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GlobalHealth - Global Health Global Health • Population...

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Unformatted text preview: Global Health Global Health • Population Pressure • Climate Change • War • Developing Nations Population Pressure Population Pressure • • • • • ½ planets population under 25 Largest cohort of young people in history >90% live in developing countries Future demo profile of planet/poorest Imperative access to repro/family planning Where people will live… Where people will live… • • • Before 2010: 50% will live in urban areas 2030:60% Infrastructure of dev countries can’t keep pace with rapid/sustained urban growth • Fleeing collapsing rural economies, infrastructure, services, low employment • Young people leading the way Population/Environment Population/Environment • Economies overshooting capacity by 37% • Ecological footprint per individual varies dramatically. • Rapid growth/no tech to protect/little choice but exploit • In countries like US, slower pop growth, higher tech/stand of living so high that large footprints United States…….. United States…….. • If entire world population had same SOL as average American or W European we’d need 3 worlds to supply needed resources at current rate of consumption/waste generation • <5% world pop/30% of global consumption Arable Land Arable Land • Population growth has contributed to land degradation • • • • • • throughout least dev countries Increase 10% (decade) prime cropland..Mod/severe soil loss and nutrient depletion, reduced yields Fertile topsoil depleted 16­300x’s faster than it can be replenished Rural environment deteriorates..flight Small farmers can’t sustain/feed families Women/girls pay price of poorer diets, protein malnutrition, lack of vit A. Chronic anemia, respiratory infections, suscept to malaria, dengue fever, cholera Others.. Others.. • Freshwater..2/3 pop mod/sever stress for part of year..shortages limiting economic growth • Oceans/wetlands..continued degradation, no improvement..fisheries exploited at unsustainable rates…many depend on for protein (Asia/Pacific) • Forests­1/2 worlds forest lost in 3 decades..deforestation dramatic increases..international action focus on enforcing regs and conservation initiatives • Biodiversity at risk with forest loss…what’s impact on human health? Poverty Poverty • Partly due to uneven population growth gap between rich/poor widened 1990 60:1 1999 74:1, 2015 100:1 • More women and children • Sub­Saharan Africa and South Asia: highest fertility/growth also face most poverty and resource constraints Environmental Distress Environmental Distress • • • • • Reemergence of infectious diseases Loss of biodiversity Growing dominance of generalist species Decline in pollinators Proliferation of harmful algal blooms Discuss… Discuss… • Why is reducing fertility important for poor developing countries…health impact? • Why is empowering women considered on of the most cost effective investment countries can make toward social and economic development? Climate Change Climate Change • Predict global temps rise 1.8­5.8 C and sea level to rise 9­88 cm • Rate of change faster than any period in last 1,000 years warming greater at poles. • Potential large scale irreversable changes Weather Extremes and Health Weather Extremes and Health • Hot and Cold extremes morbidity/mortality vs • • • “comfortable” Heat waves more deadly than hurricanes, floods, tornadoes combined. Physiologic response to heat stress limited by cardiac output required for cutaneous blood flow Most risk in elderly, preexisting illness..”harvesting”..also truly preventable as well. Heat Heat • Vulnerability driven by SES, poor housing • Urban features that impact.. Severe Storms Severe Storms • Floods, droughts and extreme storms • 80% affected in Asia • Africa greatest deaths • For every person killed, 10,000 impacted (physically or loss of livlihood) • PTSD • Hurricanes form where sea temp >26 C.. • Sea surface warming of about 2C increase hurricane wind speeds by 3­7 meters/second (5­12%) • Surface warming will cause sea level to rise..flodding, erosion Drought.. Drought.. • many live in water stress • Food production/weather conditions • Wild fires….property/health Weather/Air Pollution/Health Weather/Air Pollution/Health • Climate impacts level of pollutants formed and way dispersed • • • • • Ozone may increase with temp rise Many trees emit (VOC’s) precursers of ozone.. Isoprene (VOC) controlled by leaf temp and light…higher isoprenes/higher ozone Warmer temps promote ozone formation Pollen: higher CO2 promote growth/repro plants.. • Compared urban/rural Baltimore..ragweed grew faster, flowered earlier and produced > pollen • Dispersal:high pressure systems/temperature • inversion/trap pollutants Wind accompaning warmer air/distribute broadly Waterborne Disease Waterborne Disease Fresh Water • • • • • Quantity/Quality affected by climate Quanitity..precipitation/drought Quality…heavy precip/cryptosporidioisis, prev diarrheal disease globally Cryptosporidium protozoan assoc w/ domestic livestock/drinking water Deleware river: Girardia and cryptosporidium counts correlated with rainfall Marine/Salt Water Marine/Salt Water • • • Warm water/N2 favor algal blooms; toxins Red tide..human impacts/fish kills Bacteria feed on algae and proliferate in warm water. • Bangladesh..Cholera follows seasonal warming trends Weather/Vector Weather/Vector • Temperature effects on vectors and vector­borne pathogens • Precipitation effects on selected vectorborne pathogen Temperature Temperature • Vector­survival, geography, changes in susceptability to pathogens, population growth, feeding rate/host contact, seasonality of population • Pathogen­incubation,transmission, distribution, viral replication Precipitation Precipitation • Vector­rain increase larval habitat/pop size • Vertabrate Host.rain increase food/population size, flooding increase human contact • Malaria,Dengue: mosquitos; climate shifts distribution, biting rates/survival, pathogen development Public Health Approach to Climate Public Health Approach to Climate Change • Mitigation: primary prevention – Stabilize/reduce production of GH gases – Policies/techologies fuel efficient/less demand, sustainable sources, transportation policies • Adaptation/accommodation: secondary prevention: lessen impact..preparedness, surveillance Politics..Why does US drop the Politics..Why does US drop the ball? • Kyoto Protocol (UN)..goal reduce GH gases • 55% industrial countries; 55 countries required to sign; legal instrument to curb emissions US/Austrailia refused to sign citing scientific uncertainties, compliance costs, impact too marginal without China/India.. • Do we believe this or are there other reasons? ...
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