11 - Intergovernmental Panel on Climate Change

1 70911 Human Health: Impacts,Adaptation, and Co-BenefitsCoordinating Lead Authors:Kirk R. Smith (USA), Alistair Woodward (New Zealand)Lead Authors:Diarmid Campbell-Lendrum (WHO), Dave D. Chadee (Trinidad and Tobago), Yasushi Honda(Japan), Qiyong Liu (China), Jane M. Olwoch (South Africa), Boris Revich (Russian Federation),Rainer Sauerborn (Sweden)Contributing Authors:Clara Aranda (Mexico), Helen Berry (Australia), Colin Butler (Australia), Zo Chafe (USA),Lara Cushing (USA), Kristie L. Ebi (USA), Tord Kjellstrom (New Zealand), Sari Kovats (UK),Graeme Lindsay (New Zealand), Erin Lipp (USA), Tony McMichael (Australia), Virginia Murray(UK), Osman Sankoh (Sierra Leone), Marie O Neill (USA), Seth B. Shonkoff (USA),Joan Sutherland (Trinidad and Tobago), Shelby Yamamoto (Germany)Review Editors:Ulisses Confalonieri (Brazil), Andrew Haines (UK)Volunteer Chapter Scientists:Zo Chafe (USA), Joacim Rocklov (Sweden)This chapter should be cited as:Smith, , A.

2 Woodward, D. Campbell-Lendrum, Chadee, Y. Honda, Q. Liu, Olwoch, B. Revich, andR. Sauerborn, 2014: Human health: impacts, adaptation, and co-benefits. In: Climate Change 2014: Impacts,Adaptation, and Vulnerability. Part A: Global and Sectoral Aspects. Contribution of Working Group II to theFifth Assessment Report of the Intergovernmental Panel on Climate Change [Field, , Barros, Dokken, Mach, Mastrandrea, Bilir, M. Chatterjee, Ebi, Estrada, Genova,B. Girma, Kissel, Levy, S. MacCracken, Mastrandrea, and White (eds.)]. Cambridge UniversityPress, Cambridge, United Kingdom and New York, NY, USA, pp. Summary .. Introduction ..715 Present State of Global Health ..715 Developments Since AR4 ..715 Box 11-1. Weather, Climate , and Health: A Long-Term Observational Study in African and Asian Populations.

3 715 Non- Climate Health Effects of Climate -Altering Pollutants .. How Climate Change Affects Health .. Vulnerability to Disease and Injury Due to Climate Variability and Climate Change ..717 Geographic Causes of Vulnerability ..717 Current Health Status ..717 Age and Gender ..717 Socioeconomic Status ..718 Public Health and Other Infrastructure ..718 Projections for Vulnerability .. Direct Impacts of Climate and Weather on Health ..720 Heat- and Cold-Related Impacts ..720 Mechanisms ..720 Near-Term Future ..721 Floods and Storms ..721 Mechanisms ..722 Near-Term Future ..722 Ultraviolet Radiation.

4 Ecosystem-Mediated Impacts of Climate Change on Health Outcomes ..722 Vector-Borne and Other Infectious Diseases ..722 Malaria ..722 Dengue Fever ..723 Box 11-2. Case Study: An Intervention to Control Dengue Fever ..724 Tick-Borne Diseases ..725 Other Vector-Borne Diseases ..725 Near-Term Future ..725 Food- and Water-Borne Infections ..726 Vibrios ..726 Other Parasites, Bacteria, and Viruses ..726 Near-Term Future ..727 Table of Contents711 Human Health: Impacts, Adaptation, and Co-Benefits Chapter 1111 Air Quality.

5 727 Box 11-3. Health and Economic Impacts of Climate -Altering Pollutants Other than Long-Term Outdoor Ozone Exposures ..728 Acute Air Pollution Episodes ..729 Aeroallergens ..729 Near-Term Future .. Health Impacts Heavily Mediated through Human Institutions ..730 Nutrition ..730 Mechanisms ..730 Near-Term Future ..730 Occupational Health ..731 Heat Strain and Heat Stroke ..731 Heat Exhaustion and Work Capacity Loss ..731 Other Occupational Health Concerns ..731 Near-Term Future ..732 Mental Health ..732 Violence and Conflict.

6 Adaptation to Protect Health ..733 Improving Basic Public Health and Health Care Services ..733 Health Adaptation Policies and Measures ..733 Early Warning Systems ..734 Role of Other Sectors in Health Adaptation .. Adaptation Limits Under High Levels of Warming ..735 Physiological Limits to Human Heat Tolerance ..736 Limits to Food Production and Human Nutrition ..736 Thermal Tolerance of Disease Vectors ..736 Displacement and Migration Under Extreme Warming ..736 Reliance on Infrastructure .. Co-Benefits ..737 Reduction of Co-Pollutants ..737 Outdoor Sources ..738 Household Sources ..738 Primary Co-Pollutants.

7 739 Secondary Co-Pollutants ..739 Case Studies of Co-Benefits of Air Pollution Reductions ..740712 Chapter 11 Human Health: Impacts, Adaptation, and Co-Benefits11 Access to Reproductive Health Services ..740 Birth and Pregnancy Intervals ..740 Maternal Age at Birth .. Key Uncertainties and Knowledge Gaps ..741 References ..743 Frequently Asked Questions : How does Climate Change affect human health? ..741 : Will Climate Change have benefits for health? ..742 : Who is most affected by Climate Change ? ..742 : What is the most important adaptation strategy to reduce the health impacts of Climate Change ?

8 742 : What are health co-benefits of Climate Change mitigation measures? ..74271311 Human Health: Impacts, Adaptation, and Co-Benefits Chapter 11 Executive SummaryThe health of human populations is sensitive to shifts in weather patterns and other aspects of Climate Change (very highconfidence). These effects occur directly, due to changes in temperature and precipitation and occurrence of heat waves, floods, droughts, andfires. Indirectly, health may be damaged by ecological disruptions brought on by Climate Change (crop failures, shifting patterns of diseasevectors), or social responses to Climate Change (such as displacement of populations following prolonged drought).

9 Variability in temperaturesis a risk factor in its own right, over and above the influence of average temperatures on heat-related deaths. { } Biological and socialadaptation is more difficult in a highly variable Climate than one that is more stable. { } Until mid-century Climate Change will act mainly by exacerbating health problems that already exist (very high confidence). Newconditions may emerge under Climate Change (low confidence), and existing diseases ( , food-borne infections) may extend their range intoareas that are presently unaffected (high confidence). But the largest risks will apply in populations that are currently most affected by Climate -related diseases. Thus, for example, it is expected that health losses due to Climate Change -induced undernutrition will occur mainly in areasthat are already food-insecure.

10 { }In recent decades, Climate Change has contributed to levels of ill health (likely) though the present worldwide burden of ill healthfrom Climate Change is relatively small compared with other stressors on health and is not well quantified. Rising temperatureshave increased the risk of heat-related death and illness (likely). { } Local changes in temperature and rainfall have altered distribution ofsome water-borne illnesses and disease vectors, and reduced food production for some vulnerable populations (medium confidence). { }If Climate Change continues as projected across the Representative Concentration Pathway (RCP) scenarios, the major changes in ill healthcompared to no Climate Change will occur through: Greater risk of injury, disease, and death due to more intense heat waves and fires (very high confidence) { } Increased risk of undernutrition resulting from diminished food production in poor regions (high confidence) { } Consequences for health of lost work capacity and reduced labor productivity in vulnerable populations (high confidence) { } Increased risks of food- and water-borne diseases (very high confidence) and vector-borne diseases (medium confidence) { } Modest reductions in cold-related mortality and morbidity in some areas due to fewer cold extremes (low confidence), geographical shiftsin food production, and reduced capacity of disease-carrying vectors due to exceedance of thermal thresholds (medium confidence).