Climate Variability and Change in the Southwest

Part IV: Workshop: Cross-cutting Issues

Chapter 14

Environmental Quality and Health

Workshop report prepared by:

Robert Varady, Interim Director
Udall Center for Studies in Public Policy
The University of Arizona
Tucson, AZ

Workshop Participants: Robert Varady (facilitator), John Balbus, Heather Benway, Andrew Comrie, Bruce Goff, Robert Hackenberg, Barbara Morehouse, Richard Reynolds, Carlos Rincon, Beatriz Vera

Impacts and Vulnerability

Throughout the world, the relationship between water and environmental health has been well-known for centuries.

The harmful effects of water shortages, extreme flooding, contaminated drinking water, and inadequate sewerage are most palpable in developing countries, where both infrastructure and health care are least available. In such environments, water-related ailments include dehydration, water-borne microbial infection, and vector-borne disease.

The consequences of temperature extremes, often in combination with drought or flooding, also seriously affect public health in poor societies.

Chronic gastrointestinitis, cholera, typhoid, malaria, dengue fever, valley fever (coccidiomycosis) and other respiratory diseases, and heat stress are among the most common illnesses attributed to water, sanitation, heat, and wind-borne dust.

What is the likelihood of occurrence and possible severity of certain health problems as a result of climate changes, specifically increases in temperature? Ozone levels, at least transiently, are very likely to increase as a result of higher temperatures. Water-borne diarrheal diseases, specifically hepatitis A, shigella, and salmonella, are current problems of the border area that might exhibit non-linear responses to warmer temperatures if a critical winter killing phase is eliminated by higher temperatures. Cholera is not currently a major concern in the border area, but the proximity to southern Central America makes it worth mentioning.

Not only in developing countries but in economically disadvantaged, resource-poor, or overcrowded areas of relatively wealthy nations, similar conditions can prevail. These areas, already the least stable and most vulnerable to a variety of disruptions, are particularly at risk from changes in the availability and quality of water.

Of course, numerous sociodemographic factors determine water quantity and quality: population change, land-use characteristics, rate of economic development, planning policies, and prevailing politics.

Among physical influences on the stability of water-delivery and water-treatment systems, climate is perhaps the most pervasive. In the short-term, natural disasters, most of them climatic, pose the greatest hazards.

In the long-run, even small changes in temperature and rainfall regimes have the potential to cause serious disruption to these systems, and thus to public health.

Nowhere are the above observations more applicable than in arid and semiarid regions where climatic variability already is high. Social systems in these areas are always stressed because of permanent water shortage.

In the southwestern United States, alternating droughts and floods regularly disrupt communities and affect health. It follows, too, that the Southwest's most disadvantaged communities are also its most vulnerable to climate variability and change.

Hence, cities, towns, and colonias (unplanned urban settlements) on both sides of the U.S.-Mexico border, tribal lands, poor mining communities, and other low-income zones in Arizona and New Mexico are highly prone to climate-induced worsening of health conditions.

And everywhere, especially in inner cities and in distant, outlying rural communities, the elderly and those who cannot afford to pay for heating and cooling are most vulnerable.

Responses

Pressed by the more immediate demands of uneven access to health care, the presence of numerous low-income communities, and the prevalence of other pressing health problems, the public-health community has been slow to acknowledge the potential of climate-change-induced health threats.

Even so, authorities have become increasingly aware of the heightened incidence of certain vector-borne diseases such as dengue fever and hanta virus, and that there may be a connection to increases in these diseases and climate change.

Both of these illnesses are closely associated with temperature and rainfall increase. In response, for example, to limit urban mosquito breeding, authorities in Tucson have mounted a thus-far successful campaign to reduce the presence of stagnant-water pools.

Institutionally, the other notable effort in this domain is the general resolve by the United States and Mexico to improve environmental infrastructure in the at-risk border region (see also the discussion in Chapter 16, "U.S.-Mexico Border").

The Border Environment Cooperation Commission (BECC) and its sibling, the North American Development Bank (NADBank), were established in 1993 primarily to assist border communities in supplying treated drinking water and removing and treating household and industrial waste.

During its three years of operation, BECC, the project-certifying organization, has been mindful of the connection between this type of infrastructure and the status of public health in the communities served. Nonetheless, neither BECC nor NADBank understands or is attuned to the special requirements of responding to climatic variability and change.

Research and Information Needs

Public-health scholars and officials are only slowly beginning to understand the potential impacts of climate change on environmental quality and health.

It is widely accepted that certain socioeconomic groups will be more susceptible to climate-change-related health problems, but it is difficult if not impossible to predict when and where these problems will strike.

Researchers, for their part, need to recognize that temporal and spatial scales are important in defining environmental quality and health. Accordingly, studies should place less emphasis on long-term climatic trends than on short-term forecasts. In regard to health and environmental issues, it is apparent that seasonal and monthly variability are larger factors than decadal or annual variability.

Epidemiologists argue that longitudinal studies are the best way to uncover links between climate change and health problems. These studies could provide information necessary to change human behavior patterns to limit the spread of certain diseases and thereby assure improvements in public health.

Research on environmental quality is needed to make more concrete the linkages between climate change and activities from various economic sectors leading to environmental degradation. For example, it is possible that warmer temperature will lead farmers to increase the application of pesticides.

This increase in pesticides could have detrimental effects on the environment. In turn, increased runoff from extreme precipitation events could lead to more contaminants entering water supplies. Can existing infrastructure cope with increased runoff?

Urban sprawl stemming from increased rural-to-urban migration also is considered a form of environmental degradation. Investigations are needed to understand how climate change, in conjunction with socioeconomic factors, could lead to increased urbanization.

Policy Issues

In the United States, environmental-health planning, implementation, and enforcement are in the hands of numerous agencies, acting at the federal, state, and local levels.

Additionally, in our society, non-public-sector, sometimes voluntary organizations often play important roles in representing groups and providing care.

Almost always, complex issues are shared by several agencies at all these levels and by nongovernmental organizations.

For example, a southwestern water-related epidemic may involve such organizations as the Centers for Disease Prevention and Control (CDC), the National Institute of Environmental Health Sciences, a state department of health services, a county health department, a city health department, a university research laboratory, a private-sector health-care facility, and a nongovernmental community-support organization.

In view of this convoluted institutional web of research, intervention, monitoring, administration, intervention, and enforcement, better coordination and streamlining surely would improve responsiveness, and eventually, environmental-health conditions per se.

Further, because climate-induced health impacts are perceived as low-priority issues by the professional health-care community, heightened awareness is desirable. Campaigns to educate these professionals in the particulars of health impacts of climate change would prove highly beneficial. And priorities need to be made about which diseases to monitor and how.

Finally, it is important to recognize that politicians and other decisionmakers who are not trained as health professionals inadvertently can generate policies that affect environmental-health conditions. Very often, policies resulting from economic and political considerations--that on the surface may have nothing to do with either climate change or public health--can have important effects on both sectors.

Similarly, the close link between social and economic well-being and a high state of public health suggests that one of the best ways to improve public health is to ameliorate social conditions.

Both of these observations imply that policymakers who are more knowledgeable about climate change and health could be influential in preventing and coping with the health-related impacts of climate variability. 

For additional discussions on this topic, see the presentations for Panel 4: Environmental Quality and Health, in Chapter 8.