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finding 18.4 : key-message-18-4
Changing climate threatens the health and well-being of people in the Northeast through more extreme weather, warmer temperatures, degradation of air and water quality, and sea level rise (very high confidence). These environmental changes are expected to lead to health-related impacts and costs, including additional deaths, emergency room visits and hospitalizations, and a lower quality of life (very high confidence). Health impacts are expected to vary by location, age, current health, and other characteristics of individuals and communities (very high confidence).
This finding is from chapter 18 of Impacts, Risks, and Adaptation in the United States: The Fourth National Climate Assessment, Volume II.
Process for developing key messages:
It is understood that authors for a regional assessment must have scientific and regional credibility in the topical areas. Each author must also be willing and interested in serving in this capacity. Author selection for the Northeast chapter proceeded as follows:
First, the U.S. Global Change Research Program (USGCRP) released a Call for Public Nominations. Interested scientists were either nominated or self-nominated and their names placed into a database. The concurrent USGCRP Call for Public Nominations also solicited scientists to serve as chapter leads. Both lists were reviewed by the USGCRP with input from the coordinating lead author (CLA) and from the National Climate Assessment (NCA) Steering Committee. All regional chapter lead (CL) authors were selected by the USGCRP at the same time. The CLA and CL then convened to review the author nominations list as a “first cut” in identifying potential chapter authors for this chapter. Using their knowledge of the Northeast’s landscape and challenges, the CLA and CL used the list of national chapter topics that would be most relevant for the region. That topical list was associated with scientific expertise and a subset of the author list.
In the second phase, the CLA and CL used both the list of nominees as well as other scientists from around the region to build an author team that was representative of the Northeast’s geography, institutional affiliation (federal agencies and academic and research institutions), depth of subject matter expertise, and knowledge of selected regional topics. Eleven authors were thus identified by December 2016, and the twelfth author was invited in April 2017 to better represent tribal knowledge in the chapter.
Lastly, the authors were contacted by the CL to determine their level of interest and willingness to serve as experts on the region's topics of water resources, agriculture and natural resources, oceans and marine ecosystems, coastal issues, health, and the built environment and urban issues.
On the due diligence of determining the region’s topical areas of focus
The first two drafts of the Northeast chapter were structured around the themes of water resources, agriculture and natural resources, oceans and marine ecosystems, coastal issues, health, and the built environment and urban issues. During the USGCRP-sponsored Regional Engagement Workshop held in Boston on February 10, 2017, feedback was solicited from approximately 150 online participants (comprising transportation officials, coastal managers, urban planners, city managers, fisheries managers, forest managers, state officials, and others) around the Northeast and other parts of the United States, on both the content of these topical areas and important focal areas for the region. Additional inputs were solicited from other in-person meetings such as the ICNet workshop and American Association of Geographers meetings, both held in April 2017. All feedback was then compiled with the lessons learned from the USGCRP CLA-CL meeting in Washington, DC, also held in April 2017. On April 28, 2017, the author team met in Burlington, Vermont, and reworked the chapter’s structure around the risk-based framing of interest to 1) changing seasonality, 2) coastal/ocean resources, 3) rural communities and livelihoods, 4) urban interconnectedness, and 5) adaptation.
Description of evidence base:
Extreme storms and temperatures, overall warmer temperatures, degradation of air and water quality, and sea level rise are all associated with adverse health outcomes from heat,6b3cd0ec-1e3e-42e8-ad82-5c12ed7ab0e8,e65c896d-395c-4347-80ed-64af1333f3a7,b151fd56-2d07-47fb-88df-173212cd5059,028a4c4b-3a7f-47b3-8a78-432fd7840f21,33b39dea-d868-4ce9-9605-1fdfd3355811,aa10dde0-072c-459a-ab20-65ba830d43bd,d7ef401f-6a34-4410-ab1e-4690f3c4d161 poor air quality,54a66159-1675-43bb-b5d3-a9b7f283e4de,70c0501a-5944-49f1-9749-2cc083802da1,59666474-282e-4dea-b833-acb24f736eaf disease-transmitting vectors,953d1436-e0d0-426c-8dcc-68e5c02eef30,5a091036-8e68-41b5-a63a-ff33b8fc1889,6c4943e6-2a76-4989-b80e-8b4d9bacd78a contaminated food and water,d746e578-c6fd-4b73-8a3c-d91365668348,bcbd5def-bcf4-454a-b744-ff131acdbf39,2312e80f-cec5-445e-aad0-ce60c9ea29e2,d03f5405-42ed-46bd-9f7f-23ba5f71bdf3 harmful algal blooms,59d0bcfb-805b-472d-b6fe-3b70bacc3d25 and traumatic stress or health service disruption.15df801e-f052-4327-9b08-47c13d894ea7,c7bb5988-e9ff-41a3-87fd-5d0a12f50fe7 The underlying susceptibility of populations determines whether or not there are health impacts from an exposure and the severity of such impacts.d7ef401f-6a34-4410-ab1e-4690f3c4d161,bb6cb91e-fd58-4222-8d22-023901f265eb
New information and remaining uncertainties:
Uncertainty remains in projections of the magnitude of future changes in particulate matter, humidity, and wildfires and how these changes may influence health risks. For example, health effects of future extreme heat may be exacerbated by future changes in absolute or relative humidity.
Health impacts are ultimately determined by not just the environmental hazard but also the amount of exposure, size and underlying susceptibility of the exposed population, and other factors such as health insurance coverage and access to timely healthcare services. In projecting future health risks, researchers acknowledge these challenges and use different analytic approaches to address this uncertainty or note it as a limitation.028a4c4b-3a7f-47b3-8a78-432fd7840f21,e805bfdc-c4c2-43a0-b2e5-5a66945c74e4,59666474-282e-4dea-b833-acb24f736eaf
In addition, there is a paucity of literature that considers the joint or cumulative impacts on health of multiple climatic hazards. Additional areas where the literature base is limited include specific health impacts related to different types of climate-related migration, the impact of climatic factors on mental health, and the specific timing and geographic range of shifting disease-carrying vectors.
Assessment of confidence based on evidence:
There is very high confidence that extreme weather, warmer temperatures, degradation of air and water quality, and sea level rise threaten the health and well-being of people in the Northeast. There is very high confidence that these climate-related environmental changes will lead to additional adverse health-related impacts and costs, including premature deaths, more emergency department visits and hospitalizations, and lower quality of life. There is very high confidence that climate-related health impacts will vary by location, age, current health, and other characteristics of individuals and communities.
- Towards more comprehensive projections of urban heat-related mortality: Estimates for New York City under multiple population, adaptation, and climate scenarios (028a4c4b)
- Climate change, extreme events and increased risk of salmonellosis in Maryland, USA: Evidence for coastal vulnerability (2312e80f)
- Heat-related morbidity and mortality in New England: Evidence for local policy (33b39dea)
- The Geographic Distribution and Economic Value of Climate Change-Related Ozone Health Impacts in the United States in 2030 (54a66159)
- Climate change impacts on projections of excess mortality at 2030 using spatially varying ozone–temperature risk surfaces (59666474)
- Ocean warming since 1982 has expanded the niche of toxic algal blooms in the North Atlantic and North Pacific oceans (59d0bcfb)
- Climate Change and Range Expansion of the Asian Tiger Mosquito (Aedes albopictus) in Northeastern USA: Implications for Public Health Practitioners (5a091036)
- Heat-related mortality and adaptation to heat in the United States (6b3cd0ec)
- Drought-induced amplification of local and regional West Nile virus infection rates in New Jersey (6c4943e6)
- The impact of climate change and emissions control on future ozone levels: Implications for human health (70c0501a)
- Climate change influences on the annual onset of Lyme disease in the United States (953d1436)
- Cause-specific risk of hospital admission related to extreme heat in older adults (aa10dde0)
- Heat stroke admissions during heat waves in 1,916 US counties for the period from 1999 to 2010 and their effect modifiers (b151fd56)
- Intra-urban vulnerability to heat-related mortality in New York City, 1997–2006 (bb6cb91e)
- Extreme precipitation events and increased risk of campylobacteriosis in Maryland, U.S.A (bcbd5def)
- Self-reported and FEMA flood exposure assessment after Hurricane Sandy: Association with mental health outcomes (c7bb5988)
- Diarrheal illness detected through syndromic surveillance after a massive power outage: New York City, August 2003 (d03f5405)
- Extreme precipitation and emergency room visits for gastrointestinal illness in areas with and without combined sewer systems: An analysis of Massachusetts data, 2003-2007 (d746e578)
- Fine-scale spatial variability of heat-related mortality in Philadelphia County, USA, from 1983-2008: A case-series analysis (d7ef401f)
- Heat and mortality in New York City since the beginning of the 20th century (e65c896d)
- Projections of temperature-attributable premature deaths in 209 U.S. cities using a cluster-based Poisson approach (e805bfdc)
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