IPCC Report.pdf - Adam Curry

Managing the Risks from Climate Extremes at the Local LevelChapter 5patterns of behavior (Meehl et al., 2007), with a focus on local people’sagency within specific configurations of power relations. The challenge is,therefore, to empower the most vulnerable to pursue livelihood optionsthat strengthen their entitlements and protect what they themselvesconsider the social sources of adaptation and resilience in the face ofextreme climate stress. Better management of disaster risk alsomaximizes use of available resources for adapting to climate change(Kryspin-Watson et al., 2006).5.5.1.3. Health and DisabilityThe changes in extreme events and impacts of climate change influencethe morbidity and mortality of many populations now, and even moreso in the future (Campbell-Lendrum et al., 2003). The extreme impactsof climate change (see Sections 3.1.1 and 4.4.6) directly or indirectlyaffect the health of many populations and these will be felt first at thelocal level. Heat waves lead to heatstroke and cardiovascular disease,while shifts in air pollution concentrations such as ozone that oftenincrease with higher temperatures cause morbidity from other diseases(Bernard et al., 2001). Heat waves differentially affect populationsbased on their ethnicity, gender, age (Díaz et al., 2002), and medical andsocioeconomic status (O’Neill and Ebi, 2009), consequently raisingconcerns about health inequalities (see Case Study 9.2.1), especially atthe local scale. Health inequalities are of concern in extreme impacts ofclimate change more generally, as those with the least resources oftenhave the least ability to adapt, making the poor and disenfranchisedmost vulnerable to climate-related illnesses (McMichael et al., 2008).For extreme events, pre-existing health conditions that characterizevulnerable populations can exacerbate the impact of disaster eventssince these populations are more susceptible to additional injuries fromdisaster impacts (Brauer, 1999; Brown, 1999; Parati et al., 2001). Chronichealth conditions/disabilities can also lead to subsequent communicablediseases and illnesses in the short term, to lasting chronic illnesses, andto longer-term mental health conditions (Shoaf and Rottmann, 2000;Bourque et al., 2006; Few and Matthies, 2006).A range of vector-borne illnesses has been linked to climate, includingmalaria, dengue, Hantavirus, Bluetongue, Ross River Virus, and cholera(Patz et al., 2005). Cholera, for example, has seasonal variability thatmay be directly affected by climate change (Koelle et al., 2004). Vectorborneillnesses have been projected to increase in geographic reach andseverity as temperatures increase (McMichael et al., 2006), but thesechanges depend on a variety of human interventions like deforestationand land use. The areas of habitation by mosquitoes and other vectorsare moving to areas previously free from such vectors of transmission(Lafferty, 2009). Pools of standing water that are breeding grounds formosquitoes promise to expand, therefore increasing illness exposure(Depradine and Lovell, 2004; Meehl et al., 2007). At the same time, someliterature shows that illnesses like malaria are less prone to increasethan originally thought (Gething et al., 2010). Much of the nuance ofthis literature is due to the location-specific nature of these outcomes.Therefore, vector control programs will be best suited to the localcharacteristics of changing risks. Some programs, like those gearedtoward surveillance, need common characteristics to support nationalprograms and also need to be coordinated across scales from local tonational and between local places. In addition, there are a variety ofsocial factors that have the potential to influence disease rates that aremost suitably managed at the sub-national level or urban scale. Forinstance, certain types of population growth or change may increaserisk and affect disease rates (Patz et al., 2005). Increased population andrelated land use changes can also increase disease rates. Vector controlprograms generally implemented at the local level also have the potentialto influence health outcomes (Tanser et al., 2003). Infectious diseasepatterns also have the potential to change dramatically, necessitatingimproved prevention on the part of local providers who have knowledgeof local environmental change (Parkinson and Butler, 2005).There is concern regarding the mental health impacts of storms and floodsthat lead to destruction of livelihoods and displacement, especially forvulnerable populations (Balaban, 2006). In some hurricanes, the mentalhealth of residents in affected communities is extremely negativelyimpacted over an extended period of time (Weisler et al., 2006). Policyresponses to the event were insufficient to manage these impacts, andprovide a lesson for future events where greater mental health servicesmay be necessary (Lambrew and Shalala, 2006). Managing publichealth and disability is important in the response to disasters (Shoafand Rottmann, 2000).Human health is at risk from many extreme events linked to climatechange. While resources from scales above the local are often necessary,the direction and application of those resources by local actors whoknow how to best apply them could make significant differences inhuman morbidity and mortality linked to climate extremes.5.5.1.4. Human SettlementsSettlement patterns are another factor that influences disaster riskmanagement and coping with extremes. Human settlements differ intheir physical and governance structures, population growth patterns,as well as in the types, drivers, impacts, and responses to disasters. Asnoted earlier (see Section 5.5.1.2), rural livelihoods and poverty aredrivers of disaster risk, but not the only ones. Poverty, resource scarcity,access to resources, as well as inaccessibility constrain disaster riskmanagement. When these are coupled with climate variability, conflict,and health issues they reduce the coping capacity of rural places(UNISDR, 2009). At the other extreme are the concentrated settlementsof towns and cities where the disaster risks are magnified because ofpopulation densities, poor living conditions including overcrowded andsubstandard housing, lack of sanitation and clean water, and healthimpairments from pollution and lack of adequate medical care (Bull-Kamanga et al., 2003; De Sherbinin et al., 2007). Strengthening localcapacity in terms of housing, infrastructure, and disaster preparednessis one mechanism shown to improve urban resilience and the adaptivecapacity of cities to climate-sensitive hazards (Pelling, 2003). It is also316