finding 9.2 : existing-health-threats-amplified

Climate change will, absent other changes, amplify some of the existing health threats the nation now faces. Certain people and communities are especially vulnerable, including children, the elderly, the sick, the poor, and some communities of color.

This finding is from chapter 9 of Climate Change Impacts in the United States: The Third National Climate Assessment.

Process for developing key messages: The key messages were developed during technical discussions and expert deliberation at a two-day meeting of the eight chapter Lead Authors, plus Susan Hassol and Daniel Glick, held in Boulder, Colorado May 8-9, 2012; through multiple technical discussions via six teleconferences from January through June 2012, and an author team call to finalize the Traceable Account draft language on Oct 12, 2012; and through other various communications on points of detail and issues of expert judgment in the interim. The author team also engaged in targeted consultations during multiple exchanges with Contributing Authors, who provided additional expertise on subsets of the key message. These discussions were held after a review of the technical inputs and associated literature pertaining to human health, including a literature review,5836b5e1-c6fa-4eaa-b453-93304c3021d5 workshop reports for the Northwest and Southeast United States, and additional technical inputs on a variety of topics.

Description of evidence base: The key message and supporting text summarizes extensive evidence documented in several foundational technical inputs prepared for this chapter, including a literature review5836b5e1-c6fa-4eaa-b453-93304c3021d5 and workshop reports for the Northwest and Southeast regions.95f971d1-7189-4dd5-8949-447d2fceba57 Nearly 60 additional technical inputs related to human health were received and reviewed as part of the Federal Register Notice solicitation for public input. Current epidemiological evidence on climate-sensitive health outcomes in the U.S. indicates that health impacts will differ substantially by location, pathway of exposure, underlying susceptibility, and adaptive capacity. These disparities in health impacts will largely result from differences in the distribution of individual attributes in a population that confers vulnerability (age, socioeconomic status, and race), attributes of place that reduce or amplify exposure (floodplain, coastal zone, and urban heat island), and the resilience of critical public health infrastructure. Amplification of existing health threats: The effects of extreme heat and heat waves, projected worsening air pollution and asthma, extreme rainfall and flooding, and displacement and injuries associated with extreme weather events, fueled by climate change, are already substantial public health issues. Trends projected under a changing climate are projected to exacerbate these health effects in the future.089d8050-f4c8-4d07-bc35-25bf61691be3 Children: The effects of climate change increase vulnerability of children to extreme heat, and increased health damage (morbidity, mortality) resulting from heat waves has been well documented.0b3b0345-837c-4be4-9e68-6dd8d6ea5e51 0e8764f8-e7e0-44b4-89cc-218100c5049f 7de011b1-2d12-48e0-b3e1-0d81e4a8a7d6 315edcf2-107b-449d-b694-5d5a3c87ebbb 6168163c-2f61-4593-810e-fe389a8f7834 d58c7033-ae9f-4607-95b8-3a6abbc71506 Extreme heat also causes more pediatric deaths,28b8aa29-bfe6-4d88-b73f-fe736f5042b6 f150b127-71ae-4dd2-b414-5590dcfbb80e and more emergency room visits and hospital admissions.7ca0e947-163a-46f3-9274-cea209b94510 7ed57375-4f4f-4157-9784-0d09fb2beae1 7f0eb22c-9da0-4cc2-a04f-3bcbbbef317d 22344c1d-cee2-4f9d-91c0-60ceb6e9ca57 Adverse effects from increased heavy precipitation can lead to more pediatric deaths, waterborne diseases,91493d3b-4841-4022-860a-46f961ff4534 and illness.3c45d8a9-1195-4769-84da-bbb7d35a86d7 The elderly: Heat stress is especially damaging to the health of older people,71cceabc-45d8-4b40-bb94-30755e6db7d3 7ca0e947-163a-46f3-9274-cea209b94510 bdea0759-701d-4183-9966-cee3ce977e08 8bf8d41a-8b94-4ec2-95f0-cfd77b48685e b00a1349-fb5f-4e2d-b1bc-cfceb0863de2 5836b5e1-c6fa-4eaa-b453-93304c3021d5 as are climate-sensitive increases in air pollution. The sick: People and communities lacking the resources to adapt or to enhance mobility and escape health-sensitive situations are at relatively high risk.5f587662-8664-420f-8045-196e2bb7ec0d The poor: People and communities lacking the resources to adapt or to move and escape health-sensitive situations are at relatively high risk.5f587662-8664-420f-8045-196e2bb7ec0d Some communities of color: There are racial disparities in climate-sensitive exposures to extreme heat in urban areas, and in access to means of adaptation – for example air conditioning use.ea6394c5-29f9-4e05-a003-a7fe1294d1ca 1aca1900-c64c-4624-a696-3aab59ba6673 03a60a7d-e54d-4f82-bcc4-aec34d63b0ac 19c0ac33-832f-402b-a027-201bf0faf336 There are also racial disparities in withstanding, and recovering from, extreme weather events.60c1199f-692f-4e77-bd9b-15ae136141e7 80fdf62d-1858-4128-91d2-a87888a2fc00 Climate change will disproportionately impact low-income communities and some communities of color, raising environmental justice concerns.de5b6f9d-388d-4f67-8115-ad5fca6a95d5 ea6394c5-29f9-4e05-a003-a7fe1294d1ca 1aca1900-c64c-4624-a696-3aab59ba6673 0029eba2-f4a7-4d12-bd24-4f677da92109 60c1199f-692f-4e77-bd9b-15ae136141e7 03a60a7d-e54d-4f82-bcc4-aec34d63b0ac 7ed0591e-06c2-488f-bf19-1b3bbb520214 5f587662-8664-420f-8045-196e2bb7ec0d Existing health disparities3f2402c5-22aa-4f75-861e-f6aca127cd1f b4732765-ecb5-4098-81a2-58f8b2d77f83 27dc34c7-af90-41db-9e6d-7cc5bf34e6cf 79a37f77-26ef-4bdb-b5d4-2f7f2de1e288 6177fcba-e6ac-48c8-aed7-ef5eed7b1b9c and other inequities7ed0591e-06c2-488f-bf19-1b3bbb520214 increase vulnerability. For example, Hurricane Katrina demonstrated how vulnerable these populations were to extreme weather events because many low-income and of-color New Orleans residents were killed, injured, or had difficulty evacuating and recovering from the storm.60c1199f-692f-4e77-bd9b-15ae136141e7 80fdf62d-1858-4128-91d2-a87888a2fc00 Other climate change related issues that have an equity component include heat waves and air quality.de5b6f9d-388d-4f67-8115-ad5fca6a95d5 ea6394c5-29f9-4e05-a003-a7fe1294d1ca 0029eba2-f4a7-4d12-bd24-4f677da92109 5f587662-8664-420f-8045-196e2bb7ec0d

New information and remaining uncertainties: Important new evidence71cceabc-45d8-4b40-bb94-30755e6db7d3 confirmed findings from a prior literature review.de5b6f9d-388d-4f67-8115-ad5fca6a95d5 The potential for specific climate-vulnerable communities to experience highly harmful health effects is not entirely clear in specific regions and on specific time frames due to uncertainties in rates of adaptation and uncertainties about the outcome of public health interventions currently being implemented that aim to address underlying health disparities and determinants of health.83c3a726-2925-4e5c-afcb-eb63c56f1164 The public health community has not routinely conducted evaluations of the overall success of adaptation interventions or of particular elements of those interventions.

Assessment of confidence based on evidence: Given the evidence base and remaining uncertainties, confidence that climate change will amplify existing health threats: Very High. Among those especially vulnerable are: Children: Very High. The elderly: Very High. The sick: Very High. The poor: Very High.

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