1 00:00:00,000 --> 00:00:02,600 Well, thank you very much. 2 00:00:02,600 --> 00:00:05,080 I really appreciate all of you staying. 3 00:00:05,080 --> 00:00:09,560 I did want to start with thanking the organizers very much for the opportunity t... 4 00:00:09,560 --> 00:00:10,560 you. 5 00:00:10,560 --> 00:00:14,099 And I'd like to take a moment for all of us to thank the organizers for an absolutely 6 00:00:14,099 --> 00:00:16,080 fascinating morning. 7 00:00:16,080 --> 00:00:17,080 So thank you very much. 8 00:00:17,080 --> 00:00:21,440 We really appreciate everything that you've done. 9 00:00:21,440 --> 00:00:25,920 And I want to step back and take an even broader perspective than what you've heard... 10 00:00:25,920 --> 00:00:26,920 last few minutes. 11 00:00:26,920 --> 00:00:33,400 I'm going to start with some framing issues. 12 00:00:33,400 --> 00:00:37,240 When we think about the future, we're thinking about risk. 13 00:00:37,240 --> 00:00:40,640 Risk is probability times consequence. 14 00:00:40,640 --> 00:00:44,200 Future is inherently uncertain. 15 00:00:44,200 --> 00:00:48,000 And when we think about the health risks of a changing climate, it's the same as thinking 16 00:00:48,000 --> 00:00:51,180 about the risk in any other sector. 17 00:00:51,179 --> 00:00:57,439 It's not just climate change that is causing changes in our health and well-being. 18 00:00:57,439 --> 00:01:04,340 It's how climate change intersects with underlying susceptibilities to heat, for... 19 00:01:04,340 --> 00:01:13,640 diseases and the capacity of our health systems to be able to prepare for and mana... 20 00:01:13,640 --> 00:01:17,780 In looking at these upstream drivers of health, we need to think about the social... 21 00:01:17,780 --> 00:01:20,400 of health, for example. 22 00:01:20,400 --> 00:01:25,540 And so when we study climate change and health, in essence, we start studying... 23 00:01:25,540 --> 00:01:32,620 because we have to understand the dynamic system within which climate change is a... 24 00:01:32,620 --> 00:01:34,960 multiplier. 25 00:01:34,960 --> 00:01:39,480 And climate change is affecting our health and our well-being. 26 00:01:39,480 --> 00:01:43,980 The figure on the right shows you some factors that are changing with a changing... 27 00:01:43,980 --> 00:01:46,219 I'll talk about a few of those. 28 00:01:46,219 --> 00:01:51,599 How those interact with a broad range of environmental, socioeconomic, demographic, 29 00:01:51,599 --> 00:01:53,659 and other factors. 30 00:01:53,659 --> 00:01:58,000 For those of you in health, you can see across the middle typical exposure pathway... 31 00:01:58,000 --> 00:02:02,239 we look at in environmental health. 32 00:02:02,239 --> 00:02:06,519 Underneath is a very short list of climate-sensitive health outcomes. 33 00:02:06,519 --> 00:02:09,000 There's hundreds of them. 34 00:02:09,000 --> 00:02:13,860 There's estimates of over 600 climate-sensitive health outcomes. 35 00:02:13,860 --> 00:02:19,040 For those of you who are in health care, these are people who come in to seek health 36 00:02:19,040 --> 00:02:24,740 care that are being affected because of the changes in our climate. 37 00:02:24,740 --> 00:02:30,380 You're never supposed to put up slides like this, but it's from the Intergovernmental 38 00:02:30,380 --> 00:02:31,940 Panel on Climate Change. 39 00:02:31,940 --> 00:02:34,440 It's the latest assessment report. 40 00:02:34,440 --> 00:02:36,280 It's very thick. 41 00:02:36,280 --> 00:02:41,040 And this was the simplest way to summarize an awful lot of information without going 42 00:02:41,040 --> 00:02:43,140 way over time. 43 00:02:43,139 --> 00:02:49,079 And so it just shows you the categories of issues that were assessed in the chapter. 44 00:02:49,079 --> 00:02:54,959 These are similar to the exposure pathways that I just showed on the previous slide. 45 00:02:54,959 --> 00:03:00,159 The only that's not, and I won't talk about much, is the bullet point at the bottom, 46 00:03:00,159 --> 00:03:02,099 which is health services. 47 00:03:02,099 --> 00:03:07,959 We have far too many health care facilities around the world that are in harm's way, that 48 00:03:07,960 --> 00:03:13,620 are being affected by flooding, storm surge, sea level rise. 49 00:03:13,620 --> 00:03:21,580 And so these kinds of disruptions are critically important for populations in th... 50 00:03:21,580 --> 00:03:25,719 I won't talk about that more, but I wanted to make it clear that that is an important 51 00:03:25,719 --> 00:03:28,460 issue. 52 00:03:28,460 --> 00:03:34,580 The other point I'd like to make on this slide is that what health has done, and we... 53 00:03:34,800 --> 00:03:39,040 under-resourced, what health has done in terms of studying climate change and healt... 54 00:03:39,040 --> 00:03:42,560 look through these exposure pathways. 55 00:03:42,560 --> 00:03:49,380 But that makes the implicit assumption that these exposure pathways are independent. 56 00:03:49,380 --> 00:03:50,700 I'm from Seattle, Washington. 57 00:03:50,700 --> 00:03:54,220 I live in the Pacific Northwest of the U.S. 58 00:03:54,220 --> 00:03:58,840 We have to deal with many of these all at the same time. 59 00:03:59,060 --> 00:04:05,740 By looking one at a time, we're underestimating the magnitude and the patt... 60 00:04:05,740 --> 00:04:11,560 we're addressing, because we aren't looking at them together within a region. 61 00:04:11,560 --> 00:04:15,699 And that's an area where we've got a lot more work to do. 62 00:04:15,699 --> 00:04:22,420 An issue that is rising rapidly on our agenda is mental health. 63 00:04:22,420 --> 00:04:29,080 We know the challenges that the world is facing in terms of all kinds of disasters, 64 00:04:29,080 --> 00:04:35,640 the one right now that's going on not far from where we are, and other challenges, 65 00:04:35,640 --> 00:04:41,520 the wildfires that are going on right now in Chile, for example. 66 00:04:41,520 --> 00:04:47,759 There's been fairly few long-term studies that are designed looking at mental health. 67 00:04:47,759 --> 00:04:53,439 This is one from the U.K. that is looking at the consequences of winter flooding with 68 00:04:53,439 --> 00:04:56,079 three years of follow-up. 69 00:04:56,079 --> 00:05:00,420 And I've just shown the data for anxiety and PTSD. 70 00:05:00,420 --> 00:05:05,480 One thing that's very useful about this study is that the authors separated out people 71 00:05:05,480 --> 00:05:12,560 who lived in a residence that was not affected from a residence that was disrupted. 72 00:05:12,560 --> 00:05:16,319 Floodwaters came to the front door, did not go inside. 73 00:05:16,319 --> 00:05:20,879 And people who lived in a residence that was actually disrupted. 74 00:05:20,879 --> 00:05:25,519 You can see the first year for each of these, you see an increase in the prevalence of 75 00:05:25,519 --> 00:05:28,060 these health outcomes. 76 00:05:28,060 --> 00:05:32,959 You see over three years that there is a decline in the prevalence, but also the... 77 00:05:32,959 --> 00:05:35,959 does not go back to baseline. 78 00:05:35,959 --> 00:05:44,439 That these are long-term mental health challenges when facing very large kinds of... 79 00:05:44,439 --> 00:05:49,719 There's been lots of discussion today in this room about improving health services. 80 00:05:49,719 --> 00:05:52,480 Relatively little of that focused on mental health. 81 00:05:52,480 --> 00:05:56,040 There's no country that's got adequate mental health services. 82 00:05:56,040 --> 00:06:01,959 And as we face increases in the frequency, intensity of extreme weather and climate... 83 00:06:01,959 --> 00:06:09,920 more floods, more droughts, more wildfires, we're going to see more mental health... 84 00:06:09,920 --> 00:06:13,519 I'll spend a bit of time talking about heat. 85 00:06:13,519 --> 00:06:14,879 It's an important issue. 86 00:06:14,879 --> 00:06:17,019 It's one that's getting a lot of attention. 87 00:06:17,019 --> 00:06:19,839 And frankly, it's where most of the funding has been. 88 00:06:19,839 --> 00:06:24,879 There's as I said, incredibly little funding in this area, most of it in high-income... 89 00:06:24,879 --> 00:06:28,199 And so the focus has been on heat. 90 00:06:28,199 --> 00:06:30,439 These are data from the Lancet Countdown. 91 00:06:30,439 --> 00:06:37,680 It's an annual publication that follows over 40 indicators of climate change and health. 92 00:06:37,720 --> 00:06:45,079 You can see exposures from 1980 to 2020 for adults over the age of 65, children under 93 00:06:45,079 --> 00:06:47,720 the age of one. 94 00:06:47,720 --> 00:06:51,819 And you can read the numbers at the top. 95 00:06:51,819 --> 00:06:54,660 You live in a region that's hot. 96 00:06:54,660 --> 00:07:01,300 One of the major assumptions that people make is if you live in some place that's warm, 97 00:07:01,300 --> 00:07:07,439 you're better adapted to the heat than people who don't live in those kinds of regions. 98 00:07:07,439 --> 00:07:09,399 And that's not true. 99 00:07:09,399 --> 00:07:12,500 Again, I live in the United States. 100 00:07:12,500 --> 00:07:16,639 Our state with the highest heat-related mortality is Arizona. 101 00:07:16,639 --> 00:07:19,480 It's also one of our hottest states. 102 00:07:19,480 --> 00:07:25,300 And we need to raise awareness that heat is a problem. 103 00:07:25,300 --> 00:07:30,000 There is a lot of literature coming out about heat affecting pregnant women. 104 00:07:30,000 --> 00:07:35,159 When women are exposed towards the end of their pregnancy to high temperatures, there 105 00:07:35,160 --> 00:07:39,040 are more low-birth weight babies. 106 00:07:39,040 --> 00:07:40,760 Babies come early. 107 00:07:40,760 --> 00:07:44,360 For those of you who work in maternal and child health, you know that has consequences 108 00:07:44,360 --> 00:07:47,820 for the mother and for the baby. 109 00:07:47,820 --> 00:07:52,800 There may be an increase in stillbirth, still trying to understand that. 110 00:07:52,800 --> 00:07:58,640 But it's not well known in warm regions of the world that heat is a problem. 111 00:07:58,640 --> 00:08:03,280 The population assumes that they don't have to worry. 112 00:08:03,279 --> 00:08:09,000 When we think about heat, we're worried about core body temperatures. 113 00:08:09,000 --> 00:08:13,239 Our core body temperatures operate within a pretty narrow range. 114 00:08:13,239 --> 00:08:17,039 And that's to protect our cells and our organs. 115 00:08:17,039 --> 00:08:19,779 We have behavioral mechanisms when it's hot. 116 00:08:19,779 --> 00:08:22,459 We find a place to go seek some shade. 117 00:08:22,459 --> 00:08:24,279 We have changes in clothing. 118 00:08:24,279 --> 00:08:27,439 We have changes in patterns. 119 00:08:27,439 --> 00:08:31,759 We sleep on roofs if we need to because it's too hot at night. 120 00:08:32,240 --> 00:08:39,179 Physiologically, there's mechanisms at well, including sweating, to try and cool us down. 121 00:08:39,179 --> 00:08:45,439 When those mechanisms together are insufficient, then our core body temperatu... 122 00:08:45,439 --> 00:08:49,279 And that starts affecting our cells and our organs. 123 00:08:49,279 --> 00:08:54,360 When you look after a heat wave, about half of all the heat-related deaths are due to 124 00:08:54,360 --> 00:08:57,080 cardiovascular causes. 125 00:08:57,080 --> 00:09:02,600 These are people who have a heart attack, who would not have had a heart attack otherwise. 126 00:09:02,600 --> 00:09:07,020 Just like with COVID, we look at excess deaths, not just the total number of death... 127 00:09:07,020 --> 00:09:12,600 almost no death certificate says that death was due to the heat. 128 00:09:12,600 --> 00:09:17,400 And so this is just a schematic that outlines that challenge. 129 00:09:17,400 --> 00:09:21,440 And I had to smile with the reference from the previous speaker about where pieces of 130 00:09:21,440 --> 00:09:22,560 meat. 131 00:09:22,560 --> 00:09:26,480 There's several ways that you can model human bodies in the heat. 132 00:09:26,879 --> 00:09:30,879 There's one that's been used quite a bit, was used quite a bit by physiologists. 133 00:09:30,879 --> 00:09:33,039 It's not used so much anymore. 134 00:09:33,039 --> 00:09:36,639 And it assumes people have no arms, no legs, or no head. 135 00:09:36,639 --> 00:09:39,840 They just assume people are a ball of meat. 136 00:09:39,840 --> 00:09:43,120 And you put the ball of meat out in hot temperatures and you see what happens. 137 00:09:43,120 --> 00:09:45,399 So yes, balls of meat. 138 00:09:48,560 --> 00:09:55,600 One of the advances in our field is a field that's common in climate change called... 139 00:09:55,600 --> 00:09:57,680 and attribution. 140 00:09:57,680 --> 00:10:01,519 A detection and attribution does exactly what the name implies. 141 00:10:01,519 --> 00:10:04,080 You detect whether there's been a change. 142 00:10:04,080 --> 00:10:06,639 In this case, it's heat-related mortality. 143 00:10:06,639 --> 00:10:14,840 And then determine the extent to which climate change is altering that basic... 144 00:10:14,840 --> 00:10:17,480 heat waves. 145 00:10:17,480 --> 00:10:20,639 And this study looked across 43 countries. 146 00:10:20,639 --> 00:10:25,840 You can see just Kuwait and Iran from around this region. 147 00:10:25,840 --> 00:10:31,519 And concluded that over the last couple of decades, across these 43 countries, about 148 00:10:31,519 --> 00:10:39,279 37% of all heat-related deaths in the summer are caused by climate change. 149 00:10:39,279 --> 00:10:40,279 I'll say that again. 150 00:10:40,279 --> 00:10:41,759 It's caused by climate change. 151 00:10:41,759 --> 00:10:46,639 We can say today people are dying from climate change. 152 00:10:46,639 --> 00:10:48,059 This is not. 153 00:10:48,059 --> 00:10:49,639 We know there's associations. 154 00:10:49,639 --> 00:10:50,639 This is not. 155 00:10:50,639 --> 00:10:52,399 I'll talk about vector-borne diseases. 156 00:10:52,399 --> 00:10:55,399 This is not first principles of change. 157 00:10:55,399 --> 00:11:00,080 This is saying people today are already dying from climate change. 158 00:11:00,080 --> 00:11:07,199 The number cited earlier today by the minister of 250,000 deaths in 2030 is an... 159 00:11:07,199 --> 00:11:13,399 because tens of thousands to hundreds of thousands of people are dying right now fr... 160 00:11:13,399 --> 00:11:14,819 change. 161 00:11:14,820 --> 00:11:20,860 And we're not even looking at all the different health outcomes that I said are... 162 00:11:20,860 --> 00:11:22,720 world. 163 00:11:22,720 --> 00:11:29,100 You can see the estimates from Iran and Kuwait are about 60% of heat-related death... 164 00:11:29,100 --> 00:11:32,540 caused by climate change. 165 00:11:32,540 --> 00:11:34,660 Heat waves are critically important. 166 00:11:34,660 --> 00:11:39,880 They happen in all parts of the world, under-recognized in many regions. 167 00:11:39,879 --> 00:11:44,879 This is a big heat wave that hit the Pacific Northwest of the United States and British 168 00:11:44,879 --> 00:11:48,799 Columbia and Canada. 169 00:11:48,799 --> 00:11:54,759 Over the course of a few days, the estimate is about 900 excess deaths. 170 00:11:54,759 --> 00:12:00,080 900 people died who would not have died otherwise. 171 00:12:00,080 --> 00:12:05,200 But I also put this in the heat wave was virtually impossible without climate change. 172 00:12:05,200 --> 00:12:08,720 I also put it in to make a point when we think particularly about heat. 173 00:12:08,720 --> 00:12:11,780 Heat is an all of society issue. 174 00:12:11,780 --> 00:12:18,860 I focus on health for obvious reasons, but we need to think about the other consequences. 175 00:12:18,860 --> 00:12:22,500 This heat wave occurred during the height of our cherry picking season. 176 00:12:22,500 --> 00:12:25,320 The cherries cooked on the trees. 177 00:12:25,320 --> 00:12:31,000 We're one of four states in the United States that has protections for outdoor workers. 178 00:12:31,000 --> 00:12:33,480 Those protections had to be activated. 179 00:12:33,480 --> 00:12:38,720 There were things that companies had to do to protect their workers. 180 00:12:38,720 --> 00:12:43,039 Between Seattle and Vancouver is an area called the Salish Sea. 181 00:12:43,039 --> 00:12:47,519 During low tide, because the temperatures were so high, over a million mussels, clams, 182 00:12:47,519 --> 00:12:50,399 and oysters were cooked. 183 00:12:50,399 --> 00:12:55,639 That is food security for coastal tribes. 184 00:12:55,639 --> 00:13:02,360 Thinking about these issues requires us to think more broadly about the impacts on... 185 00:13:02,360 --> 00:13:08,560 where health fits into that, and how we can work together to make a difference. 186 00:13:08,560 --> 00:13:12,840 Making a difference for heat involves developing heat action plans. 187 00:13:12,840 --> 00:13:15,960 They have two basic components. 188 00:13:15,960 --> 00:13:19,840 One is to have an early warning and response system. 189 00:13:19,840 --> 00:13:24,560 More than just telling people it's hot, but telling them what it is they can do, what 190 00:13:24,560 --> 00:13:30,120 actions they can take on the left, in this case, without using air conditioning. 191 00:13:30,120 --> 00:13:35,620 On the right is a long-term planning of thinking about how to make cities more... 192 00:13:35,620 --> 00:13:41,960 as temperatures continue to rise. 193 00:13:41,960 --> 00:13:44,320 When I talk about heat, I live in the Pacific Northwest. 194 00:13:44,320 --> 00:13:46,480 I talk about wildfires. 195 00:13:46,480 --> 00:13:51,759 This is another part of the world that is being affected by wildfires. 196 00:13:51,759 --> 00:13:57,039 Also data from the Lancet Countdown, the map on the left, shows you the concentrations 197 00:13:57,039 --> 00:14:01,519 of particulate matter during wildfires. 198 00:14:01,519 --> 00:14:04,279 The concentrations are high. 199 00:14:04,279 --> 00:14:09,879 Four million people die needlessly every year from air pollution. 200 00:14:09,879 --> 00:14:13,319 Particulate matter just measures the size of the particle. 201 00:14:13,319 --> 00:14:19,199 There's data coming out showing that the particles released in a wildfire are more... 202 00:14:19,199 --> 00:14:22,159 the other source of particles. 203 00:14:22,159 --> 00:14:26,719 So we're looking at situations where we've got much greater exposure. 204 00:14:26,719 --> 00:14:32,339 The bottom shows you the trend in fine particulate matter exposure. 205 00:14:32,339 --> 00:14:37,120 Both the West Coast of the U.S. and this region are places where we're seeing large... 206 00:14:37,120 --> 00:14:42,179 in these exposures. 207 00:14:42,179 --> 00:14:44,360 Those are observations. 208 00:14:44,360 --> 00:14:50,620 This is a similar kind of slide for the projections. 209 00:14:50,620 --> 00:14:58,460 In categories, the bottom line is climate change is, as I said, a stress multiplier. 210 00:14:58,460 --> 00:15:03,899 It's increasing the challenges that we're facing, dramatically in some cases. 211 00:15:03,899 --> 00:15:08,720 So when you look at the major categories of climate-sensitive health outcomes, when... 212 00:15:08,720 --> 00:15:14,299 are done, there is very high confidence in all of these that unless we take action, both 213 00:15:14,299 --> 00:15:22,059 adaptation and mitigation, the risks are going to increase. 214 00:15:22,059 --> 00:15:26,500 Specifically for heat, this is from, again, from the Intergovernmental Panel on Climate 215 00:15:26,500 --> 00:15:32,779 Change showing one in 10-year heat events, one in 50-year heat events, and how much... 216 00:15:32,779 --> 00:15:37,679 already increased from pre-industrial periods. 217 00:15:37,679 --> 00:15:43,099 The one in 10-year and the one in 50-year is on the left of each set of figures. 218 00:15:43,100 --> 00:15:48,500 I'm just showing you how much increase there's been and projections for how much... 219 00:15:48,500 --> 00:15:50,740 increase. 220 00:15:50,740 --> 00:15:56,420 The Pacific Heat Dome was a more than one in 150-year event. 221 00:15:56,420 --> 00:16:04,220 We are way past these kinds of return periods. 222 00:16:04,220 --> 00:16:10,100 An example from the U.S. of showing the importance of adaptation and mitigation. 223 00:16:10,100 --> 00:16:14,180 Adaptation is at the end of the century for mortality under different levels of... 224 00:16:14,180 --> 00:16:20,460 gas emissions and in terms of whether or not there's some amount of adaptation to rising 225 00:16:20,460 --> 00:16:22,019 temperatures. 226 00:16:22,019 --> 00:16:27,519 If you compare the top left with no adaptation high emissions, the bottom righ... 227 00:16:27,519 --> 00:16:32,779 low emissions, those are two very different worlds. 228 00:16:32,779 --> 00:16:38,139 It also shows you that even if we adapt and we mitigate, we're going to have what we call 229 00:16:38,179 --> 00:16:39,699 as residual risk. 230 00:16:39,699 --> 00:16:42,819 More people are going to suffer and die in the heat. 231 00:16:42,819 --> 00:16:47,500 We're going to need to do more than what we have in the last few years to make sure that 232 00:16:47,500 --> 00:16:55,139 we really address these challenges with our changing environment. 233 00:16:55,139 --> 00:16:59,819 Infectious diseases, always a topic that draws a great deal of interest. 234 00:16:59,819 --> 00:17:06,359 The bottom line is the mosquitoes and the ticks are changing their geographic range. 235 00:17:06,359 --> 00:17:08,599 They're lengthening their season. 236 00:17:08,599 --> 00:17:12,879 There's more mosquitoes, which leads to more disease transmission. 237 00:17:12,879 --> 00:17:18,399 Most of the research has been on dengue and on malaria and just showing that as we have 238 00:17:18,399 --> 00:17:25,639 warmer environments, as we change our precipitation patterns, that we are seeing... 239 00:17:25,639 --> 00:17:28,839 just take advantage of the situation. 240 00:17:28,839 --> 00:17:36,079 Unless we do something, again, more infectious disease. 241 00:17:36,079 --> 00:17:40,539 Like all fields in climate science, we are underestimating the challenges. 242 00:17:40,539 --> 00:17:47,559 Our models are inherently conservative because we can't really tell in our models... 243 00:17:47,559 --> 00:17:51,299 change could happen with a small change in the environment. 244 00:17:51,299 --> 00:17:55,039 They make often linear kinds of assumptions. 245 00:17:55,039 --> 00:17:59,359 These are two maps, obviously, for the United States. 246 00:17:59,359 --> 00:18:05,379 This on the left shows the current and projected future distribution of the mosqu... 247 00:18:05,460 --> 00:18:11,140 dengue fever, zika, chikungunya, yellow fever. 248 00:18:11,140 --> 00:18:14,260 It's towards the end of the century with high emissions. 249 00:18:14,260 --> 00:18:19,860 You can see in the red a very large increase in the geographic range, including in Seattle 250 00:18:19,860 --> 00:18:22,420 up on the upper left. 251 00:18:22,420 --> 00:18:25,100 But it's not just having a mosquito present. 252 00:18:25,100 --> 00:18:30,780 You have to have a summer that's hot enough and long enough that you can introduce dengue 253 00:18:31,180 --> 00:18:35,460 into a population and then have sustained transmission. 254 00:18:35,460 --> 00:18:39,740 The map on the right shows you what would happen when you take that into account. 255 00:18:39,740 --> 00:18:42,259 Not such a big increase. 256 00:18:42,259 --> 00:18:46,019 Seattle's no longer in the picture, which is great. 257 00:18:46,019 --> 00:18:49,460 But this was published in 2016. 258 00:18:49,460 --> 00:18:55,019 A couple of years later, breeding colonies of this mosquito were found in Toronto, Toledo, 259 00:18:55,019 --> 00:19:02,019 and Detroit up in the Midwest, which is not shown as being a major area in either of 260 00:19:02,900 --> 00:19:04,740 these maps. 261 00:19:04,740 --> 00:19:10,400 Once you have the mosquito present, it's almost impossible to get rid of. 262 00:19:10,400 --> 00:19:16,619 It breeds in the water in the bottom of a flower pot, completely adapted to humans. 263 00:19:16,619 --> 00:19:20,859 And I'm running a little bit out of time, so I'm going to go a little bit faster. 264 00:19:20,859 --> 00:19:26,779 This basically shows you we're doing pretty poorly with surveillance systems. 265 00:19:26,779 --> 00:19:29,619 These are from the World Health Organization data. 266 00:19:29,619 --> 00:19:35,879 What you can't read very well is that the Y-axis is capped at 28 countries. 267 00:19:35,879 --> 00:19:42,939 So there's a very low uptake of having surveillance systems to be able to manage... 268 00:19:42,939 --> 00:19:48,179 in the geographic range of vector-borne diseases. 269 00:19:48,180 --> 00:19:54,560 And I'm going to end here, and I'm going to talk about the major risk for climate change 270 00:19:54,560 --> 00:19:58,100 and health, which is going to be food insecurity. 271 00:19:58,100 --> 00:20:00,660 And that's from two mechanisms. 272 00:20:00,660 --> 00:20:02,900 The first mechanism is shown on this slide. 273 00:20:02,900 --> 00:20:06,740 I'm going to focus on maize, rice, and wheat. 274 00:20:06,740 --> 00:20:09,060 Soybeans are really, really different. 275 00:20:09,060 --> 00:20:14,060 And if you just look at these patterns, mid-century on the top, end of the century... 276 00:20:14,059 --> 00:20:18,779 you see declines in crop yields in major parts of the world. 277 00:20:18,779 --> 00:20:23,139 All the projections of what's going to happen with food security in a changing climate 278 00:20:23,139 --> 00:20:28,819 indicate that there will be less food in the places where we're going to need it the most. 279 00:20:28,819 --> 00:20:34,220 We'll have enough food in the world, but the distribution is inequitable. 280 00:20:34,220 --> 00:20:39,419 The other mechanism is carbon dioxide itself. 281 00:20:39,419 --> 00:20:42,419 Carbon dioxide affects all of our plants. 282 00:20:42,420 --> 00:20:48,380 All of our plants have a photosynthetic pathway whereby the plant brings in carbon... 283 00:20:48,380 --> 00:20:54,420 from the atmosphere, breaks it apart into carbon and oxygen, and uses the carbon to 284 00:20:54,420 --> 00:20:55,420 grow. 285 00:20:55,420 --> 00:20:59,500 You'll read that carbon dioxide is plant food, which it is. 286 00:20:59,500 --> 00:21:04,340 85% of our plants use one photosynthetic pathway. 287 00:21:04,340 --> 00:21:10,259 The characteristics of that pathway means that these are called C3 plants. 288 00:21:10,259 --> 00:21:19,059 And C3 plants, which include wheat, rice, barley, potatoes, crops that constitute about 289 00:21:19,059 --> 00:21:22,900 65% of the diets around the world. 290 00:21:22,900 --> 00:21:27,480 With higher CO2, you see more carbohydrates. 291 00:21:27,480 --> 00:21:38,700 You see less protein by about 10%, 30% reduction in B vitamins, and a 5% reductio... 292 00:21:38,700 --> 00:21:43,340 There are about 800 million people in the world who are food insecure. 293 00:21:43,340 --> 00:21:47,059 There's 2 billion that have got micronutrient deficiencies. 294 00:21:47,059 --> 00:21:51,779 1.5 billion women and girls have iron deficiency anemia. 295 00:21:51,779 --> 00:21:57,700 A small reduction in those is going to have a huge impact on our health and well-being. 296 00:21:57,700 --> 00:22:03,500 And I'm two minutes over time, so I'm going to end, actually now, with saying the last 297 00:22:04,500 --> 00:22:10,980 leave everyone with is when you look at the major mitigation strategies and you count 298 00:22:10,980 --> 00:22:14,700 the benefits from those strategies. 299 00:22:14,700 --> 00:22:19,819 Reducing exposure to air pollution, having more people walking and biking, changing... 300 00:22:19,819 --> 00:22:24,420 so people only eat as much red meat as their doctor recommends. 301 00:22:24,420 --> 00:22:29,920 When you look at the avoided hospitalizations, the avoided premature... 302 00:22:29,920 --> 00:22:35,320 the health benefits are of the same order of magnitude, if not larger, than the cost 303 00:22:35,320 --> 00:22:36,880 of mitigation. 304 00:22:36,880 --> 00:22:39,600 We should be mitigating for our health. 305 00:22:39,600 --> 00:22:39,840 Thank you.