Cities, Climate Change, and Public Health

Building Human Resilience to Climate Change at the Local Level

Ella Jisun Kim

• Publisher: Anthem Press
• Year: 2020
• ISBN:
  9781785273261
• Edition: 1
• Topic: Biological Sciences
• Subtopic: Global Warming & Climate Change
• Index: Biological Sciences

To date, climate adaptation has mostly focused on protecting physical assets from potentially catastrophic climatic changes. While the lack of human vulnerability and equity components in adaptation plans and policies has been critiqued by many, this has not yet led to climate adaptation planning and policymaking processes that situates people's health and well-being front and center.

This book examines how cities can use a public health frame of climate change to boost people's understanding of and concern about climate change and increase policy support for climate adaptation efforts at the local level. In addition, it aims to strengthen our understanding of different tools cities can use to operationalize a focus on the health implications of climate change, enhance collective decision-making capacities, and, ultimately, build human resilience to climate change.

Chapter 1

INTRODUCTION

Recent years’ increases in the intensity, frequency, and duration of hurricanes in the Atlantic and Pacific ocean basins, along with the incidence of the most intense (Categories 4 and 5) storms, are in part due to higher atmospheric and sea surface temperatures from climate change (Emanuel 2017; Melillo et al. 2014). More importantly, even if we were to stop emitting greenhouse gases today, with the lock-in of irreversible temperature increases from past emissions, climate impacts are expected to continue for the next few centuries (IPCC 2014; Melillo 2014; Solomon et al. 2009).

In 2017, Hurricane Harvey, a Category 4 storm, dumped more than 50 inches of rain over southeast Texas, resulting in more than eighty deaths and $180 billion of damage (Amadeo 2017). The historic and catastrophic devastation caused by the storm posed a host of public health concerns. Hurricane Harvey caused more than eight hundred wastewater treatment facilities and thirteen Superfund sites with toxic chemicals to flood (Hernandez, Zezima, and Achenbach 2017). Standing water in flooded homes in Houston was found to contain up to 135 times of what is considered safe of E. coli, a measure of fecal contamination (Kaplan and Healy 2017). News stories broke of how a senior citizen and a firefighter contracted necrotizing fasciitis, or “flesh-eating bacteria,” from the contaminated floodwaters (Astor 2017). Long after the water drained and media attention subsided, post-Harvey residents had to grapple with increased risks of wound infections, diarrhea from toxic waters, and health threats from mold, mosquitoes, and other disease vectors, along with mental health stressors (Grigg 2017). The public health implications of climate change are significant.

As cities in the United States and around the world are increasingly experiencing the impacts of climate change, many are starting to include climate considerations in their planning and policymaking processes (Bierbaum et al. 2013; IPCC 2014). Cities are looking not only to mitigate greenhouse gas emissions from buildings, industries, and transportation to prevent future climate change but also to prepare for and manage climatic changes that have already been set in motion.

Urban climate adaptation to date has mostly focused on how cities can protect their physical assets from potential climate-related disasters, with an increasing emphasis on enhancing resilience, or creating places that can absorb and withstand climatic shocks (Hughes 2015). Scholars and practitioners have critiqued climate adaptation’s current emphasis on building physical resilience to climate change, pointing out that adaptation plans rarely incorporate equity or social vulnerability (Hughes 2015). Consequently, calls have emerged for climate adaptation to focus on human vulnerabilities instead (IPCC 2014, ch. 15; Rumbach and Kudva 2011).

To that end, this book is about why and how the health impacts of climate change should be given a more prominent role in climate adaptation efforts at the local level. While the lack of attention to climate-related health risks in adaptation plans and policies have been pointed out by many, this has not yet led to climate adaptation planning and policymaking processes that situate citizens’ health and well-being front and center. Therefore, cities will need new approaches to enhance awareness of and facilitate engagement with climate risk management choices that will build human resilience to climate change.

The Frames and Games Research Project

This book is based on the Frames and Games research project that was carried out from 2015 to 2017. The project was initiated with the expectation that an emphasis on the health impacts of climate change would increase people’s understanding of and concern about climate change, and, furthermore, increase policy support for climate adaptation efforts at the local level. In addition, the project was designed to examine whether game-based public engagement approaches can be used to strengthen people’s capacities to engage with climate adaptation planning and policymaking processes with a focus on health and well-being in their city.

The Frames and Games research project took place in Cambridge, Massachusetts—a city in the Northeast region known for its high educational attainment, progressive politics, and early climate adapter status within the country. A unique partnership between a research initiative at the Massachusetts Institute of Technology (MIT) and two municipal departments within the City of Cambridge enabled the Frames and Games project to collectively formulate a public health orientation to climate adaptation in municipal planning and policymaking processes.

Cambridge should be viewed as a friendlier place suited to attempting and testing the value of new tools in climate adaptation efforts at the local level rather than as a generalizable or representative example of other municipalities in the country. There are many lessons from designing and evaluating public engagement approaches in an early adapter city, particularly in enhancing awareness of technical issues and people’s capacities to engage with policy choices that impact their health and well-being, that can inform climate planning and policymaking processes in other cities in the United States.

Introducing the Book

This book is intended to help readers understand how cities can reframe the conversation around climate change to be about public health. In addition, it aims to strengthen our understanding of different tools cities can use to operationalize a focus on the health implications of climate change, enhance collective decision-making capacities, and, ultimately, enable technically sound and politically feasible pathways to adapt to the changing climate.

The rest of this book is organized as follows. The first part provides the background for the research project featured in the book: Chapter 2 examines climate-health linkages and health-oriented climate adaptation frameworks, and Chapter 3 summarizes climate adaptation planning and policymaking efforts at the local level in the United States. The next part goes into more detail on the Frames and Games research project: Chapter 4 probes framing climate change as a public health issue, Chapter 5 examines the design and implementation of face-to-face role-play simulations, and Chapter 6 does the same for digital games. Finally, in the last part of the book, Chapter 7 compares the results of the project’s two serious games, namely face-to-face role-play simulations and digital games, and Chapter 8 discusses the overall results of the Frames and Games project and its policy implications for policymakers and practitioners in furthering climate adaptation with a focus on human resilience to climate change.

Chapter 2

CITIES, CLIMATE CHANGE, AND PUBLIC HEALTH

Health Impacts of Climate Change

Over the last decade, deaths, injuries, and other health problems from floods, droughts, and other climate-related disasters cost an estimated $14 billion in the United States (IPCC 2014; USGRPC 2016; Watts et al., 2015, 1864). Climate change poses a series of significant and far-reaching threats to human health and well-being all over the world (IPCC, 2014; Kinney et al., 2015; Luber et al., 2014; USGCRP 2016), leading the World Health Organization (WHO) to declare climate change as the defining issue for public health in the twenty-first century (Chan 2006). In 2019, over seventy health organizations in the United States, including the American Medical Association and American Heart Association, issued a climate policy agenda to avert a public health crisis, calling climate change “one of the greatest threats to health America has ever faced” (Devitt 2019).

Focusing on climate-health linkages, Table 2.1 details how each climate impact translates into public health outcomes and indicates the populations most vulnerable to climate-sensitive health threats.

Table 2.1 Human Health Effects of Climate Change

Climate Impacts	Health Impacts	Populations Most Affected
Extreme Heat	Premature death Cardiovascular stress and/or failure Heat-related illnesses, such as heat stroke, heat exhaustion, and kidney stones	Children Elderly Diabetics People with respiratory conditions People with cardiovascular conditions Outdoor workers Low-income populations
Poor Air Quality/Pollution	Increased asthma, allergies, chronic obstructive pulmonary disease (COPD), and other cardiovascular and respiratory diseases	Children Elderly People with respiratory conditions People with cardiovascular conditions Outdoor workers Low-income populations
Wildfires	Injuries and death from burns and smoke inhalation Eye and respiratory illnesses from air pollution Exacerbation of asthma, allergies, chronic obstructive pulmonary disease (COPD), and other cardiovascular and respiratory diseases Population displacement, loss of home and livelihood	People with respiratory conditions
Extreme Weather Events	Injuries or death from drowning Lack of access to drinking water, water- and food-borne diseases from damage to potable water, wastewater, and irrigation systems Population displacement, loss of home and livelihood	Children Elderly Low-income populations
Increased Average Temperatures	Cardiovascular stress and/or failure Increased number and range of: Vector-borne diseases, such as West Nile virus, malaria Water-borne diseases, such as cholera, E.coli Food-borne diseases, such as salmonella poisoning Allergies from pollen	Children Elderly Diabetics People with respiratory conditions People with allergies Outdoor workers
All Impacts	Mental health effects, such as depression, anxiety, post-traumatic stress disorder (PTSD)

Adapted from CDPH (2012), WHO (2013), Watts et al. (2015), and USGCRP (2016).

Planning for and Managing the Health Impacts of Cl...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Dedication
• Contents
• Figures and Tables
• Acknowledgments
• Chapter 1 INTRODUCTION
• Chapter 2 CITIES, CLIMATE CHANGE, AND PUBLIC HEALTH
• Chapter 3 COLLECTIVE CLIMATE ADAPTATION AT THE LOCAL LEVEL
• Chapter 4 FRAMING CLIMATE CHANGE AS A PUBLIC HEALTH ISSUE
• Chapter 5 ROLE-PLAY SIMULATIONS
• Chapter 6 DIGITAL GAMES
• Chapter 7 ROLE-PLAY SIMULATIONS VERSUS DIGITAL GAMES
• Chapter 8 DISCUSSION AND POLICY RECOMMENDATIONS
• Appendix A. Issue Framing Vignettes
• Appendix B. Issue Framing Survey Questions
• Appendix C. Role-Play Simulation Before-Survey Questions
• Appendix D. Role-Play Simulation After-Survey Questions
• Appendix E. Role-Play Simulation Facilitator Questionnaire
• Appendix F. Role-Play Simulation Debriefing Script
• Appendix G. Role-Play Simulation Post-Game Interview Questions
• Appendix H. Role-Play Simulation Workshop Sample Characteristics
• Appendix I. Digital Game Before-Survey Questions
• Appendix J. Digital Game After-Survey Questions
• Appendix K. Digital Game Post-Game Interview Questions
• Appendix L. Digital Game Sample Characteristics
• References
• Index