:47First, I'll answer the question
41:48then maybe I'll go back to the genesis
41:51of the health cost work.
41:53Yes, from almost the start when (indistinct)
41:56Dr. Limaye in particular, because
42:00frankly the 2019, the GeoHealth paper that you have
42:03both the paper and the back sheet from
42:07Dr. Vijay did a really interesting analysis
42:10that got to a lot more of the particulars.
42:14And we found that in among the 10 sites
42:16that were the case studies,
42:20there was interest from some like governor's offices
42:23and some of the states.
42:25We heard the paper referenced in congressional hearings
42:29on climate and health topics.
42:33The earlier 2011, that first work,
42:36the NRDC worked on with health economists
42:40at University of California.
42:42That was cited recently in an amicus brief.
42:47That is, you know, when friends of the court get together
42:50and put together evidence that supports their side.
42:53That was cited in support of, you know,
42:56kind of the previous court findings
43:02kind of asserting and I'm sorry, EPAs
43:06ability to regulate greenhouse gases.
43:08It was cited there.
43:10It got both of the valuation studies
43:13got quite a lot of press at the time.
43:17So between media and those mentions in state
43:23and federal level hearings,
43:25I wouldn't say that, you know,
43:27legislation has not been based on them.
43:30It's not always like a law or a regulation per se,
43:34but just to see the work used
43:38in a policy building framework is very satisfying.
43:45And you know, I think that for any of us,
43:48when we see our science kind of move out of the ivory tower
43:52or off the bookshelf and into, you know,
43:55movement toward action, that's great.
43:59That's why only speaking personally, that's why I do this.
44:02And I don't even expect that it's gonna happen,
44:05but when it does, it feels good.
44:09<v ->Excellent.</v>
44:10Here comes a relatively more technical question
44:13regarding how you actually calculated the, you know,
44:17economic burden of this cost.
44:19So the students are not very familiar with,
44:22for example, the statistical life lost.
44:25And they're wondering, like, for example,
44:27they understand if you have the Hurricane Sandy,
44:30you can calculate the health damages.
44:33But they're not quite sure
44:34about how you calculate for example,
44:36let's see the ozone pollution.
44:38The ozone air pollution in Nevada.
44:40So how do you, you know,
44:42calculate the cost associated with this mobility
44:45and the mortality?
44:49<v ->I'll try to do a decent job,</v>
44:51just noting that Dr. Limaye could do an awesome job
44:54because he knows the insight and the method,
44:59but to your two,
45:01I mean the two main components
45:03of the valuation assignment are the
45:06mortality and the morbidity.
45:08The mortality, the value of a statistical life
45:12is the basis for that cost assignment.
45:18We've had a lot of discussion,
45:19a lot of questions about what that means.
45:22It's then wide use the environmental protection agency,
45:25for example, has used it for many years.
45:27It kind of evolves.
45:29It is not a statement about the value,
45:32the inherent value of life.
45:34It's comprised of kind of looking at again statistically,
45:40a large group of people and the,
45:42what people would pay to avoid risk of death
45:46across you know, a large and you know, millions of people,
45:51and then assigning that.
45:52So it's way of assigning
45:58willingness to pay to avoid death.
46:01That may not have helped much, but just to be clear,
46:06it's not a statement of life value.
46:08For the morbidity,
46:09for the emergency room visits, hospitalizations,
46:13the outpatient, visits, home healthcare medications.
46:18There are two fantastic databases,
46:22Healthcare Utilization Project HCUP,
46:25and the Medical Expenditure Panel Survey MEPS
46:29that were used to take
46:33the already tabulated health outcomes.
46:36We used already existing reports,
46:39either published literature or state or federal reports.
46:43Excuse me.
46:45And then to assign a value to
46:50the cost related to treatment care
46:56in those different categories.
46:58So we're using kind of national data sets
47:01to assign appropriate costs,
47:04to what was already documented,
47:06and then adding those costs together
47:09and trying to always use and apply a consistent methodology.
47:14If you look in the GeoHealth paper at table four,
47:18it gives you a sense of the different types of costs
47:23that go into the totals for the different locations
47:28and different health outcomes.
47:31So I recommend if that wasn't entirely satisfying,
47:34check out table four in the GeoHealth paper.
47:38But those are great questions.
47:40I mean, we could have a whole,
47:42or maybe do want to have a whole session with Dr. Limaye
47:46to dig in 'cause it's fascinating.
47:47And of course, methodological work is evolving all the time.
47:54It showed us very clearly the great value
47:59of having inter...
48:01Or let's say our goal
48:03to advocate for more integrated climate health
48:08and cost data sets because we had to
48:12spend quite a bit of time and effort
48:15to assemble the different data sets used to
48:18eventually assign those costs.
48:21I hope that helped a bit.
48:22<v ->That helps a lot.</v>
48:23Thank you, Kim.
48:25We do have a question from online audience from Leo.
48:31The question as we saw in the US and world wide
48:34directly related to the shutdowns and closures we made
48:37at the start of the pandemic,
48:40the pollution level was dropped.
48:41So how do we get back on track
48:44with those gains that we have now lost?
48:49<v ->And the reference...</v>
48:50And this is a question just to be clear,
48:53the fact that emissions are rising again
48:56after the diminishment owing to
49:00relating to the economic shutdown
49:03and like diminished transportation travel economic activity.
49:08How do we get back on track?
49:12Well, we've seen the kind of reductions
49:17that are possible not to in any way minimize
49:21the journey that, and you know, the suffering,
49:24the loss that people have been through,
49:27continue to be through with the pandemic,
49:31not to equate the two in any way,
49:33but I think we, with everything that's happening right now,
49:37the realization of that climate impacts
49:41associated air pollution,
49:43associated flooding heat related mortality and morbidity
49:47are just accelerating.
49:50There simply must be a commitment,
49:52a demand to move toward cleaner energy systems
49:57whereby no matter what is happening,
50:00we can support robust economic activity and not be polluting
50:05and creating the health harms today
50:09and the climate related harms in future.
50:11I think if anything, you know,
50:14it sobers us as to how vulnerable
50:19we are as a global society to a pandemic.
50:23How differential the vulnerabilities are.
50:25How we have to pay attention to the inequities,
50:28but we simply have to invest and demand
50:31cleaner energy now.
50:33there is no time to wait.
50:37<v ->What a powerful message.</v>
50:37Thank you Kim.
50:39As you know, like our students at the MPH students
50:45and the master students in other schools.
50:47So they're wonder like for public health students,
50:51if they're interested in this field,
50:53I want to, you know, make it do intent
50:56or at future career plans.
50:58So what kind of skills do you think that the students
51:02are currently to liking or maybe
51:04is best for them to help
51:06in order to be successful in this field?
51:10<v ->Well, first good, great.</v>
51:13Keep your interest alive.
51:14We need you.
51:15We need you at the field.
51:16The world needs you so badly.
51:19Please continue.
51:21You know, with every week, with every month, every year,
51:24the need is greater.
51:25So good for you, I applaud you.
51:29MPH students continue your basic,
51:31you know, skill building.
51:33I mean, epidemiology, statistics, you know,
51:37environmental health, social sciences, all of it.
51:43It's foundational.
51:44Two communication.
51:47Building communication skills, writing more.
51:52Is there an outlet where
51:53you can, you know, blog or write essays
51:56or you know, write, write, write,
51:58and listen, listen, listen.
52:01Talk with other people.
52:03Talk with, you know, use every opportunity
52:05to hone your own speaking and listening skills
52:10because the amount of information and learning
52:13and studies that are coming out
52:17it's like a gusher right now.
52:19But keep at it and make common cause.
52:22Find a group, local group, community group, citizens group,
52:28student group join in with other student,
52:31do not let your yourself get to the point where
52:34you have a sense of being alone.
52:36Like the news is so sober rank,
52:38the latest science, the data is so sober rank.
52:42Don't get to the point where you feel like
52:44you're working alone in a bell jar.
52:46You are not.
52:47There are, you know, hundreds of millions likely
52:50people around the world.
52:51Maybe more in be interesting to have someone try
52:54and assign that sometime,
52:56but you're part of a huge community
52:59and we all have to have each other's backs,
53:01but we all have to keep kind of bolstering one another.
53:06And you know, having a good outlet for our outrage
53:10and turning it into action,
53:12making it move so that we're, you know, not burdened.
53:16Not laid down in our work.
53:18And keep doing your work.
53:19Be the best scientist and the most involved person
53:23that you can be.
53:25And you'll have skills of plenty
53:28and people will come and find you.
53:31But it helps when you go and look yourself
53:34and make common cause.
53:37(indistinct)
53:38<v ->I think we do have a not question,</v>
53:40but a commenter from the Chan saying that
53:44the importance of now looking by professional reservations
53:47is also suggested like the students should be members
53:50of the APHA.
53:53<v ->Yes, the American Public Health Association</v>
53:56has been great on climate change and health
54:00a few years back, not too many.
54:02I think it was 2017.
54:04Climate change was the annual meeting theme.
54:08And they have student groups.
54:12This is all, you know,
54:14it's really important to stay connected locally.
54:17Find a local community group.
54:18Ask what can you do?
54:20How can you learn from them?
54:23How can you serve them?
54:24You've got skills.
54:25I mean, face it.
54:26Even if you're, you know, in your student hood,
54:30you're gaining skills, use them.
54:34Yeah.
54:36<v ->Thanks Kim.</v>
54:37A kind of related question to that is
54:40you have been doing a lot of work
54:41on the science communications to the general public.
54:44So the students are wondering, you know,
54:46we do a lot of academic work,
54:48we know the science.
54:50But how can we better communicate
54:53this connection between climate change of health
54:55and economy costs to their general public?
54:59<v ->Oh, well I mean, I could put in a plug for, you know,</v>
55:03please stay tuned at NRDC via
55:07the URLs I showed you before.
55:10www.nrdc.org, but specific to the valuation work,
55:15it is our intention to keep that going.
55:19And with you know, new partners and new applications,
55:21because we're really interested in having a hand
55:25doing what we can to help
55:26build that sense of the larger fabric.
55:29Like the whole fabric
55:31of what are the climate sensitive events
55:34and climate sensitive health outcomes
55:37that climate change is fueling.
55:39Right now we've got like six one year
55:41and 10 another year.
55:43Like little great spots on a map
55:45that are lit up because there's data and information there.
55:49But if we're going to have you know,
55:51an appreciation of who do we serve
55:55with preparedness and adaptation
55:57and funding and support first,
55:58we need a more complete picture so there's that.
56:02There's also, it occurs to me the at Mailman
56:06School of Public Health,
56:08they have put together have organized a global consortium
56:12made up of over 250 health profession schools.
56:16Yale school of public health is a member.
56:19It's called the Global Consortium
56:21on Climate and Health Education.
56:23Dr. Cecilia Sorensen at Mailman is the director now.
56:28And they're doing a fantastic job
56:31of putting information content trainings, networking
56:37through their website.
56:39And because you're a member at Yale School of Public Health,
56:43I'm sure that there is opportunity to enrich that
56:47and participate in groups like The Consortium,
56:50as well as these other membership groups there.
56:53And all of those groups would be only too happy to
56:56have you help them learn and then do
57:00about climate and health communication.
57:01I guess the last pitch on that is,
57:04it definitely needs to be a part
57:06of the climate and health training.
57:08This communication piece.
57:10I don't think that we scientists should have to do
57:13a turn at a place like NRDC,
57:16where I very fortunate to work with a very, you know,
57:21enriched and experienced communications group.
57:27But we all need to have that training
57:29and learn from one another.
57:31So put it in the curriculum.
57:32Maybe that's a conversation you can have
57:36with your faculty and administration.
57:38It wouldn't hurt.
57:40<v ->Thanks Kim.</v>
57:41And we can have, like...
57:45I feel like we can have another hour discussion
57:47on all these topics,
57:48but unfortunately we have another class right after this.
57:52So we have to end the discussion today,
57:55but just to remind everyone that
57:57the recordings of this lecture will be online.
58:00So, yeah.
58:03<v ->I'm sorry, Kai.</v>
58:04I didn't mean to interrupt,
58:04but thank you for the opportunity.
58:06And I did have one last question,
58:08tell you what it's about a resource.
58:10I don't know if people know about
58:12the Climate Change and Human Health Literature Portal,
58:15which NIEHS put together and it's a compendium
58:19of lots of climate and health literature.
58:22I'll be sure to give you the link
58:25so that you can distribute it among
58:28the folks who are here today.
58:29'Cause it's a resource that's online
58:31and although it's a couple years kind of behind the current,
58:34it's very it's very good.
58:36So.
58:37<v ->Yeah, thank you Kim.</v>
58:38<v ->Thank you for everything you've given me</v>
58:40with your questions.
58:41It's very nourishing to me.
58:43So I thank you for that everyone
58:45and good luck with your work.
58:47<v ->Thank you Kim.</v>