!oseph Crazlano, hu Creg lreyer, hu Lecture |an Slgns Loday of a warmlng world PlsLorlcal Lrends ln cllmaLe LxpecLaLlons abouL fuLure cllmaLe PealLh lmpacLs of cllmaLe change Case sLudy: assesslng healLh lmpacLs from alr polluLlon and heaL sLress MlLlgaLlon sLraLegles 1he Intergovernmenta| ane| on C||mate Change (ICC) stated |n ear|y 2013 that:
Warmlng of Lhe cllmaLe ls !"#$!%&'()*. MosL of Lhe observed lncrease ln globally averaged LemperaLures slnce Lhe mld-20Lh cenLury ls &#+, *%.#*, due Lo Lhe observed lncrease ln greenhouse gas concenLraLlons." !"## %&' ())* +,--./001.2232,04 G|oba| Warm|ng |s nappen|ng National impacts over recent decades US Global Change Research Program (2009) 2F (1.1 C) rise in US average temperature over the past 50 yrs Sea IeveI rise >8" in past 50 yrs in parts of Atlantic & Gulf Coasts Oceans 30% more acidic than in pre-industrial times Increase in heavy downpours, as much as 67% in Northeast Current record warmth: Atlantic sea surface temperatures 4F (2C) above average Destructive potential of Atlantic tropical storms, hurricanes since 1970 c) Changes in heavy rainfall kecent summers have been hot. ln Lhe easLern uS, over 80 of locaLlons ln 2010 had average nlghLLlme lows ln Lhelr 3 hoLLesL years on record. 40 (of Lhe 313 L of Mlss) reporLed Lhelr record hoLLesL average summer nlghLLlme LemperaLure slnce 1893. Climate change interacts with existing environmental challenges, such as: "#$%&'(%)'*& +&,#-. /,0%&1 2**1 3,45#'). 6%),# 35778. 9'*1':,#;'). WhaL do you Lhlnk are some of Lhe drlvlng forces LhaL cause cllmaLe change? 1 2 3 4 2S 2S 2S 2S a. Lnergy use, urbanlzaLlon, populaLlon growLh b. 1ransporLaLlon sysLems, land use, deforesLaLlon & hablLaL desLrucLlon c. AgrlculLural pracLlces, Lhe amounL of meaL ln people's dleLs, freshwaLer & marlne resource use d. All of Lhe above M|n|-kecap #1 CllmaLe changes are occurrlng. ulrecLlon of changes already observed across many secLors ls conslsLenL wlLh warmlng. lmpacLs wlll be superlmposed on exlsLlng global healLh challenges. vulnerablllLy and capaclLy for adapLaLlon varles among populaLlons & places. 1he greenhouse effect |s essent|a| for mak|ng the earth |nhab|tab|e !"## %&' ())* +,--./001.2232,04 LoLs of 8eef roduclng MeLhane! CO 2 , CH 4 and N 2 O Concentrations
- far exceed pre-industrial values - increased markedly since 1750 due to human activities Relatively little variation before the industrial era Human and Natural Drivers of Climate Change From PCC's 4 th Assessment Report !"## %&' ())* +,--./001.2232,04 1,000 Years of Changes in Carbon Emissions, CO 2
Concentrations, and Temperature !"## %&' ())* +,--./001.2232,04 100 0.0740.018 50 0.1280.026 Period Rate
Years /decade Global mean temperatures are rising faster with time !"#$%&' )* +%"#&, -*)-.)//0.-*)*. -**1.-**2.-**-.-**/.-**3.-**4. -**5 Whlch of Lhese gases conLrlbuLe Lo warmlng of Lhe aLmosphere? 1 2 3 4 S 20 20 20 20 20 a. carbon dloxlde b. nlLrous oxlde c. waLer vapor d. ozone e. all of above M|n|-kecap #2 CllmaLe depends ln parL on Lhe energy balance of Lhe aLmosphere (sunllghL, lnfrared radlaLlon), Several gases ln Lhe aLmosphere absorb ouLgolng heaL (lnfrared radlaLlon), PlsLorlcal Lrends show lncreaslng concenLraLlons of several of Lhese greenhouse" gases, PlsLorlcal LemperaLure Lrends show an lncrease over pasL 100 years, suggesLlng a connecLlon wlLh lncreaslng greenhouse gas concenLraLlons. What m|ght the future ho|d? 1o address Lhls quesLlon, we rely on general clrculaLlon models, or CCMs. CCMs are global scale cllmaLe predlcLlon models. Several dlfferenL CCMs have been used Lo examlne poLenLlal fuLure cllmaLes under alLernaLlve assumpLlons (or scenarlos") abouL greenhouse gas levels. ulfferenL models glve a range of predlcLlons, Lhough Lhere ls conslderable agreemenL abouL Lrends ln LemperaLure and sea level. ro[ecLlons of luLure Changes ln CllmaLe "Cont|nued greenhouse gas em|ss|ons at or above current rates wou|d cause further warm|ng and |nduce many changes |n the g|oba| c||mate system dur|ng the 21st century that wou|d !"#$ &'("&$ be |arger than those observed dur|ng the 20th century." IPCC 2007 ro[ecLlons of luLure Changes ln CllmaLe Ior the next two decades a warm|ng of about 0.2C per decade |s pro[ected for a range of GnG em|ss|on scenar|os. Lven |f the concentrat|ons of a|| greenhouse gases and aeroso|s never rose above year 2000 |eve|s, a further warm|ng of about 0.1C per decade wou|d be expected due to |nert|a. Lar||er ICC pro[ect|ons of 0.1S to 0.3 o C per decade can now be compared w|th observed va|ues of 0.2 o C If we stop all emissions now, we still get warming Land areas are pro[ected to warm more than the oceans w|th the greatest warm|ng at h|gh |at|tudes Annual mean temperature change, 2071 to 2100 relative to 1990: Global Average in 2085 = 3.1 o C Norfo|k, VA: 14.S" sea |eve| r|se s|nce 1930 lronL-Llne ClLy SLarLs 1ackllng 8lse ln Lhe Sea" n?1lmes Peadllne 11/26/10 8esldenLs ad[usLs dally walklng, parklng paLLerns Lo avold floodlng aL hlgh Lldes CosL Lo repalr roads on one sLreLch: $1.23 mllllon, mulLlply by ???
Photo: Matthew Eich for the NY Times 11/26/10 Sea level has also risen steadily in New York City, where measurements of sea level have been taken since 1888. FDR Drive, October 29, 2012 !"#$%&"'(")*+ %(-./((01 2(*3+(#(+ )%*"0/%(00$&" 04("*%$&0 -&% 5*"/+*6(07 Adapted from Milliman et al. (1989). lncreased rlsk of floods, poLenLlally dlsplaclng Lens of mllllons of people, due Lo sea level rlse and heavy ralnfall evenLs.
8angladesh ls pro[ecLed Lo lose abouL 17 of lLs land area wlLh a sea level rlse of one meLer - very dlfflculL Lo adapL due Lo lack of adapLlve capaclLy LnvlronmenLal 8efugees 8y reduclng CPC emlsslons now (l.e. ln 2010), we can sLop furLher global warmlng wlLhln a decade or Lwo. 1 2 S0 S0 1. 1rue 2. lalse M|n|-kecap #3 CllmaLe models are slmpllfled maLhemaLlcal descrlpLlons of Lhe behavlor of Lhe earLh's cllmaLe sysLem, CCMs offer useful way Lo examlne fuLure scenarlos of cllmaLe as greenhouse gas concenLraLlons change 8y examlnlng a range of greenhouse gas growLh scenarlos & uslng dlfferenL CCMs, a range of posslble fuLures" can be examlned, Whlle resulLs vary, all models predlcL conLlnued warmlng lnerLla of earLh sysLems suggesLs need for early acLlon.
Possible Pathways for Health Impacts of Climate Change McMichael et al. 2003a 56670%8-9:;6:<9 =1>98>9> !<?92-16@> =1>98>9 A1: "6BB@-16< C A>-,D8 ABB9:E19> F98- G-:9>> HI-:9D9 G-6:D> !"#$% '$$( )*( +),-. #/00"12 0$0 345.),4$*2 6$*'"46,2 3-*,)" 7-)",7 neat Waves Ma[or cause of death, hosp|ta||zat|ons & |||ness August 2003 Luropean heat wave: 3S,000+ d|ed Iu|y 199S Ch|cago heat wave: 700+ deaths 8ecenL example: 2006 Callfornla PeaL wave - uayLlme LemperaLures >100l for Lwo weeks - 8ecord nlghL Llme hlghs - > 1 mllllon people wlLhouL elecLrlclLy - Cfflclal deaLh Loll 146, AssoclaLed ress deaLh Loll 466 - MorbldlLy excess: over 16,000 L8 vlslLs & nearly 1,200 hosplLallzaLlons - 23,000 caLLle and 700,000 chlckens dled Ground-|eve| ozone (smog) format|on Source: PL Kinney, ScD Higher temperatures increase the rate of formation of ozone. kagweed and G|oba| Warm|ng CC 2 levels Loday - 131 more pollen CC 2 levels ln 2030 - 320 more pollen
.compared wlLh pre- lndusLrlal levels. J1>K8 C #8@B?19B7L !/#, 8 9")*, 971#4$" (*/MNOPML ())) Waterborne D|seases 2/3 of uS waLerborne dlsease ouLbreaks followed preclplLaLlon above 80Lh percenLlle norLheasL: 67 lncrease ln sLorms w/exLreme ppL ln lasL 60 years LxLreme ralnfall evenLs pro[ecLed Lo lncrease ln fuLure wlLh warmlng aLmosphere Dengue Iever Dengue fever is moving north due to global warming and more mosquito habitat. First case on Long Island announced this week: a man in Suffolk County. From: Confalonieri, U., B. Menne, R. Akhtar, K.L. Ebi, M. Hauengue, R.S. Kovats, B. Revich and A. Woodward, 2007: Human health. Climate Change 2007: Impacts, Adaptation and Vulnerability. Contribution of Working Group II to the Fourth Assessment Report of the IPCC, M.L. Parry, O.F. Canziani, J.P. Palutikof, P.J. van der Linden and C.E. Hanson, Eds., Cambridge University Press, Cambridge, UK, 391-431. Greenhouse Lm|ss|ons by Country (uenslLy-Lquallzlng CarLogram) Mark Newman, University of Michigan | www.worIdmapper.org Data from: WHO 2004 Map from: Jonathan Patz, University of Wisconsin nea|th Impacts of C||mate Change Heat Floods Malaria Diarrhea Malnutrition M|n|-kecap 4 CllmaLe changes go beyond melLlng polar caps & rlslng sea levels. CllmaLe change can lmpacL a wlde range of healLh ouLcomes. CllmaLe change wlll exacerbaLe already-exlsLlng healLh problems. oorer populaLlons are frequenLly leasL able Lo cope & dlsproporLlonaLely lmpacLed. 1wo-step process used to study c||mate-hea|th |mpacts: )* +," -.'/"0'1&12'3 4..#153, SLudy and quanLlfy hlsLorlcal relaLlonshlps beLween cllmaLe-relaLed exposures" and human healLh ouLcomes 1he goa| |s to |dent|fy and quant|fy "exposure- response" re|at|onsh|ps 6* +," 7"5&8, 90.538 4::"::0";8 4..#153, redlcL fuLure healLh lmpacLs by modellng fuLure cllmaLe-relaLed exposures and assumlng hlsLorlcal exposure-response relaLlonshlps wlll sLlll operaLe rov|des answers to "what |f?" quest|ons nea|th Impact Assessment Wldely used ln regulaLory declslon maklng Model fuLure envlronmenLal condlLlons under varlous scenarlos (e.g., alLernaLlve alr polluLlon emlsslons conLrol opLlons) ro[ecL exlsLlng knowledge regardlng human healLh lmpacLs glven fuLure envlronmenLal condlLlons LsLlmaLe healLh lmpacLs of modeled envlronmenLal changes CfLen, analyze cosL/effecLlveness, or asslgn dollar values Lo Lhe healLh lmpacLs and do cosL/beneflL analysls 87( 9(: ;&%< =+$'*)( > ?(*+)7 @%&A(4) Linking models for global and regional climate, land use and cover, and air quality.
to examine the potential public health impacts of heat and air pollution under alternative scenarios of climate change and regional land use in the 2020s, 2050s, and 2080s in the NYC metropolitan region.
Funded by the USEPA STAR Research Program. !"#$%&'() +,&-.(/ "- 01,2$3 /'&-)&3) (4+(()(-+( )&5/ 6"', +%"#&'( +,&-.( 7889/ :9:9/
CIimate-ReIated MortaIity, Current vs. Future ModeI SimuIations 0 500 1,000 1,500 2,000 2,500 3,000 3,500 4,000 1990s 2020s A2 2050s A2 2080s A2 Decade A t t r i b u t e d
D e a t h s summer heat- reIated mortaIity summer ozone- reIated mortaIity Estimated progression over time of heat & O 3
related deaths in NY metro region C||mate change |mpacts |n NC Summer heaL-relaLed morLallLy could double by Lhe 2030s, wlLhouL furLher prevenLlon measures Summer ozone-relaLed morLallLy could lncrease sllghLly, buL depends on polluLlon conLrols Also, more frequenL severe sLorms
Some of Lhe sources of uncerLalnLy ln pro[ecLlng posslble fuLure healLh lmpacLs of cllmaLe change lnclude: 1 2 3 4 S 20 20 20 20 20 a. Change ln Lhe numbers of people affecLed/populaLlon growLh. b. Changes ln access Lo healLh care, chronlc dlsease raLes, eLc. c. 1he numbers of people who use alr condlLlonlng. d. Cur level of undersLandlng of aLmospherlc & LerresLrlal chemlsLry & physlcs LhaL go lnLo Lhe model pro[ecLlons. e. All of Lhe above kecap CllmaLe & healLh llnked ln dlrecL & lndlrecL ways CllmaLe models can be comblned wlLh healLh sclence Lools (epldemlology & rlsk assessmenL) Lo pro[ecL posslble fuLure scenarlos of cllmaLe-healLh lmpacLs as greenhouse gas concenLraLlons change Local-scale pro[ecLlons are now belng done ln uS & are posslble for oLher world reglons ulfferenLlal vulnerablllLles wlll deLermlne who could be mosL affecLed and Lhus ln need of greaLer lnvesLmenL ln bulldlng reslllence CllmaLe change LhreaLens healLh CllmaLe change ls one of Lhe mosL serlous publlc healLh LhreaLs faclng our naLlon. ?eL few Amerlcans are aware of Lhe very real consequences of cllmaLe change on Lhe healLh of our communlLles, our famllles and our chlldren. - ur. Ceorges 8en[amln, LxecuLlve ulrecLor of Lhe Amerlcan ubllc PealLh AssoclaLlon
$14 billion in health-related costs from just six US climate change-related events, 2002-2009 (Knowlton et al., Health Affairs 2011) 2011: A ?ear of LxLremes 14 bllllon-dollar evenLs: heaL, droughL, floods, snow, wlnds LoLaled <=> ?'&&'1; ln damages WeLLesL-ever sprlng ln 10 sLaLes, and urlesL-ever year ln 1exas arL of a Lrend: 2000-2010: WarmesL uecade on 8ecord 2012: PoLLesL year ln u.S. hlsLory 2010, 2012: hoLLesL years slnce 1880 33 consecuLlve years wlLh global LemperaLures >20 Lh cenLury average
1wo SLraLegles for CllmaLe Change SoluLlons lour key LlemenLs of Clobal Warmlng reparedness =+$'*)( 2&+.)$&"0B C7*) 4*" :( 6&1
1wo SLraLegles for SoluLlons D$)$/*)$&" Adaptat|on 1<-9:Q9<-16<> -6 :97@29 9D1>>16<> +6: 9<,8<29 >1<K>4 6? E:99<,6@>9 E8>9> 1<1-18-1Q9> C D98>@:9> -6 :97@29 -,9 Q@B<9:8;1B1-R 6? <8-@:8B C ,@D8< >R>-9D> 8E81<>- 82-@8B 6: 9I.92-97 2B1D8-9 2,8<E9 9??92-> C||mate So|ut|ons: Strateg|es - GHG laws or regulations (mandatory) - Energy efficiency - Rely more on renewable energy sources - Biological carbon sequestration - Reducing other greenhouse gases from industry, agriculture, waste management - Decarbonization - CO 2 removal and storage M|t|gat|on opt|ons
US EIA (http://www.eia.doe.gov) UN IkAMLWCkk CCNVLN1ICN CN CLIMA1L CnANGL (or unlCCC, LarLh SummlL ln 8lo 1992) vCLun1A8? goals, reduce CPCs Lo 1990 levels by 2000, Lo sLablllze aL a level LhaL would prevenL dangerous anthropogen|c |nterference w|th the c||mate system kC1C kC1CCCL (1997) 8lnulnC LargeLs Lo reduce emlsslons 3 below 1990 levels by 2012, ln force 2003 for lndusLrlal counLrles LhaL raLlfled, lnLernaLlonal emlsslons Lradlng + Clean uevelopmenL Mechanlsm Copenhagen 2009, Cancun 2010, Durban, South Afr|ca (Dec 2011)
Internat|ona| GnG regu|at|ons 2007: Supreme Court: ruled CO 2 is Clean Air Act pollutant, and EPA has power to regulate (or explain why not) !PCC +th Assessment Report 2007 Nobel Prize: Al Gore, !PCC Federal proposals to reduce greenhouse gases (GHGs) 18 states with regional agreements to reduce GHGs 2009: EPA Endangerment finding 2011: 2 proposed adaptation bills 2012: EPA new-source carbon rule proposed 2007-2011: A Lot of Progress 8 Work Still to Do LA Lndangerment I|nd|ng4]17]09 names CC 2 & 3 oLher CPCs as polluLanLs sub[ecL Lo regulaLlon under Lhe federal Clean Alr AcL
LA clalms LhaL CPCs endanger Lhe healLh of Lhe publlc.
2012: u.S. CourL of Appeals upholds Lhls declslon.
LAs proposed new Carbon 8ule (Mar 27 Lh 2012) llrsL naLlonwlde regulaLory llmlLs on carbon polluLlon (CPCs) from "#/ power planLs new llmlLs wlll acceleraLe Lhe shlfL from coal Lo naLural gas & cleaner alLernaLlve fuels Wlll promoLe cleaner energy Lechnologles llke Carbon CapLure & SLorage (CCS), Lrap CC2 before lL leaves smokesLack, Lhen sLore below-ground
1he 8oad Lo Lhe 8ule 1he Clean Alr AcL (CAA) requlres LA Lo seL llmlLs on alr polluLanLs LhaL LhreaLen publlc healLh and welfare.
Supreme CourL ruled ln 2007, 2011: CC2 ls a polluLanL under CAA, LA musL acL lf lL deLermlnes LhaL lL endangers healLh.
LlmlLs announced 3/27/12 conLlnue Lo honor LhaL rullng, and follow precedenLs esLabllshed ln 40 yrs of CAA uest|on S 3. 1he group charged wlLh seLLlng llmlLs on carbon polluLlon ls: a. 1he Pouse of 8epresenLaLlves b. 1he SenaLe c. 1he uS LA no currenL lederal leglslaLlon, now LA Clean Alr AcL (CAA) regulaLlon of CPCs Aprll 2010: roposed lederal regulaLlon of naLlonal fuel economy sLandards for 2016 model cars/Lrucks would lnclude CPCs for 1 sL
US Legislative & Regulatory Initiatives The Rising Tide for Global Warming Solutions November 2008
lan?C: reduce n?C CPCs 30 by 2030
Design and construction practices that significantly reduce or eliminate the negative impact of buildings on the environment and occupants in five broad areas: Energy efficiency and renewable energy Sustainable site planning Safeguarding water and water efficiency Conservation of materials and resources Indoor environmental quality C7*) $0 "/%((" 6(0$/""1 65% of total U.S. electricity consumption
32% of total U.S. greenhouse gas emissions 79% of NYC GHGs produced by 950,000 buildings (US average: 32%)
* Commerclal and resldenLlal
E'F%&#$"/ !"(%/G !--$4$("4G *"6 H("(:*I+(0B 5.$+6$"/0J One Bryant Park (Bank of America Bldg)
New 2,350,000 sq. foot office building near Times Square
The first LEED Platinum building in NYC LEED = Leadership in Energy and Environmental Design kenewab|e energy sources: So|ar ower for a 8rook|yn home STGHU=AV> W9; >1-9 1>/ !!!"#$!%&'()*&(++,"$&- ",6-6>/ X9< G2,B9> n?C 8esldenLlal cusLomers can speclfy 100 renewable power (reglonal Wlnu and/or P?u8C) lnsLead of drawlng on LradlLlonal nuclear power and fossll fuel sources ($3-9/mo exLra cosL Lo consumer) =&"!6 2&+.)$&"0 F%&/%*'B K%((" F&:(% ,--.>/00WWW326<97>6B@-16<>326D029>Y9<:6BB0Z.:67@2-[E:99< 1he Arlzona ConnecLlon !"#$%&'()*$+)'(, .)% /0+%$#+)'( #$( #'12"(3$+" 4'% 56 7 "1)33)'(3 $(89:"%" A:- #6@:-9>R XB8@> \82K<9:L #6B@D;18 H8:-, !<>-1-@-9 uest|on 6 6. WhaL ls new ?ork ClLys blggesL secLoral conLrlbuLor Lo lLs Creenhouse Cas emlsslons? a. Creenhouse gases from lndusLrles b. 1ransporLaLlon emlsslons c. 8ulldlngs energy consumpLlon d. Landfllls
1wo SLraLegles for SoluLlons M|t|gat|on L6*F)*)$&" C||mate So|ut|ons: Adaptat|on (or reparedness) 1<-9:Q9<-16<> -6 :97@29 9D1>>16<> +6: 9<,8<29 >1<K>4 6? E:99<,6@>9 E8>9> 1<1-18-1Q9> C D98>@:9> -6 :97@29 -,9 ,8:D -6 <8-@:8B C ,@D8< >R>-9D> ?:6D 2B1D8-9 2,8<E9 9??92-> n8uCs 0*%1)2# 03)"4# 53+#)2#"6 7#)*23 webslLe: local cllmaLe-healLh LhreaLs, and adapLaLlon acLlons
rocesses for declarlng an Lxcesslve PeaL Warnlng ln coordlnaLlon wlLh Lhe naLlonal WeaLher Servlce, A process for lncreaslng Lhe number of LMS resources avallable for response, AcLlvaLlon and managemenL of Lhe hlladelphla CorporaLlon for Aglng's 7#)28%"#9 ueploymenL of hlladelphla ueparLmenL of ubllc PealLh moblle Leams and dlsLrlcL envlronmenLal healLh Leams, A summary of acLlvlLles assoclaLed wlLh Code 8ed acLlvaLlons and summer ouLreach for homeless persons, A summary of Lhe procedures for acLlvaLlng coollng cenLers (alr- condlLloned faclllLles LhaL are free and open Lo Lhe publlc), 8oles and responslblllLles of uLlllLy companles regardlng halLlng servlce suspenslons due Lo non-paymenL.
uest|on 7 7. 1he sub[ecL of cllmaLe change . a. ls presenLed ln a way LhaL seems overly alarmlsL. b. makes me wanL Lo do someLhlng abouL lL. c. ls upseLLlng & makes me wanL Lo noL llsLen anymore. d. ls a Loplc lll work Lo geL a decenL grade on, buL lL doesnL really lnLeresL me Loo much.
Cll dependence Lven wlLhouL cllmaLe change, should we noL wanL Lo wean ourselves from oll and coal?
WhaL are Lhe ecologlc cosLs of our dependence on carbon for energy? Where does Lhe uS geL mosL of lLs oll? ln 1973 36 of uS oll consumpt|on was lmporLed from Lhe mlddle easL. 1oday mosL of our lmporLed oll comes from Canada, Mexlco and Afrlca. Canada ls Lhe largesL exporLer of oll Lo Lhe uS. 8uL aL whaL cosL? 1he cosL of oll producLlon ln Canada? hLLp://www.Led.com/Lalks/garLh_lenz_lmages _of_beauLy_and_devasLaLlon.hLml
Photo: Ofc of Gov. Bobby Jindal Photo: Steven Johnson/Miami Herald Photo: NRDC C|| affects ecosystems & human hea|th A C|ean Lnergy Iuture To prevent more disasters, move toward cleaner, non- polluting energy sources that wont run out Prepare for climate change impacts via preparedness Reduce carbon pollutions current sources Photo: Ken Schles Conc|us|ons LffecLs of cllmaLe change have a human face Lnergy/envlronmenLal pollcles musL alm Lo proLecL chlldren's healLh & socleLys mosL vulnerable, buL none of us are lmmune Lo cllmaLe change More healLh-harmlng changes are lnevlLable wlLhouL acLlons Lo reduce carbon polluLlon reparedness pays: proLecL healLh, avold $$ cosLs ubllc PealLh professlonals can be powerful leaders We can creaLe healLhler, more secure communlLles Cvera|| Conc|us|ons We wlll experlence Lhe lmpacL of cllmaLe change on healLh for aL leasL Lhe nexL 30+ years More changes are lnevlLable wlLhouL acLlons Lo reduce green house gas emlsslons Puman healLh & ecologlcal sysLems wlll be affecLed by energy cholces & cllmaLe change, mllllons are hlghly vulnerable, none are lmmune reparedness pays ollcles & leadershlp are needed Lo creaLe healLhler, more reslllenL communlLles nLvL8 uCu81 1PA1 A SMALL C8Cu Cl 1PCuCP1luL, CCMMl11Lu Cl1lZLnS CAn CPAnCL 1PL WC8Lu. lnuLLu, l1 lS 1PL CnL? 1PlnC 1PA1 LvL8 PAS.
-:;<=;<>5 :>;? @A ;B57<CDC8C=EA5 FGHIG J GHKL M "We know enough now to act"