The Yale-Lancet Countdown Regional Launch Event

Transcript

• 00:00<v ->Welcome everyone, I'm Robert Dubrow.</v>
• 00:03I'm a professor of Epidemiology
• 00:06and also the Faculty Director of the Yale Center
• 00:09on Climate Change and Health
• 00:11at the Yale School of Public Health.
• 00:13And welcome to this Yale Lancet Countdown launch event.
• 00:19So the Lancet Countdown on Health and Climate Change
• 00:22is an international collaboration
• 00:25that's been monitoring the health consequences
• 00:27of climate change through an annual report
• 00:30that's been published
• 00:31in the medical journal, The Lancet since 2015.
• 00:36The collaboration includes researchers
• 00:38from 43 academic institutions and UN agencies.
• 00:44And researchers from Yale
• 00:45have been part of the collaborations since 2019.
• 00:50The 2021 report was published
• 00:53in the Lancet this year on October 20th
• 00:57and that was followed
• 00:58by a Global Launch Event the following day,
• 01:01but subsequently there've also been
• 01:03regional launch events around the world.
• 01:05And this is one of those regional events.
• 01:09Given the COP26, that was just completed,
• 01:12the 2021 report which is organized around
• 01:16five domains and 44 indicators was particularly timely
• 01:21in framing the climate crisis as a public health crisis.
• 01:26So today we're gonna have five speakers
• 01:32and I'm gonna introduce them now
• 01:34and let you know what they'll talk about.
• 01:37So the first speaker is, Marina Romanello,
• 01:40who's the Research Director at the Lancet Countdown
• 01:43and the first author of the 2021 Report.
• 01:47And she's gonna give an overview and highlights
• 01:49of the Global Report.
• 01:52Then Dr. Jodi Sherman, who is a professor here at Yale,
• 01:56of both Anesthesiology and Environmental Health Sciences,
• 02:01and also the director of the Yale Program
• 02:03on Healthcare, Environmental Sustainability
• 02:06will talk about one of the indicators
• 02:09which is Healthcare Sector Emissions.
• 02:12Then I'm gonna talk about another indicator,
• 02:15which is air conditioning, benefits and harms.
• 02:19Yes sir, it's interesting Jeremy
• 02:21is a professor in the Department of Environmental
• 02:24and Occupational Health Sciences,
• 02:25Global Health and Emergency Medicine.
• 02:28And he's also the Director of the Center for Health
• 02:31and the Global Environment at the University of Washington.
• 02:34And he's gonna give an overview and highlights
• 02:37of the Lancet Countdown U.S. Policy Brief,
• 02:40which was a very important ancillary report
• 02:44that was done in conjunction with the Global Report.
• 02:47And then finally, Dr. Laura Bozzi,
• 02:50who's the Director of Programs
• 02:52at the Yale Center on Climate Change and Health
• 02:54will give an overview and highlights of
• 02:57a report that our center did
• 02:59on Climate Change and Health in Connecticut 2020 Report
• 03:02that was not associated with the Lancet Countdown,
• 03:05but nevertheless used it as a model in terms
• 03:09of organizing the report around the indicators.
• 03:12So without further ado, let me turn it over to Marina.
• 03:20Let's see (indistinct).
• 03:24<v ->Thank you Rob, thank you so much.</v>
• 03:27Let me see if I can share screen.
• 03:31Can you see my performance screen there?
• 03:36<v All>Yes.</v>
• 03:39<v ->Awesome, so I'm gonna try</v>
• 03:44to give you a very brief overview
• 03:46of the report and (mumbles)
• 03:49what the Lancet Countdown means
• 03:50but first of all,
• 03:51I really wanted to thank Yale for hosting this event.
• 03:55As Rob said, Yale is one of our key partners
• 04:00(mumbles) says it's really an honor to be here with you.
• 04:04So we are 43 partners around the world.
• 04:07The Lancet Countdown is patients
• 04:08and UN agencies around the world.
• 04:10And as Rob just said,
• 04:11we produce indicators tracking progress
• 04:13on health and climate change across impacts
• 04:15and what their response to climate change means for health
• 04:19and the data is published every year
• 04:20in a medical journal, The Lancet.
• 04:22The report that you see last year is the latest report
• 04:27that is labeled a code red for health.
• 04:28So I'm gonna tell you a bit about why that is,
• 04:30but this is just the latest of the series
• 04:33of the Lancet Countdowns Reports
• 04:36with our 5th year of iterations
• 04:38of this tracking and monitoring exercise.
• 04:43So I'll report to say that
• 04:45it's entitled a code red for a healthy future.
• 04:48And this is because across all of the indicators,
• 04:52we're tracking the impacts of climate change on health.
• 04:54We're seeing trends rapidly worsening
• 04:57and affecting particularly the most vulnerable
• 04:59in every society in every country exacerbating in this way,
• 05:03the inequities around the world.
• 05:06When we think about climate change
• 05:07the first thing that comes to mind
• 05:09is increase of heat waves, increased temperatures.
• 05:11And we're seeing that the very vulnerable population,
• 05:13people over 65 years of age are increasingly being exposed
• 05:17to life-threatening heat waves.
• 05:21(mumbles) silent killers
• 05:22they're more than just uncomfortable
• 05:24and we're seeing very vulnerable groups
• 05:25increasingly affected.
• 05:26As you can see here mainly starting the year 2010,
• 05:30really rapid increase in exposure to heat waves.
• 05:34And heat waves not only affect our health directly
• 05:38in terms of morbidity or mortality,
• 05:41but they also affect our health indirectly
• 05:42by undermining our capacity to work.
• 05:45We also monitor the extent to which heat exposure
• 05:47is reducing our labor capacity
• 05:49particularly in the agricultural sector
• 05:51we're seeing big impacts in terms of hours of labor loss
• 05:54in countries that are very vulnerable,
• 05:56the low Human Development Index country group
• 05:58and the medium Human Developments in this country group
• 06:01seeing particularly big losses.
• 06:02Especially in the agricultural sectors
• 06:05we estimate that the losses
• 06:06in the low Human Developments Index country group
• 06:08amount to 4-8% of the total GDP of those countries
• 06:11being lost due to heat exposure.
• 06:13So social determinants of health also being put at risk
• 06:16and obviously increase heat-related mortality.
• 06:19We've seen the heat waves this year in Canada,
• 06:22in (mumbles) Kazakhstan.
• 06:28And here's for sure is increasing
• 06:30as is heat-related mortality as well.
• 06:33On increased heat and increased temperatures,
• 06:35our capacity to grow crops is also reducing.
• 06:37So we're seeing crop (indistinct)
• 06:41reducing across all major staple crops,
• 06:44anywhere from three to 6% of reduction
• 06:47of crop yield potential of the 1950s baseline,
• 06:50which is even getting exacerbated by the increased land area
• 06:54being affected by extreme drought.
• 06:57The percentage of land area
• 06:58affected by extreme drought exposure
• 07:00risk about 20% of record in 2019.
• 07:05And with dry weather, hot weather
• 07:06also coming in with incidents of wildfires in the U.S.
• 07:09who have been suffering a horrendous wildfire seasons
• 07:13as a result of climate change,
• 07:14much of which we have detection attribution study
• 07:16that bring down the cause to climate change.
• 07:19As temperatures change, precipitations patterns change
• 07:22and humidity changes.
• 07:24So to does the environmental suitability
• 07:26for the transmission of infectious diseases.
• 07:28And we're seeing particular increases
• 07:30in the suitability for transmission of dengue, of malaria,
• 07:33of vibrio pathogen and vibrio cholerae
• 07:35and other vibrio bacteria as well all around the world,
• 07:38particular vibrio bacteria
• 07:39in the Pacific, North Eastern Atlantic, Northeast as well.
• 07:45So all of our indicators are flashing red,
• 07:47really raising an alarm
• 07:48to the health risks of climate change,
• 07:52but perhaps the most concerning thing is that
• 07:55not only climate change is exacerbating health impacts,
• 07:58particularly on the most vulnerable,
• 08:00but our response to climate change
• 08:02is also increasing the inequities camp.
• 08:04Also we have failed to deliver
• 08:06adjust response to COVID-19,
• 08:08we're seeing an unjust response to climate change.
• 08:13The main thing that we need to do
• 08:14in order to reduce the impacts of climate changes
• 08:17obviously to quickly adapt and decarbonize.
• 08:20And when we talk about
• 08:21climate change mitigation, decarbonization,
• 08:23the energy system is the center (indistinct),
• 08:25it is the main contributor to greenhouse gas emissions.
• 08:28As you can see in this black line,
• 08:32the carbon intensity of the global energy system,
• 08:35that is the amount of carbon dioxide produced
• 08:40per unit of energy generated,
• 08:42has not changed practically since the '70s.
• 08:45And at the pace of slow reduction
• 08:46that we've seen from 2014 to 2018,
• 08:49it would take us roughly 150 years
• 08:51to fully decarbonize our energy systems.
• 08:54The other thing that is notable here is that
• 08:56it is the high Human Development Index countries,
• 08:58the ones that are adopting technologies to decarbonize
• 09:00and to benefit from the health permanently
• 09:02to perverse decarbonization
• 09:04whereas the high Human Development Index
• 09:06and the medium Human Development Index country groups
• 09:08are still growing at a carbon intensive way,
• 09:11not benefiting from a low carbon transition.
• 09:13And the low Human Development Index country groups
• 09:15still has to do that development
• 09:19and industrialization there.
• 09:22And what this mean for health
• 09:23is that exposure to air pollution is still incredibly high.
• 09:27We have not managed to reduce exposure
• 09:29to air pollution since 2015 significantly.
• 09:32In 2019, we saw roughly 3 million deaths
• 09:35attributed to ambient PM2.5 air pollution
• 09:38the most harmful form of air pollution
• 09:40and 1/3 that came from fossil fuels.
• 09:43And as we can see here,
• 09:45this is disproportionately affecting
• 09:47the high and medium Human Development Index country groups
• 09:52that are very carbon intensive,
• 09:55but the low Human Development country groups
• 09:57is being particularly affected
• 09:58by indoor exposure to air pollution,
• 10:00to the use of dirty fuels for cooking and for heating.
• 10:02So also big inequities in the transition
• 10:05to a cleaner source of fuels.
• 10:08However, there is still some hope
• 10:09that comes from our reports
• 10:10and that's really worthwhile noting.
• 10:12When we talk again about energy system,
• 10:14while we're still lagging behind,
• 10:16we are seeing a very fast adoption
• 10:17increase in the use of renewable,
• 10:19clean, new, renewable energies for energy production,
• 10:22particularly in the U.S. and in China,
• 10:24the biggest contributors to greenhouse gas emissions,
• 10:27which is really positive.
• 10:28Total energy produced from clean sources
• 10:31has reached 7.2% in 2018, and this is still growing.
• 10:34So we do have the technology.
• 10:36And one other thing that is really worth noting
• 10:38is that the health sector that is crucial in protecting
• 10:42our health from climate change and we acknowledged that
• 10:45a climate change is a health crisis.
• 10:46They must be at the forefront
• 10:48of the fight against climate change.
• 10:51Health sector is now taking the lead
• 10:52and we've seen many commitments made during COVID
• 10:56of national health systems that have committed
• 10:59to reaching net zero by 2050,
• 11:01and over 50 health systems around the world
• 11:03committing to become more sustainable
• 11:05and more resilient to climate change.
• 11:10So just to finish off,
• 11:12I find a reflection that comes from our report,
• 11:14but also from what happened at COP26,
• 11:17we're currently exiting the COVID-19 pandemic.
• 11:21And as the world tries to recover
• 11:22around rolling trillions of funds
• 11:25towards economic reactivation and reframing.
• 11:28However, so far we see that only 18% of those trillion,
• 11:32almost $2 trillion allocated to COVID recovery
• 11:36would lead to reduction in greenhouse gas emissions.
• 11:40All the rest will have negative effects on climate change.
• 11:44So we're here at five or 10 points where we have to decide
• 11:47whether we're gonna go through a carbon intensive route
• 11:50that will lead us to a new crisis.
• 11:51A crisis of climate change impacts on health,
• 11:54and that will undermine our progress against the targets
• 11:56that we (mumbles) nationally
• 11:57determined contributions,
• 11:59or whether the world will act together
• 12:01to deliver adjust transition and make use of this moment
• 12:04to deliver a world of environmental sustainability,
• 12:09economic sustainability and growth,
• 12:12better health and reducing inequities.
• 12:15And with that, I will just close
• 12:16and invite you to visit lancetcountdown.org
• 12:18where you can explore a bit more of our indicators
• 12:21that I just gave you a very brief overview of.
• 12:26<v ->Thanks very much Marina.</v>
• 12:27<v ->(mumbles).</v>
• 12:29<v ->So next we'll have Dr. Jodi Sherman talking about</v>
• 12:34the indicator that she took the lead on.
• 12:39<v ->Thanks, can you hear me and see the screen okay?</v>
• 12:42<v All>Yes.</v>
• 12:43<v ->So my talk is going to focus</v>
• 12:46on the role of the healthcare sector,
• 12:48its contribution to climate change.
• 12:51Now, as Dr. Romanello was saying,
• 12:54we have increased demands for health services
• 12:57because of the problem,
• 12:58the myriad of health impacts of climate change,
• 13:01health care itself is ironically a significant contributor
• 13:06to global greenhouse gas emissions
• 13:08and non-greenhouse gas emissions.
• 13:10We've got a very high resource consumption industry,
• 13:14hospitals run 24/7,
• 13:16high-tech diagnostic therapeutic equipment,
• 13:19high energy intensive buildings.
• 13:21And health care is a unique risk for unique infection risks
• 13:26and prevention requirements
• 13:27that drive a lot of disposability
• 13:29and utilization of resource
• 13:31both in our energy as well as materials.
• 13:35We also live in a complex regulatory environment
• 13:39designed to protect our patients,
• 13:42patients and also occupational health,
• 13:45but we also have business models
• 13:46and that regulatory compliance and business models
• 13:48drive low volume consumption of resource.
• 13:52We also particularly in high-income nations
• 13:54and especially in the U.S. have the culture of excess
• 13:56and where disposability is normalized.
• 13:59And how can particularly, because we have a social mission
• 14:02to protect individual patients,
• 14:04we've really been neglecting about
• 14:05the impact of how care delivery affects public health
• 14:10and we can't really do that anymore.
• 14:12So the key results of the Lancet Countdown
• 14:16latest publication of 2021,
• 14:19globally health care emits 4.9%
• 14:22of total global greenhouse gas emissions.
• 14:24And this is rising at a rate of five to 6% annually.
• 14:29This is the most recent.
• 14:30There are several international studies.
• 14:31This is the most recent result.
• 14:34U.S. healthcare is an outlier and not in a good way.
• 14:37We spend twice as much
• 14:38on health care as any industrialized nation,
• 14:4118% of our GDP, health care globally is 10% of the economy.
• 14:45So if we can not want,
• 14:46should health care be leading as an industry
• 14:49and health care and all policies of protecting health,
• 14:53because we intersect with so many areas
• 14:56within the global economy,
• 14:58we have the opportunity to help drive change globally.
• 15:04Of that 4.9% emissions of health care in the U.S.
• 15:08is responsible for a 1/4 of those emissions globally,
• 15:12despite only having 4% of the global population.
• 15:17And we have the highest per capita
• 15:18health care greenhouse gas emissions.
• 15:21Now, if we have the best health outcomes for that impact,
• 15:25for those expenditures, there might be some justification,
• 15:30at least till we transition our energy sources
• 15:33and our embodied emissions but that's not really the case.
• 15:39So what we did is we associated
• 15:41per capita healthcare greenhouse gas emissions,
• 15:44along with the global burden of diseases,
• 15:46health care access, and quality index.
• 15:47This is from the 2020 paper of 2021.
• 15:50We did the same association with the Human Development Index
• 15:53and the results are the same.
• 15:55So we wanna have as low greenhouse gas emissions
• 16:00per health care capita as possible and as high performance
• 16:03in terms of health care, quality and access.
• 16:06And we can see the highest performers
• 16:07here in Europe particularly France is a notable outline
• 16:13performer in a good way versus the U.S.
• 16:15So not only do we have the highest
• 16:16per capita greenhouse gas emissions, we do not perform
• 16:19the best in terms of health care access and quality.
• 16:22And we're about 1700 kilograms of CO2
• 16:25equivalent emissions per capita for health care
• 16:29versus 450 in France.
• 16:30So 450 is around the break-even point.
• 16:33The good news is what that means
• 16:34is we can reduce our emissions
• 16:35without sacrificing quality of care.
• 16:38And in fact 11% of U.S. population is presently uninsured.
• 16:44About 1/3 of U.S. healthcare resources
• 16:46are deemed low value and inappropriate,
• 16:48it's about 1/4 globally.
• 16:50What that means is that we have room
• 16:52to improve our environmental performance
• 16:55without sacrificing quality of care
• 16:57and preserving resources to improve our access to care.
• 17:02I'm gonna shift gears
• 17:03in terms of where this information comes from.
• 17:06In order for us to understand
• 17:08where the levels of influence are,
• 17:10I'm gonna turn to the greenhouse gas protocol.
• 17:12This is from the U.K.
• 17:13National Health Service Net Zero report.
• 17:16The National Health Service in England
• 17:17is leading the world in its commitment
• 17:19to net zero emissions in health care.
• 17:21The virtue of the greenhouse gas protocol
• 17:24is it allows us to group emissions
• 17:26in terms of our influence
• 17:28so we understand the levels for change.
• 17:30So scope one, direct emissions are coming from a facility
• 17:33from burning fuel to heat the building for example,
• 17:37or release of inhaled anesthetic gases,
• 17:39so direct emissions on our scope one.
• 17:42Scope two is indirect coming from the supply chain.
• 17:45So whether or not, excuse me, is coming from electricity.
• 17:48So whether or not that is renewable or not
• 17:51affects our calculations.
• 17:53And scope three is everything else,
• 17:55most notably the supply chain and also travel.
• 17:58So applying that to the U.S. healthcare system,
• 18:02we see the most recent results
• 18:05are absolute emissions from health care in the U.S.,
• 18:08554 million metric tons
• 18:10or 8.5% of our nation's greenhouse gases
• 18:13coming just from U.S. healthcare.
• 18:16And emissions are on the rise.
• 18:19We see a slight difference in 2012
• 18:20with improvements of renewable energy in our system,
• 18:25but overall we're rising at a faster rate
• 18:29than other nations globally this far.
• 18:32And as you can see the breakdown by scopes,
• 18:34the vast majority of emissions are coming from scope three,
• 18:36which we'll come back to in a moment.
• 18:38The other thing that we did in the U.S.
• 18:39is we associated greenhouse gas
• 18:41and non-greenhouse gas emissions with disease burden
• 18:44and found that harm from health care pollution
• 18:46from U.S. healthcare pollution
• 18:48is equivalent to 388,000
• 18:50disability adjusted life years annually.
• 18:53Most of that is due to particulate matter or air pollution
• 18:57and both air pollution and greenhouse gas emissions
• 18:59come from combustion of fossil fuels.
• 19:01So cleaning up our energy system
• 19:04is one of the most important things we can do
• 19:06to reduce health care's impacts.
• 19:08And then this is similar in magnitude
• 19:10to deaths due to medical errors,
• 19:13which were first reported by this (mumbles) in 2000,
• 19:17the 44-98,000 deaths annually
• 19:20were lost due to medical errors,
• 19:22about 10 years of life loss for age
• 19:24so if you multiply by 10,
• 19:25you see we're in the same order of magnitude.
• 19:27And why that matters is that
• 19:29this harmful medical errors sparked
• 19:30the patient safety movement
• 19:31that everything we do in healthcare
• 19:33is through the lens of patient safety.
• 19:35And what we're trying to say is that this problem
• 19:36is just as big and just as serious,
• 19:39and that pollution prevention
• 19:40is a new patient safety movement
• 19:41that needs to be taken seriously.
• 19:43And so where those emissions come from
• 19:45in terms of levels of impact?
• 19:47About 4/5ths in the U.S.
• 19:49and this is similar in other health,
• 19:51this National Health (mumbles) Forfeits
• 19:53is coming from the supply chain.
• 19:55So notably, pharmaceuticals, chemicals,
• 19:57medical devices, and food.
• 19:59And these are things we have direct influence over
• 20:01as health care administrators and clinicians and regulators,
• 20:04because we determine how resources are consumed,
• 20:07manufacturers and regulators control what's embedded,
• 20:10what the emissions are that are embedded,
• 20:12what goes to marketplace.
• 20:14So this helps us to understand
• 20:15the different levels of influence.
• 20:17And ultimately the question is what is best practice
• 20:20both for patients and public health?
• 20:22And really there are three direct approaches
• 20:25to try and influence.
• 20:29One is reducing emissions embodied in healthcare service,
• 20:32so electrification of our buildings
• 20:34and our capital equipment,
• 20:35but they must be paired with cleaning up our energy sources.
• 20:39Moving to a circular economy we're using materials,
• 20:42reducing waste resource stewardship,
• 20:44which could not be more clearly needed
• 20:47as evidenced by the pandemic.
• 20:51Matching supply with the demand
• 20:52meaning we have to address inappropriate or low value care,
• 20:57care that is unwanted, unneeded, ineffective.
• 21:00All those things need to be addressed, and we can do it.
• 21:03And then reducing,
• 21:04moving all the way upstream to reducing
• 21:06the need for health care to begin with
• 21:08health promotion, disease prevention,
• 21:10addressing the social determinants of health,
• 21:12and certainly mitigating all those causes of climate change
• 21:16and ultimately value in health care, high values,
• 21:19maximizing the best benefits for patients and populations,
• 21:22minimizing costs as well as environmental and social harms.
• 21:25Thank you very much.
• 21:27<v ->Thanks, Jodi.</v>
• 21:40<v ->I think just share the screen.</v>
• 21:51<v ->Yes, everyone see?</v>
• 21:54Okay, great.
• 21:55So I'm gonna talk about indicator 2.3.2,
• 21:59which is air conditioning benefits and harms.
• 22:02I'd like to acknowledge my collaborator
• 22:04on this Lingzhi Chu and also the International Energy Agency
• 22:09for providing essential
• 22:11and published data for this indicator.
• 22:15And so let me get right to the headline finding.
• 22:19Use of air conditioning averted an estimated
• 22:22195,000 heat-related deaths
• 22:25among people 65 years or older in 2019, that's globally.
• 22:31AC however, AC also contributed to greenhouse gas emissions,
• 22:36air pollution, peak electricity demand,
• 22:39and urban heat islands.
• 22:42So we could see that on the one hand indoor cooling,
• 22:46you're represented by air conditioning
• 22:48provides great benefits.
• 22:50On the other hand there is significant harms.
• 22:53So I'll elaborate, but first let's look at this graph
• 22:58on the right-hand side.
• 23:01The blue is proportion of households with air conditioning.
• 23:05This is global.
• 23:06So you can see a steady rise and in 2019, it was about 33%.
• 23:13So a 1/3 of the households in the world
• 23:14have air conditioning.
• 23:17The green up here is carbon dioxide emissions
• 23:20and you can see a steady increase
• 23:22in carbon dioxide emissions
• 23:25as a result of air conditioning
• 23:27using more and more electricity
• 23:28because they're being more and more air conditioning.
• 23:31And in 2019, it was up to about one gigaton
• 23:36or a billion tons of carbon,
• 23:37which represents carbon dioxide,
• 23:39which represents about 3%
• 23:42of total anthropogenic CO2 emissions.
• 23:47Okay, so now let's take a deeper dive into some of this.
• 23:52Let's take a look at the bottom row first, which is world.
• 23:57So heat-related deaths were about 345,000.
• 24:01This was estimated in one of the other
• 24:05Lancet Countdown Indicators
• 24:07and note that it's just for people greater
• 24:10or equal to age 65 years.
• 24:13Heat-related deaths averted by air conditioning
• 24:16again was about 195,000.
• 24:18So what that means is that
• 24:20if there had been no air conditioning in the world,
• 24:23there would have been roughly 540,000 heat-related deaths
• 24:27in people over age 65,
• 24:29instead of the 345,000 that actually occurred
• 24:33and of course these are estimates.
• 24:37And that's with a proportion of house,
• 24:39overall proportion as I said is 33% with air conditioning.
• 24:43Let's look at a few of the countries.
• 24:45So first China was estimated
• 24:47to have 72,000 heat-related deaths
• 24:51and roughly the same number of heat-related deaths
• 24:54averted due to the presence of air conditioning.
• 24:57So without air conditioning,
• 24:59the number of heat-related deaths
• 25:01would have been about double.
• 25:03And you can see that proportion of households
• 25:05with air conditioning in China is fairly substantial.
• 25:09It's about two thirds.
• 25:11On the other hand, India is estimated to have
• 25:1646,500 heat-related deaths,
• 25:19but only 2,400 averted by air conditioning.
• 25:24And that of course is due to the small proportion
• 25:27of households with air conditioning in India
• 25:29which is about 6%.
• 25:32And then one more example,
• 25:34the United States which has a very high proportion
• 25:38of households with air conditioning,
• 25:4092% is estimated to have had about
• 25:4520,500 heat-related deaths,
• 25:49but almost 48,000 heat-related deaths averted by
• 25:53the presence of air conditioning meaning that
• 25:56if there had been no air conditioning in the United States,
• 25:59there would have been almost 70,000 heat-related deaths.
• 26:02This is all among people of age 65.
• 26:08So you could see that
• 26:09one of the points to take out of this is number one,
• 26:12indoor cooling is very effective,
• 26:14but number two, there're a lot of inequities right now.
• 26:17There are some countries
• 26:18with very low prevalence of air conditioning,
• 26:20others with very high prevalence
• 26:23and you could see how that's manifested in these numbers.
• 26:30So now let's go through the harms and a little more detail.
• 26:35Air conditioning represents 8%
• 26:38of global electricity consumption in 2019.
• 26:43I mentioned the greenhouse gas emissions, the CO2 emissions,
• 26:46but we also have the problem that the main refrigerants
• 26:51that use an air conditioning is hydrofluorocarbons
• 26:55and those are powerful greenhouse gases
• 26:57it turns out in themselves,
• 26:59and they often leak into the atmosphere
• 27:02and that's an issue.
• 27:04We were able to estimate 21,000 premature deaths
• 27:08due to PM2.5 and that's the fine particulate matter
• 27:12of emissions from fossil fuel powered electricity
• 27:16used for air conditioning in 2019, that's global.
• 27:22Air conditioning is a major contributor
• 27:24to peak electricity demand on hot days,
• 27:27often contributing to more than half of the demands
• 27:31and that contributes to power outages.
• 27:35And finally, it turns out that there's so much waste heat
• 27:39that goes from the inside to the outside
• 27:43as a result from using air conditioning,
• 27:46that it could actually contribute
• 27:48to the urban heat island effect
• 27:50as much as one degree centigrade at nighttime.
• 27:58So sustainable indoor cooling is urgently needed.
• 28:07The IEA projects that according
• 28:10to a business-as-usual scenario in 2050,
• 28:13air conditioning use will soar understandably
• 28:18because people in India deserve
• 28:20to have indoor cooling for example
• 28:22and there are a lot of people in India.
• 28:2516% of air conditioning will represent
• 28:2716% of global electricity consumption.
• 28:32It will be 2 gigatons of CO2 emissions
• 28:34instead of the current 1 gigaton.
• 28:38And in addition,
• 28:39we have the hydrofluoro carbon emission problem
• 28:42and that would represent 1-2 gigaton CO2 equivalent.
• 28:47So the goal we have before us
• 28:49is to make sustainable indoor cooling accessible
• 28:52to everyone in the world who needs it.
• 28:55So it needs to be accessible and also sustainable.
• 28:59And so this is an outline of a possible way forward.
• 29:03First, we need energy efficient building design
• 29:07through strong, enforced building codes.
• 29:10And a key element of that is to utilize lessons
• 29:15from traditional building designs
• 29:17and tropical and subtropical regions
• 29:19that over the period of centuries
• 29:21people lived in very hot climates,
• 29:24developed a lot of wisdom about how to build buildings
• 29:29that would remain cool, including by ways to provide shade,
• 29:34thermal mass, insulation and ventilation.
• 29:37And that wisdom has largely been ignored
• 29:41for the past few decades.
• 29:43So we need to return to that wisdom.
• 29:46We need strong weatherization programs
• 29:51and that's actually a justice issue too.
• 29:54We need low-tech solutions.
• 29:56Fans are often useful, also cool roofs.
• 30:02We need continuous strengthening
• 30:03of air conditioning performance standards
• 30:05and mandatory labeling.
• 30:07So for example if through technology,
• 30:10we could make air conditioning,
• 30:12several orders of magnitude more efficient,
• 30:15then it's not really onerous.
• 30:17We solve a lot of the problems.
• 30:19So air conditioning just because
• 30:21it's cold air conditioning isn't there,
• 30:23in its current form that has these major issues.
• 30:29The electricity that powers air conditioning
• 30:31needs to be zero-carbon electricity.
• 30:34We need to regulate the use
• 30:36and disposal of the refrigerants.
• 30:40There's progressing along those lines,
• 30:42the Montreal Protocol Kigali Amendment
• 30:45aims to phase out hydrofluorocarbons
• 30:48and so that needs to be actually implemented.
• 30:51We need to prevent leakage of refrigerants
• 30:55during air conditioning operation and maintenance.
• 30:58And finally, not finally, but we need to recycle
• 31:01or destroy refrigerants at the end of life
• 31:04often when air conditioners are disposed of improperly
• 31:09and then the refrigerants leak out into the atmosphere.
• 31:13And then we need to expand urban green
• 31:16and blue space to cool down cities
• 31:18so that we need less air conditioning in the first place.
• 31:22So with that I'll conclude and turn it over to Jeremy.
• 31:34<v ->Great, thanks Robert.</v>
• 31:36I'm gonna go ahead and try and share my screen.
• 31:41I think that's gonna kick yours off.
• 31:50<v ->Okay, good so you have yours on?</v>
• 31:52<v ->Yes.</v>
• 31:53<v ->Okay, great.</v>
• 31:56<v ->Excellent.</v>
• 32:01So I'm gonna give you a very brief overview
• 32:04of the U.S. policy brief for the Lancet Countdown
• 32:09on health and climate change.
• 32:14And I'm gonna start out by highlighting the goals.
• 32:17The goals of the global countdown are to influence
• 32:22global processes including the COP and so
• 32:25the report is released every year in advance of the COP.
• 32:29And the goal there
• 32:30is to introduce health into the conversation
• 32:32and it's been very successful at that over the years.
• 32:35The goals of the U.S. brief are related to that,
• 32:38but also different.
• 32:40And so one of our goals is to highlight trends in data
• 32:46from the global report that are relevant
• 32:48and specific to the U.S.
• 32:51We're also interested in promoting awareness
• 32:54and understanding of the intersections
• 32:55between climate change and health for a U.S. audience,
• 32:58which sometimes refracts these questions
• 33:02through a different set of considerations and experiences.
• 33:08We also are a very large country with a diverse population,
• 33:12and a diverse set of
• 33:15environmental climate sensitive hazards.
• 33:18And so the goal of the U.S. brief is to present findings
• 33:24through the lens of experience of populations in the U.S.
• 33:29and to highlight the very important,
• 33:31really fundamental considerations related to equity
• 33:37in these impacts for U.S. populations.
• 33:41Next, we are very keen on advancing collaboration
• 33:45within the health sector around this issue in the U.S.
• 33:48and that's a major goal of our effort
• 33:50is to organize that community.
• 33:52And then lastly, we wanna promote action by policy makers
• 33:55that is informed by the findings from the global report
• 33:59and the U.S. brief.
• 34:01So this year we produced our fifth report.
• 34:04It presented a suite of indicators
• 34:07from the global report specific to the United States,
• 34:10and also brought in some other scientific work
• 34:12that was relevant to the U.S. context.
• 34:15This brief represents the consensus
• 34:17of over 70 institutions domestically.
• 34:21And as I said, it brings in data from the global report.
• 34:26The brief this year brings in emphasis
• 34:31on three climate sensitive hazards
• 34:33that have plagued the United States in recent years;
• 34:38extreme heat, drought, and wildfires,
• 34:41and it calls for policy makers to make three commitments.
• 34:45One is an urgent investment in research and interventions
• 34:48to protect health and prioritize equity in the process.
• 34:51The second is to account for the health costs
• 34:54of fossil fuel combustion in their decision-making.
• 34:58And the third is to rapidly cut greenhouse gas emissions.
• 35:02I'm gonna go into each of those briefly,
• 35:04and then tell you a little bit about
• 35:06the report and the launch.
• 35:08So as Marina emphasized, we know from global data
• 35:15that health risks from extreme heat are growing
• 35:17and the trend is the same in the United States.
• 35:20And particularly we wanted to emphasize the impact on groups
• 35:24at different points in the life cycle.
• 35:27And this is the theme we've developed
• 35:28at different points in different ways over the years.
• 35:32The data for the U.S. shows that we continue to see
• 35:36a pretty dramatic rise in exposure among people over 65
• 35:42and among infants to extreme heat
• 35:46relative to this baseline here from 1986-2005.
• 35:52The second point is the droughts harm health.
• 35:58And this is something that
• 35:59a lot of people may not be as well aware of.
• 36:01And so we put some energy this year
• 36:05into clarifying the ways in which drought harms health
• 36:10and those are elaborated here in this infographic.
• 36:14Of course, some of the impacts
• 36:16are mediated through extreme heat exposure,
• 36:19but a number of others go through pathways
• 36:21that are a little more indirect,
• 36:22including changes in water quality,
• 36:24changes in infectious disease exposure
• 36:27and changes in infectious disease ecology
• 36:29associated with drought, impacts on mental health
• 36:32particularly in rural communities
• 36:33and then also respiratory disease impacts.
• 36:36And we also brought out the equity dimension highlighting
• 36:42the wide range in intensity of exposure
• 36:46to drought across the United States
• 36:48and then how drought affects different communities
• 36:52quite differently in its various impacts
• 36:57and particularly highlighting
• 36:58the impact on rural and farming communities.
• 37:02And then lastly, we focus this year on wildfires.
• 37:05And of course, as you all know,
• 37:06wildfire seasons have been very intense of late.
• 37:10So we collaborated with some colleagues at Emory
• 37:15who developed this figure showing that
• 37:20we're seeing earlier onset of the wildfire season,
• 37:23the wildfire season is becoming more intense,
• 37:25and that there's a clear correlation
• 37:27with temperature anomalies over this 20 year time series.
• 37:31We also emphasize in the report
• 37:33the fact that smoke exposure,
• 37:37it seems like it's a local issue
• 37:38and of course it is very intense locally
• 37:40when these fires occur mostly in the West,
• 37:42but that the smoke extends all the way over to you all
• 37:46in the Northeast and impacts
• 37:50your air quality quite adversely.
• 37:55And these impacts again
• 37:57are really not equitably distributed.
• 38:00And these communities here, Black, Latino,
• 38:02Latino communities, American Indian communities,
• 38:05and low income groups are all much more highly exposed
• 38:09and more adversely affected the groups.
• 38:13The report also developed some case studies
• 38:16and I don't have a chance
• 38:18to go into all of the specifics here,
• 38:20but we explored the role of climate change
• 38:24in increasing risk for dengue in the United States,
• 38:27particularly through increasing
• 38:29vectorial capacity and/or not.
• 38:33And then also throwing some analogies
• 38:37between the COVID pandemic energy issues
• 38:44and infrastructure challenges that we've seen,
• 38:48and then interactions with climate sensitive hazards,
• 38:52including extreme heat and wildfires
• 38:55that exacerbated the impacts
• 38:57of those hazards at multiple points.
• 39:00We experienced that definitely here
• 39:01in the Pacific Northwest
• 39:02with our extreme heat event this past summer,
• 39:06which was catastrophic
• 39:07and would have been really difficult on its own,
• 39:10but was that much more difficult to handle
• 39:13because of all of the capacity issues
• 39:15that we're focusing, we've experienced with COVID,
• 39:17and this is likely a glimpse of
• 39:20what we'll see in the future in terms of strain
• 39:22on the healthcare system driven
• 39:25certainly by climate sensitive hazards,
• 39:27but also interacting with a number of other
• 39:31elements of social destabilization
• 39:34that we're seeing in the U.S.
• 39:37So our policy recommendations are to focus on adaptation
• 39:40through research that really gets down to local levels
• 39:47and thinks through how to reduce exposure,
• 39:49how to implement effective interventions
• 39:51quickly and at scale, focusing on economics and finance,
• 39:55and do a more comprehensive accounting
• 39:58of the health-related costs of fossil fuels.
• 40:01So taking those externalities
• 40:02and incorporating them into decision-making, policy-making.
• 40:05And then lastly of course,
• 40:07an urgent focus on mitigation
• 40:09and an emphasis there on policies
• 40:12that will advance health equity
• 40:15rather than undermine it.
• 40:19We have a suite of additional resources
• 40:21in addition to our policy brief,
• 40:23we have executive summaries,
• 40:24we have briefs that are aimed at the general public
• 40:29both of those are in English and Spanish.
• 40:32We have a brief that
• 40:34is written specifically for health professionals,
• 40:36and we have a brief that focuses on the novel science
• 40:39that is in this year's report.
• 40:42We also have regional briefs that emphasize impacts
• 40:47for different areas of the United States.
• 40:50And we have a big launch event every year
• 40:53and it coincides with the launch of the global report
• 40:56and we really work hard with our partner Climate Nexus
• 41:01to bring in a diverse range of voices and perspectives,
• 41:07and to reach a large range
• 41:11of communities with this launch.
• 41:13And so you can see here we had
• 41:15a really nice diverse collection of speakers
• 41:20at this last year's event which was recorded,
• 41:24and you can access the recording
• 41:26and all of those other resources at this link here,
• 41:29lancetcountdownus.org.
• 41:32Thanks and I look forward to ongoing conversation
• 41:35and answering your questions later in the session.
• 41:39<v ->Thanks, Jeremy.</v>
• 41:41Okay, so last but not least is Laura Bozzi
• 41:45who's gonna talk about the Connecticut Report.
• 41:48<v ->Thank you, and I also wanna acknowledge</v>
• 41:54my (mumbles) about (indistinct)
• 41:58on the appointment I wanna talk about today.
• 42:02So last September the Yale Center
• 42:04on Climate Change and Health released
• 42:05the Climate Change and Health 2020 Report.
• 42:08I mentioned it during initial inspiration
• 42:10from the global Lancet Countdown (mumbles).
• 42:13It's one of those with the recognition
• 42:14that there was a gap and clear information
• 42:16specific to Connecticut on how climate change (mumbles).
• 42:21The report is based on 19 Indicators,
• 42:23you can see on the right,
• 42:24tracking changes to the environment
• 42:26and health outcomes.
• 42:27It's purpose is to inform policy makers,
• 42:30health professionals, advocates, and residents,
• 42:32about the impacts of climate change
• 42:34now in the future on human health in Connecticut.
• 42:37Wherever possible,
• 42:38we were printed indicator results for each county.
• 42:41There are eight counties in Connecticut.
• 42:42We talked as far back as the dataset would allow
• 42:45and some cases to the late 1800s.
• 42:48Some of our indicators
• 42:50do already demonstrate a trend consistent
• 42:52with what's expected under climate change,
• 42:55such as increasing the average temperature
• 42:57or rising number of heavy rainfall events.
• 43:00Other indicators don't yet show a trend,
• 43:02but scientific studies project such changes
• 43:06(indistinct).
• 43:10We also produced an issue for each series,
• 43:12three of what you see here.
• 43:14The issue briefs (mumbles) the 2020 reports for domains,
• 43:18summarizing key indicator findings,
• 43:20and extending the report
• 43:21to include specific policy requisitions.
• 43:27An important theme of the 2020 report
• 43:29and the issue briefs is recognition of climate change
• 43:31as an environmental justice issue.
• 43:34A climate change affects everyone we know
• 43:36but some people are hit much harder.
• 43:38It's often called a risk amplifier or a threat multiplier.
• 43:42Some people are more vulnerable than others
• 43:44because of where they live or work, their age or race,
• 43:48their health condition, their socioeconomic status.
• 43:51These underlying drivers of vulnerability
• 43:53are often tied to deep among standing inequities
• 43:56which are now made worse by climate change.
• 43:59Our issue briefs in particular elevate policy solutions
• 44:02that apply a justice or an equity lens in response.
• 44:08I'll now turn to some examples of our indicators
• 44:11following that they're ports for domains
• 44:13beginning with temperature.
• 44:17Annual average temperature
• 44:18has increased over three degrees Fahrenheit
• 44:20across Connecticut and in each county
• 44:22in the last 125 years.
• 44:25Over that time, six of the hottest years in Connecticut
• 44:28have been since 2005
• 44:30versus has very broad implications for health
• 44:33among other impacts, high heat days causing stress,
• 44:36heat stroke and even death.
• 44:38High heat days often coincide with close and alert days
• 44:41because high temperatures magnify those official levels.
• 44:45Annual winter temperatures
• 44:46that we're seeing now in here in Connecticut this year
• 44:50can create conditions for larger tick
• 44:52and mosquito populations that are active
• 44:54over a greater proportion of the year.
• 44:56A longer season for ragweed pollen,
• 44:58which causes hay fever and exacerbates asthma.
• 45:03And particular in heat-related illness,
• 45:07we tracked reported cases of heat stress in Connecticut
• 45:10and found that from 2007-2016 there were on average
• 45:14422 emergency department visits
• 45:16and 45 hospitalizations per year for heat stress
• 45:20but this is certainly an underestimate.
• 45:23Young adults were more likely to be admitted to the ED
• 45:26for heat-related illness than other age groups,
• 45:29but the risk of inpatient admission increases with age
• 45:33and is highest for those 75 and older.
• 45:37Heat risks can be confounded
• 45:38to do the urban heat island effect.
• 45:40As you can see on the right
• 45:42that cities are hotter than the surrounding area
• 45:45because of more manmade infrastructure that absorbs heat
• 45:48as well as air conditioning accepted by (mumbles).
• 45:52This health risk is magnified for those low financial
• 45:55or social resources to adapt.
• 45:57And importantly vulnerability factors are cumulative.
• 46:00Some people are associated
• 46:01with a number of the categories that are on the left,
• 46:04which puts them at people greater risk.
• 46:07As we look to the future,
• 46:10the Governor's Council on Climate Change reported five
• 46:14projected five degree very high increase
• 46:16in average temperature by 2015 in Connecticut
• 46:21compared to a 1978 and 1999 reference period.
• 46:26So we can expect more extreme heat events
• 46:29for them to become more common
• 46:30and more severe and to last longer.
• 46:32Importantly temperature increases after 2050
• 46:35depends on how quickly we stop emitting greenhouse gases.
• 46:38And thus the Governor's Council on Climate Change said,
• 46:39"Coordinated mitigation now means it is more likely
• 46:42"the temperatures will stabilize after 2050.
• 46:45"If not, warming is likely to accelerate."
• 46:49Moving to extreme events.
• 46:53We tracked national or really declared weather disasters
• 46:58that were issued for Connecticut
• 46:59and found that from 2010-2019,
• 47:02there were nine such disaster declarations
• 47:04compared to only 13 in the previous 56 years.
• 47:09In addition to direct health apart from weather disasters,
• 47:11there're important indirect effects,
• 47:15including disruptions that can occur
• 47:17to critical infrastructure, assessment of electricity,
• 47:20drinking water, food refrigeration, internet service,
• 47:24transportation is one implication of health,
• 47:27losing our electricity can be life-threatening
• 47:29for someone who uses home dialysis.
• 47:32There are mental health impacts from the trauma of disasters
• 47:36and their long-term community impacts.
• 47:39And the building staff and lower income communities,
• 47:41the doctrine that increased risk
• 47:42for damage by natural disasters,
• 47:45partly because of historic patterns
• 47:47of development in vulnerable areas,
• 47:50plus a chronic under investment in public infrastructure
• 47:52(indistinct).
• 48:00We tracked Lyme disease cases in Connecticut
• 48:04and found that the number of cases in the last decade or so
• 48:07have decreased statewide, which is good news.
• 48:10However, there are emerging concerns
• 48:13when issues we highlighted at the report
• 48:15is expansion of the lone star tick in Connecticut.
• 48:18Once a tick transmit a number of diseases
• 48:20and medical conditions that you can see on the slide,
• 48:24it's the most common human biting tick
• 48:25in the Southeastern U.S.
• 48:28It's expanding into Connecticut likely due to factors,
• 48:31including warming temperatures
• 48:33and especially warmer winters.
• 48:36Importantly established breeding populations
• 48:38were discovered in Fairfield County in 2018
• 48:41and New Haven County where we are today in 2019,
• 48:44meaning that ticks aren't transient but established here.
• 48:49Finally air quality.
• 48:52You may be aware that Connecticut has issues
• 48:54with ground-level ozone solutions
• 48:57which is a strong long year attempt.
• 48:59And back to the American Lung Association gave each county
• 49:02thinking that getting an upgrade for ozone solution
• 49:04in its 2019 report.
• 49:07And as you can see from this figure,
• 49:11we found that while the number
• 49:12of air quality alert days for ozone decreased over time,
• 49:17the more still needs to be done.
• 49:19Ground-level ozone is largely
• 49:21the result of burning fossil fuels,
• 49:23whether in our vehicles or power plants or our homes.
• 49:26So this is where we can see the strong health benefit
• 49:28of climate mitigation as other speakers have mentioned.
• 49:32Switching into clean energy sources also drives,
• 49:35also reduces fuse drivers of global air pollution.
• 49:40And on that note I'll conclude
• 49:42with our systems level recommendations
• 49:44that we have in our report.
• 49:46I invite you to read the report to learn more about those,
• 49:49but I'll conclude with our overarching recommendation
• 49:54for swift action to reduce
• 49:56and eliminate greenhouse gas emissions in Connecticut
• 49:59for our health today and for the future.
• 50:07<v ->Thanks Laura.</v>
• 50:08Think we could end it here.
• 50:10Thanks to all the speakers
• 50:12and thanks to everyone who attended and have a good day.
• 50:20<v ->Thank you everyone.</v>