Images of physical damage have been prominent in the news coverage of Hurricane Sandy – the charred frames of houses in Breezy Point, Queens, for example, or a roller coaster submerged in the Atlantic City breakers. Far less conspicuous are long-term health effects, from increased rates of tetanus and respiratory disease to post-traumatic stress disorder.
Given that climate change is expected to increase the frequency and severity of weather extremes, a broad new set of questions and implications is confronting the public health community. So a growing number of public health experts are recognizing the need to integrate information about climate change into their disaster preparedness and response mechanisms.
“With growing climate-related effects, the public health and disaster preparedness communities need to be planning prospectively,” said Gregg Greenough, assistant professor of global health and population at the Harvard School of Public Health. “There are huge decisions that need to be made with no easy answers and very little precedent.”
Equally important is the basic act of drawing experts from diverse disciplines around a single table to “learn one another’s languages,” said Kim Knowlton, a senior scientist at the Natural Resources Defense Council and assistant clinical professor at Columbia University. “It sounds simplistic, but really it’s not.”
One core challenge is monitoring and quantifying the connection between changing weather patterns and adverse health effects, as ailments are diffuse and arise only at the end of a very complex causal chain. Inquiry into the number of asthma cases caused by Hurricane Sandy, for instance, promises no easy answer.
“There’s no set methodology widely recognized to put these numbers together,” Dr. Knowlton said. For precisely this reason, the enormous price tag of Sandy – more than $60 billion of damages in New York State and New Jersey alone – does not reflect health care costs.
In 2011, Dr. Knowlton was the joint author of a paper that set out to tabulate the cost of six representative climate-related events projected to worsen in coming decades. From these six events, which took place between 2002 and 2009, emerged $14 billion in healthcare costs, with a high-end figure of $40 billion.
“This is “a huge underestimate of the total health costs” from “all the climate change-related events that occurred over those years, in every state,” Dr. Knowlton was quoted as saying later in an interview.
Yet as young researchers enter the field, the convergent challenges of climate change and public health are gaining visibility, she said. At this year’s annual meeting of the American Public Health Association, which took place as Hurricane Sandy made landfall, seminars explored the vast common ground between these two sciences. The Union of Concerned Scientists recently released a report on the “hidden health risks of flooding in a warming world.”
“The health community sees mounting evidence in the exam rooms, in the emergency rooms,” Dr. Knowlton. said. “We’re making the connection.”
Foremost among public health priorities, Dr. Greenough said, is “to feel comfortable with climate science, and now start to make that jump to the population.” Forecasts from climate models must be integrated with local and regional data on demography, geography and infrastructure, he said, as health planners refine their emergency response planning. “Most climate modeling and predictive mathematics have not yet drifted down to epidemiologists or disaster planners,” he said.
The recently released Atlas of Health and Climate, a collaborative project between the World Health and World Meteorological Organizations, provides one example of how disparate data sets across climate, hydrological and public health sciences might be stitched together.
In New York City, Dr. Knowlton is an active member of the Climate-Health Adaptation Workgroup, an initiative within the Mayor’s Office of Long-Term Planning and Sustainability. With assistance from the Centers for Disease Control’s Climate-Ready States and Cities Initiative, a group of New York State agencies is studying emerging climate-related threats to public health.
But, in some ways, New York’s position near the vanguard in such work only serves to underscore the monumental task that remains. “The fact is, Hurricane Sandy hit a city that is making significant efforts to be prepared for this challenge, and still tens of thousands people were harmed,” Dr. Knowlton said. “That should be really, really sobering.”