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The Health Impacts of Climate Change in Washington State

(And what we can do)

Chris Covert-Bowlds, MD,

Presentation created by Howard Frumkin, M.D., Dr.P.H., FACP

Emeritus Professor, Environmental and Occupational Health Sciences

University of Washington School of Public Health

https://docs.google.com/presentation/u/0/?authuser=0&usp=slides_web

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Health impacts of climate change, what we can do

Heat/droughts
Wildfires/smoke
Sea level rise, floods
Harmful algal blooms
Infections
Loss of livelihood
Mental health impacts
What we can do

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High temperatures in western Washington on June 28, 2021. Source: National Weather Service

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Counts of heat-related emergency department visits across the Pacific Northwest (WA, OR, AK, and ID) during 2021 (right panel) and, for comparison, during 2019 (left panel)

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In addition to fatalities, crime rates rise on hotter days. Heat may also predispose people to self-harm; some studies link high temperatures with suicide. Heat increases the risk of kidney disease—especially for outdoor workers without adequate cooling breaks and hydration. Adverse pregnancy outcomes—preterm birth and low birthweight—increase with heat. Heat increases food and water bacterial contamination; the incidence of severe diarrhea such as shigella and campylobacter rises during hot weather. Heat worsens children’s academic performance. Hot weather worsens sleep; sleep deprivation, in turn, is a risk factor for inflammatory, metabolic, neuroendocrine, and cardiovascular conditions. Workplace injuries rise during hot weather. People reduce their physical activity during hot weather, including the cancellation of sports events; less summertime physical activity reduces important health-promoting opportunity. Heat also reduces work capacity, affecting outdoor workers such as police officers, farm workers, and construction workers, and workers in non-air-conditioned facilities, to the point that economic output may decline substantially. Planting trees, opening cooling centers and proactive community outreach to vulnerable may reduce health risks.

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nytimes.com/interactive/2021/08/11/climate/deaths-pacific-northwest-heat-wave.html

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Local ways to reduce harms of heat

Plant trees, support groups that do
Use energy-efficient appliances
Build community, friends, family, neighbors, prevent/address overheating
Use rooftop gardens: vegetation grown on a rooftop
Install cool roofs: light colored roofs reflect heat and light
Organize cooling centers, plan for heatwaves
Strengthen laws for outdoor workers’ cooling breaks

Source: epa.gov/heatislands/what-you-can-do-reduce-heat-island

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Wildfires: world’s worst air quality in September 2020

Air quality measurements around Washington in early September 2020, due to wildfire smoke. Good air quality is defined as an Air Quality Index up to 50. A level above 200 is “very unhealthy” and a level above 300 is “hazardous,” qualifying as an emergency.

Source: Wineke R. Smoke siege. a look back at the smoke storm of 2020.: Washington Department of Ecology; 2020.

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Liu et al. Health impact assessment of the 2020 Washington State wildfire smoke episode: excess health burden attributable to increased pm_2.5 exposures and potential exposure reductions. GeoHealth 2021; 5(5): e2020GH000359. doi: https://doi.org/10.1029/2020GH000359

Estimated excess deaths:

Short-term (13 days): 92

Long-term (1 year): 1076

Wildfire flames threaten the people who are directly affected—people caught in the fires, and firefighters who battle them. But the risk extends further. Wildfire smoke can travel hundreds of miles, blanketing entire regions, a risk to everybody who breathes it, especially to people with heart disease, asthma, chronic lung disease, and many other conditions. In areas affected by wildfire smoke, deaths increase, rates of low birth weight and preterm births rise, and more people report to emergency rooms with asthma attacks.^14-16 Wildfire smoke harms the developing lungs of children.¹⁷ A statewide study of the 2012 wildfire season found that each 10 mcg/m³ increase in the smoke level was associated with an 8% increase in the risk of asthma hospitalization (with equivocal results for chronic obstructive lung disease),¹⁸ and a study over the period 2006-2017 found a 9% increase in deaths from respiratory causes on days of wildfire smoke exposure.¹⁹ More recently, a study of the September, 2020 wildfires estimated that smoke exposure over a two-week period caused dozens of excess deaths across the state (38 using one method of analysis and 92 using another, with 95% confidence intervals extending to as many as 179 excess deaths).²⁰

Warming temperatures and drier summers, and increasing invasions by pests such as pine bark beetles, combine to increase the risk of forest fires.²¹ Other factors, such as land management, fire suppression strategies, and changes in forest type also affect the risk.²² But with continuing longer, warmer, drier summers, the area of severely water-limited forests across the Northwest is projected to increase by almost 50 percent by midcentury, and the typical annual area burned by fire could quadruple by the 2080s.²³

On the positive side, forest thinning and selective burns effectively reduce wildfires. Near Winthrop in eastern Washington, two areas next to each other were threatened by the Cedar Creek wildfire. The previously thinned and selectively burned area was significantly less damaged than the untreated area, according to Hilary Franz, Commissioner of Public Lands. Washington state has greatly increased efforts to apply such treatments, which have been used by Native American tribes for many years.

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Harmful algal blooms

Saltwater State Park, Des Moines, June 2018.

Source: WA Department of Ecology, https://ecology.wa.gov/Blog/Posts/June-2018/Puget-Sound-Nutrient-Watch-Algal-Blooms

Diseases causes by harmful algal blooms
Human health impact	Primary toxin
Amnesic Shellfish Poisoning	Domoic acid
Neurotoxic Shellfish Poisoning	Brevetoxin
Paralytic Shellfish Poisoning	Saxitoxins
Diarrhetic Shellfish Poisoning	Okadaic acid
Ciguatera Fish Poisoning	Ciguatoxin/Maititoxin

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Quileute Tribe

La Push, Clallam County

Quinault Nation

Taholah, Grays Harbor County

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Flooding and droughts: wet areas wetter, dry areas dryer

2021: record-setting flooding in 14 counties
Nooksack and Skagit river in Whatcom and Skagit counties record-setting floods. ($50+ million)
In Sumas, floodwaters damaged 85% of homes, businesses, and structures
1 Latino man driving to dairy work, flooded road, telephoned for help, drowned after several hours of no help, rescuers overwhelmed by calls.

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“I feel like I can’t in good conscience bring a child into this world and force them to try and survive what may be apocalyptic conditions.”

27-year-old woman

“I regret having my kids because I am terrified that they will be facing the end of the world due to climate change.”

40-year-old mother

Survey: 607 Americans aged 27-45

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Reasons for hope and action

Technology is advancing
Economics is improving
Policy is maturing
Activism is blossoming
Public opinion is shifting
Culture change is possible
Results are emerging
Extensive co-benefits

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Technology is advancing: batteries, EV’s, aviation fuel

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Economics improving

https://ourworldindata.org/grapher/solar-pv-prices

Price reduction >99% since 1976

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Policy is maturing, including WA state

WA passes Clean Fuel Standard

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Policy is maturing: Earth Day 2021

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Policy is maturing: Transformational local initiatives

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Activism is blossoming

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Public opinion is shifting

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70% of voters surveyed by Fox News favor increased government spending on green and renewable energy

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Culture change is possible, WWII

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https://ourworldindata.org/grapher/modern-renewable-energy-consumption

Results are emerging

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Health benefits of climate mitigation

LESS HEART DISEASE

BETTER MENTAL HEALTH

LESS LUNG DISEASE

LESS CANCER

HEALTHIER CHILD DEVELOPMENT

FEWER INJURIES

LESS INFECTIOUS DISEASE

CLEAN ENERGY

HEALTHY, SUSTAINABLE DIETS

WELL-DESIGNED CITIES

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It’s us/real/bad, experts agree, there’s hope

Climate change is a health emergency.
The impacts are happening here and now.
Anxiety, depression, and despair are real
There are compelling reasons for hope.
Action is the antidote to despair
What can we do? personal/local/policy recommendations

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Climate action: we can all do our part

Personal: LESS: Internal combustion engine (ICE) vehicles/flying, meat, long distance buying, household fossil fuel use, lower thermostat, plastic
MORE: walk/bus/bike/electric vehicles, plant trees, buy local, plant-based diet, farmers markets, insulate/energy efficient homes, solar/heat pumps, efficient appliances/lights, community sharing, reduce/reuse/recycle
Join others advocating for group/policy climate action

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Climate prescription: doctors bicycling to Olympia Jan 28, to urge Governor Inslee/legislators:

Public info campaign in media, public buildings, bus/rail stations to inform people exactly what is at stake with climate crisis
Electrify/decarbonize residential, commercial buildings at faster pace.
Pass legislation on growth management to rapidly build affordable housing, increase public transportation, and eliminate discriminatory zoning statewide.
Support low-income communities w climate mitigation and adaptation.
Ensure pandemic recovery investments support climate action and reduce social and health inequities.
Health workers: sign: secure.everyaction.com/1FDMqS32RkyC0M1J04aDBw2

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WA transportation policy recommendations:

Implement 2021 Clean Fuel Standard
Pass HB 1204: all vehicles sold in WA to be fully electric by 2030.
Focus transportation $$ on public transportation & reducing pollution in most highly impacted communities
Support electric vehicles (EV) charging stations, electric buses, safer streets for walking, bicycling

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Hold Governor Inslee to Glasgow climate pledges:

New cars zero-emission by 2035 (2030 in HB 1204)
Conserve at least 30% of land and 30% of coastal waters by 2030
Ensure zero-emissions from new buildings by 2030
All WA government vehicles to zero-emissions by 2040
At least 40% of expenditures benefit overburdened communities and vulnerable populations
Launch the Low Carbon Construction Task Force

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Fix the WA Growth Management Act

HB 1099 requires climate change planning and targets in new land use proposals,
HB 1220 requires more affordable housing planning in cities, and
SB 5042 amends the "vesting loophole" in the Growth Management Act that allows for illegal land use expansions.

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Healthy Homes/Clean Buildings Act (HB 1084)

Requires gas utilities to develop clean heat transition plans for meeting a share of WA Greenhouse Gas (GHG) targets – by 2024
Conversion of existing gas to electric equipment
Gas companies provide a just transition for workers
Provides for use of renewable hydrogen

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WA building electrification/phasing out fossil fuels:

State Building Code Council (SBCC) should be required to achieve zero carbon emissions in commercial & residential energy codes by [2030/2035/2040]
Set standards for improving energy performance after 2031
Remove language allowing delay due to economic, technological, or process factors

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National policy recommendations

Pass Build Back Better
National carbon price (“fee/dividend”) (citizensclimatelobby.org)
End fossil fuel subsidies
Support renewable energy
Help workers with “just transition to clean energy economy”
Help disproportionately affected communities

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Taking action

WA Physicians for Social Responsibility: wpsr.org
WA Conservation Voters: wcvoters.org
Sierra Club: sierraclub.org/washington
Carbon dividend: citizensclimatelobby.org
Earthministry.org
350seattle.org
WA legislature: leg.wa.gov, 800-562-6000
What more can YOU do?

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Thank you and thank your mother!