Gary Cohen

Health Care Without Harm USA

Climate Change and Human Health

Gary Cohen President, Health Care Without Harm

RUNNING A FEVER
10 Hottest Years on Record

2012

2007

2009

2002

2003

2006

2004

2001

1990 2000

2008

9 occurred in the first 12 years of this century

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Source: NASA/GISS

Chemical Dependency

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Revolution in Environmental Health Sciences

Babies in the womb and young children are more vulnerable than adults.

Chemical exposures in incredibly small doses impact the hormonal system and disrupt normal development.

Chemical exposure at critical windows of development can manifest health effects later in life. Chemicals can interact in synergistic ways in our bodies.

Body Burden Profile: Pollution in Newborns

A benchmark investigation of industrial chemicals, pollutants, and pesticides in human umbilical cord blood.
Though scientists once thought that the womb protected developing babies from pollution, a study of umbilical cord blood from newborns found an average of 200 industrial chemicals, pesticides and other pollutants in 10 newborns. Of 287 chemicals detected, 180 have been linked to cancer, 217 are neurotoxins and 208 are linked to birth defects.

OBESITY PROBLEM

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HIGH LEVEL OF STRESS AND OVERCONSUMPTION

2050 2.3X
TODAY 1.5X BALANCE 1:1

# of Planet Earths

1970s

\
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 Making the link between the environment and

health Evolving the Hippocratic Oath Leveraging the purchasing power of health care Activating health messengers for broader societal transformation Implementing a disease prevention agenda

Climate Change Framing

Climate change as ultimate environmental crisis

Melting ice caps and habitat loss

Energy Security

Kiowa County Memorial Hospital

Greensburg Kansas (USA)

May 4, 2007 tornado 1-mile wide 200 MPH winds

90% of the structures destroyed or severely damaged

21st Century Chronic Diseases

Asthma rates doubled between 1980 and 1995.

(Mannino 2002)

127 million Americans are overweight; 60 million are obese. (AOA 2006) Between 1997 and 2004 diabetes incidence increase 45% among 18-44 year olds (CDC 2005)

The Environmental Impacts of Climate Change Will Directly Impact Human Health

Infectious Disease

Waterborne diseases
Source: Living Water International / Flickr www.water.cc

Asthma

Allergies Heat Stress

Food Insecurity

West Nile Virus Activity by State 2013 (as of

September 24, 2013)

Greenhouse Gas Emissions by Country

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Health Impacts of Climate Change

Countries that have contributed least to greenhouse-gas emissions will the first and hardest hit by climate change. - Dr. Margaret Chan, Director General WHO Data from: WHO 2004
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Healthcares Critical Roles in Addressing Climate Change

Preparedness and Resilience
Climate Mitigation/Lead Transition to Low Carbon Economy Messengers Linking Climate Change and Health

Hurricane Katrina
September 2005

Memorial Medical Center New Orleans, Louisiana

St. Ritas Nursing Home

Hurricane Sandy
October 2012

Bellevue Hospital Floods and Evacuates Patients

http://abcnews.go.com/Health/york-citys-bellevue-hospital-forced-evacuate-patients-sandy/story?id=17607625

Kiowa County Memorial Hospital

1st LEED Platinum critical access hospital in US Two on-site 50kW wind turbines 59% energy savings Waste water reduced 50%

Greensburg is being rebuilt by its residents as a global

example of how clean energy can power an entire community.
President Obama, joint session of Congress, February 22, 2009

Combined Heat and Power Improves Healthcare Resilience

Invested $3 million in new CHP system

Annual Energy Savings: $500,000 Reduction in NOx from 110,000 lbs/yr to 5,600 lbs/yr Hospital was able to operate for 15 days off the grid with CHP

Hospitals energy consumption contributes to disease and rising costs

Electricity: 57 B kWh (~43% of total energy consumed)

Health impacts
(CO2, NO2, SOX, Hg emissions)

Incidents
Respiratory Symptoms Work Loss Days Asthma Attacks Premature Death Hospital Incident Visits Chronic Bronchitis

Per Year
452,561 83,798 9,521 464 420 295

Societal Value
$3,514,987,379

Direct Medical Costs

$412,831,922

Source: Estimated using Energy Impact Calculator. Does not include effects associated with other energy fuel sources: natural gas, fuel oil, and district energy.

Climate change mitigation strategies in healthcare sector

Hospitals have a mission-related incentive to reduce carbon burden
Hospitals save millions of dollars through climate mitigation

Gundersen Healthcare invested $30 million

La Crosse, Wisconsin Total Investment : $30m

Our goal is to show that we can be environmentally

sound and improve our finances at the same time."
Jeff Thompson, Gundersen CEO, Fast Company, May 2012

Gundersen Healthcare:
Community Energy Projects
Partnered with Organic Valley on wind project for Cashton, Wisconsin Partnered with dairy for waste to biogas project in Dane County Partnered with local brewery to take waste heat and develop electricity Partnered with La Crosse County on landfill methane energy project

Years ago, you would rarely hear healthcare and climate change in the same sentence..we are responsible for the health and well-being of our community.
Jeff Thompson, Gundersen CEO, Midwest Energy News, August 2013

Kaiser Permanente committed to reduce its greenhouse gas emissions by 30% by 2020
The strategy includes investing in clean and renewable energy sources while also targeting energy conservation measures Invested $24 million in renewable energy (both on-site and RECs)

"These measures will improve the overall health of our communities and

reduce our operating costs at the same time." Rame Hemstreet, Chief Energy Officer at Kaiser Permanente

Global Green and Healthy Hospitals Agenda: 10 Goals

Leadership

Chemicals

Waste

Energy

Water

Transportation

Food

Pharmaceuticals

Buildings

Purchasing

GGHH Objectives
To serve as a vibrant virtual community for hospitals and health systems seeking to reduce their environmental footprint. To chart progress in achieving measurable outputs, while sharing best practices, finding solutions to common challenges, and raising the bar. To mobilize health care around the world to work together toward and advocate for greater environmental health, locally and globally.

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IMAGINE
Cancer treatment centers built without materials linked to cancer Pediatric clinics free of chemicals that trigger asthma Hospitals with healthy food, fresh air, sunlight ...

265 hospital pilots Basis for LEED for Healthcare www.gghc.org

Philippines: SPC Health Care Ministry

16 Hospital Catholic system Mercury substitution Autoclave waste Vermiculture Food cultivation Trash to works of art

Mercury as Messenger
Seventeen year global campaign. Organizing on every continent. Global treaty signed in Japan in October, 2013 A global network of hospitals, health systems, health organizations and ministries of health.

Catholic Healthcare and Climate Change

As Catholic healthcare providers, climate change is a moral concern and our faith demands prudent action to reduce our climate footprint, protect human life and dignityand raise our voice on behalf of creation and the poor. Over 600 Catholic hospitals serve 100 million Americans

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Mercury in Health Care Coalition Evolves to Address Climate

Coal and Health Initiative CHI Goals

Generate a worldwide consensus in the health sector on coals consequences for human health. Mobilize the health sector to advocate for the phase-out and replacement of coal with healthier low-carbon sources of power. Contribute to a broader campaign-- prevent some 500 Gigawatts of coal-fired electricity from coming on line--the bulk in India and China.

Full energy chain CO2

equivalent

emissions by primary energy

Source: The Lancet, 2007; Data from IAEA, 2001.40

Health Impacts of Coal

Respiratory disease Cardiac trauma Reproductive health Neurological impairment Shortened life expectancy

Right to Environmental Health and Access to Health Care