Protecting the Health and
Well-Being of Communities
in a Changing Climate
PROCEEDINGS OF A WORKSHOP
Leslie Pray, Rapporteur
Roundtable on Population Health Improvement
Roundtable on Environmental Health Sciences, Research, and Medicine
Board on Population Health and Public Health Practice
Health and Medicine Division
THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu
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This activity was supported by contracts between the National Academy of Sciences and AAMC, Aetna Foundation (#1002892), The California Endowment (#10003309), Dartmouth Hitchcock Medical Center, Exxon Mobil, General Electric Company (#10003080), Fannie Rippel Foundation, HealthPartners, Health Resources and Services Administration (DHHS-10003351), Kaiser Permanente (#10002957), Kresge Foundation (#10002910), Low Income Invest Fund, National Association of County & City Health Officials (#10003582), Nemours, New York State Health Foundation (#10002907), NIEHS (DHHS-10003294), NYU Langone School of Medicine, Office of the Assistant Secretary for Health (DHHS-10003388), Robert Wood Johnson Foundation (#10002897), Samueli Institute, and Wake Forest Baptist Medical Center. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.
International Standard Book Number-13: 978-0-309-46345-4
International Standard Book Number-10: 0-309-46345-9
Digital Object Identifier: https://doi.org/10.17226/24846
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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2018. Protecting the health and well-being of communities in a changing climate: Proceedings of a workshop. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/24846.
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PLANNING COMMITTEE ON PROTECTING THE HEALTH AND WELL-BEING OF COMMUNITIES IN A CHANGING CLIMATE1
HENRY ANDERSON, Adjunct Professor, Occupational and Environmental Health, University of Wisconsin Department of Population Health Sciences; former Chief Medical Officer, Wisconsin Division of Public Health
PAUL A. BIEDRZYCKI, Director, Disease Control and Environmental Health, City of Milwaukee Health Department
JOHN BOLDUC, Environmental Planner, Cambridge Community Development Department
KATHY GERWIG, Vice President, Employee Safety, Health and Wellness, and Environmental Stewardship Officer, Kaiser Permanente
SURILI PATEL, Senior Program Manager, Environmental Health, American Public Health Association
LINDA RUDOLPH, Director, Climate Change and Public Health Project, Public Health Institute
Health and Medicine Division Staff
ALINA BACIU, Activity Co-Director
KATHLEEN STRATTON, Activity Co-Director
HOPE HARE, Administrative Assistant
ROSE MARIE MARTINEZ, Senior Board Director, Board on Population Health and Public Health Practice
Consultant
LESLIE PRAY, Rapporteur
__________________
1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the rapporteur and the institution.
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ROUNDTABLE ON POPULATION HEALTH IMPROVEMENT1
GEORGE J. ISHAM (Co-Chair), Senior Advisor, HealthPartners; Senior Fellow, HealthPartners Institute for Education and Research
SANNE MAGNAN (Co-Chair), Adjunct Assistant Professor, University of Minnesota
PHILIP M. ALBERTI, Senior Director, Health Equity Research and Policy, Association of American Medical Colleges
TERRY ALLAN, Health Commissioner, Cuyahoga County Board of Health
JOHN AUERBACH, Executive Director, Trust for America’s Health
CATHY BAASE, Chair, Board of Directors, Michigan Health Improvement Alliance; Consultant for Health Strategy, The Dow Chemical Company
RAPHAEL BOSTIC, Judith and John Bedrosian Chair in Governance and the Public Enterprise; Director, Bedrosian Center on Governance, University of Southern California
DEBBIE I. CHANG, Senior Vice President, Nemours
CHARLES J. FAZIO, Senior Vice President and Medical Director, HealthPartners
GEORGE R. FLORES, Senior Program Officer, The California Endowment
KATHY GERWIG, Vice President, Employee Safety, Health and Wellness and Environmental Stewardship Officer, Kaiser Permanente
ALAN GILBERT, Director of Global Government and NGO Strategies, GE Healthymagination
MARY LOU GOEKE, Executive Director, United Way of Santa Cruz County
MARTHE GOLD, Senior Scholar in Residence, The New York Academy of Medicine
MARC N. GOUREVITCH, Muriel G. and George W. Singer Professor of Population Health, Department of Population Health; Professor, Department of Medicine; Professor, Department of Psychiatry; Chair of the Department of Population Health, New York University School of Medicine
GARTH GRAHAM, President, Aetna Foundation
GARY R. GUNDERSON, Vice President, Faith Health, Wake Forest University
WAYNE JONAS, Executive Director, H & S Ventures
ROBERT M. KAPLAN, Professor, Stanford University
___________________
1 The National Academies of Sciences, Engineering, and Medicine’s forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteur and the institution.
DAVID A. KINDIG, Professor Emeritus of Population Health Sciences; Emeritus Vice Chancellor for Health Sciences, University of Wisconsin–Madison
PAULA M. LANTZ, Associate Dean for Academic Affairs and Professor of Public Policy, University of Michigan
MICHELLE LARKIN, Associate Vice President, Associate Chief of Staff, Robert Wood Johnson Foundation
THOMAS A. LAVEIST, Professor and Chair, Department of Health Policy, Milken Institute School of Public Health, The George Washington University
JEFFREY LEVI, Professor, Milken Institute School of Public Health, The George Washington University
SARAH R. LINDE, Chief Public Health Officer, Health Resources and Services Administration
SHARRIE McINTOSH, Vice President for Programs, New York State Health Foundation
PHYLLIS D. MEADOWS, Senior Fellow, Health Program, The Kresge Foundation
BOBBY MILSTEIN, Director, ReThink Health
JOSÉ T. MONTERO, Director, Office for State, Tribal, Local and Territorial Support; Deputy Director, Centers for Disease Control and Prevention
MARY PITTMAN, President and CEO, Public Health Institute
PAMELA RUSSO, Senior Program Officer, Robert Wood Johnson Foundation
JAMES N. WEINSTEIN, CEO and President, Dartmouth-Hitchcock, Peggy Y. Thomson Professor, Evaluative Clinical Sciences, Dartmouth-Hitchcock Medical Center
Roundtable on Population Health Improvement Staff
ALINA BACIU, Director
CARLA ALVARADO, Program Officer (from October 2017)
KIMANI HAMILTON-WRAY, Senior Program Assistant (from April 2017)
DARLA THOMPSON, Program Officer (until August 2017)
ROSE MARIE MARTINEZ, Senior Board Director, Board on Population Health and Public Health Practice
ROUNDTABLE ON ENVIRONMENTAL HEALTH SCIENCES, RESEARCH, AND MEDICINE1
FRANK LOY (Chair), U.S. Representative to the 66th Session of the General Assembly of the United Nations
LYNN R. GOLDMAN (Vice Chair), Professor, Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University
HENRY A. ANDERSON, Adjunct Professor, Occupational and Environmental Health, University of Wisconsin Department of Population Health Sciences; former Chief Medical Officer, Wisconsin Division of Public Health
JOHN M. BALBUS, Senior Advisor for Public Health, National Institute of Environmental Health Sciences, National Institutes of Health
FAIYAZ BHOJANI, Chief Medical Officer, Global Manufacturing and Chemicals, Royal Dutch Shell
LINDA S. BIRNBAUM, National Institute of Environmental Health Sciences, National Institutes of Health
WAYNE E. CASCIO, Director, Environmental Public Health Division, National Health and Environmental Effects Research Laboratory, Environmental Protection Agency Initiative Office of Public Engagement
LUZ CLAUDIO, Associate Professor, Community Outreach & Education, Mount Sinai School of Medicine
DENNIS J. DEVLIN, Senior Environmental Health Advisor, ExxonMobil Corporation
RICHARD A. FENSKE, Professor and Associate Chair, School of Public Health and Community Medicine, University of Washington
DAVID D. FUKUZAWA, Managing Director, Health, The Kresge Foundation
BERNARD D. GOLDSTEIN, Consultant, Department of Environmental and Occupational Health, Graduate School of Public Health, University of Pittsburgh
RICHARD J. JACKSON, Professor and Chair, Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles
SUZETTE M. KIMBALL, Senior Advisor, Office of the Director, U.S. Geological Survey, U.S. Department of the Interior
___________________
1 The National Academies of Sciences, Engineering, and Medicine’s forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteur and the institution.
JAY LEMERY, Assistant Professor of Emergency Medicine; President, Wilderness Medical Society, School of Medicine, University of Colorado Denver
MAUREEN Y. LICHTVELD, Professor and Chair, Freeport McMoRan Chair of Environmental Policy; Director, GROWH Research Consortium; and Director, Center for Gulf Coast Environmental Health Research, Leadership and Strategic Initiatives, Tulane University School of Public Health and Tropical Medicine; and Associate Director, Population Sciences, Louisiana Cancer Research Consortium
AL MCGARTLAND, Office Director, National Center for Environmental Economics, Environmental Protection Agency
DAVID M. MICHAELS, Professor, Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University
SUSAN L. SANTOS, Assistant Professor, School of Public Health, Rutgers University
KIRK P. SMITH, Professor of Global Environmental Health, School of Public Health, University of California, Berkeley
AGNES SOARES DA SILVA, Regional Advisor, Sustainable Development and Health Equity, Pan American Health Organization/World Health Organization
JOHN D. SPENGLER, Professor, Environmental Health and Human Habitation, Harvard T.H. Chan School of Public Health
G. DAVID TILMAN, Director, Cedar Creek Ecosystem Science Reserve; Regents Professor, Department of Ecology, Evolution and Behavior, University of Minnesota
JULI TRTANJ, One Health and Integrated Climate and Weather Extremes Research Lead, Climate Program Office, National Oceanic and Atmospheric Administration
PATRICIA VERDUIN, Chief Technology Officer, Global Research & Development, Colgate-Palmolive Company
DICK ZIMMER, former Congressman, Zimmer Strategies, Inc.
Roundtable on Environmental Health Sciences, Research, and Medicine Staff
KATHLEEN STRATTON, Director
HOPE HARE, Administrative Assistant
ROSE MARIE MARTINEZ, Senior Board Director, Board on Population Health and Public Health Practice
Reviewers
This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.
We thank the following individuals for their review of this proceedings:
PHILIP M. ALBERTI, Association of American Medical Colleges
WAYNE CASCIO, National Health and Environmental Effects Research Laboratory
ALLISON GOST, Maryland Institute for Applied Environmental Health
MAUREEN LICHTVELD, Tulane University
Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by DEREK YACH of The Vitality Group. He was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteur and the National Academies.
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Contents
Organization of the Workshop and This Proceedings
The Global Climate Crisis: Large Health Risks and Opportunities
3 REGIONAL PERSPECTIVES FROM THE SOUTH
Louisville Metro Government Office of Sustainability
Faith in Landscape Stewardship
4 REGIONAL PERSPECTIVES FROM THE MIDWEST
Local Public Health Perspectives: Climate Health Preparedness and Response
Protecting the Health and Well-Being of Communities in a Changing World
5 REGIONAL PERSPECTIVES FROM THE NORTHEAST
Health Care Emergency Preparedness in New York City
Planning for Climate Change in New Hampshire
City of Baltimore: Community Resilience in a Changing Climate
6 REGIONAL PERSPECTIVES FROM THE WEST
Climate + Community Health + Health Care in the West
California’s Innovative Climate and Agriculture Policies
A Perspective from The Institute for Tribal Environmental Professionals
Boxes, Figures, and Table
BOXES
2-1 Key Points Made by Individual Speakers
3-1 Key Points Made by Individual Speakers
4-1 Key Points Made by Individual Speakers
5-1 Key Points Made by Individual Speakers
6-1 Key Points Made by Individual Speakers
FIGURES
2-2 Three scenarios for the Earth’s temperature show the importance of applying a health frame
2-3 Effects of physical activity on relative risk for several health outcomes
3-2 Cumulative pollution overlay
4-2 First U.S. health system heated, powered, and cooled by local renewable energy
5-1 BRACE (Building Resilience Against Climate Effects) framework
5-2 New Hampshire Social Vulnerability Index (SVI)
5-3 Shocks and stresses affecting the City of Baltimore
TABLE
6-1 2016 Kaiser Permanente Prioritized Community Health Needs