New York City Panel on Climate Change 2015 Report. Chapter 5: Public health impacts and resiliency.

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Recent experience from Hurricane Sandy and high-temperature episodes has clearly demonstrated that the health of New Yorkers can be compromised by extreme coastal storms and heat events. Health impacts that can result from exposure to extreme weather events include direct loss of life, increases in respiratory and cardiovascular diseases, and compromised mental health. Other related health stressors—such as air pollution, pollen, and vector-borne, water-borne, and food-borne diseases—can also be influenced by weather and climate. Figure 5.1 illustrates the complex pathways linking extreme weather events to adverse health outcomes in New York City. New York City and the surrounding metropolitan region face potential health risks related to two principal climate hazards: (1) increasing temperatures and heat waves, and (2) coastal storms and flooding. The health impacts of these hazards depend in turn on myriad pathways, the most important of which are illustrated in the figure. Figure 5.1 Pathways linking climate hazards to health impacts in New York City. Although New York City is one of the best-prepared and most climate-resilient cities in the world, there remain significant potential vulnerabilities related to climate variability and change. As part of the NPCC2 process, a team of local climate and health specialists was mobilized to assess current vulnerabilities and to identify strategies that could enhance the resilience of New York City to adverse health impacts from climate events. The goal was to highlight some of the important climate-related health challenges that New York City is currently facing or may face in the future due to climate variability and change, based on emerging scientific understanding. As indicated in Figure 5.1, health vulnerabilities can be magnified when critical infrastructure is compromised. Critical infrastructure is a highly complex, heterogeneous, and interdependent mix of facilities, systems, and functions that are vulnerable to a wide variety of threats, including extreme weather events. For example, delivery of electricity to households depends on a multi-faceted electrical grid system that is susceptible to blackouts that can occur during heat waves. These, in turn, can expose people to greater risk of contact with exposed wires or to greater heat stress due to failure of air conditioning. Understanding and predicting the impacts that extreme weather events may have on health in New York City require careful analysis of these interactions. Two recent plans to enhance climate resiliency in New York City have been released. A Stronger, More Resilient New York (City of New York, 2013) was developed in the aftermath of Hurricane Sandy by a task force of representatives from City agencies and consultants. This plan was informed by a detailed analysis of the impacts of Hurricane Sandy on infrastructure and the built environment and by the NPCC’s updated 2013 climate projections for the New York metropolitan region. It includes more than 250 initiatives and actionable recommendations addressing 14 domains of the built environment and infrastructure including the healthcare system and several other domains relevant to protecting public health. In addition, the 2014 New York City Hazard Mitigation Plan (HMP) (City of New York, 2014), developed by the NYC Office of Emergency Management in collaboration with the Department of City Planning, updated the 2009 HMP and assesses risks from multiple hazards that threaten New York City. These include but are not limited to several climate-related hazards such as coastal storms and heat waves, and it lays out comprehensive strategies and plans to address these hazards. Many of the measures recommended by A Stronger, More Resilient New York and the HMP have already been implemented, are in progress, or are planned (City of New York, 2013; 2014). This chapter does not include a detailed review of these plans, which would be beyond the expertise and charge of the contributors. Nonetheless, the recommendations in this chapter do broadly support the plans laid out in A Stronger, More Resilient New York and the 2014 HMP, and these are referenced at several points where they are especially relevant. Here we focus on summarizing and synthesizing the emerging scientific knowledge on climate-related health hazards, knowledge that can inform ongoing preparedness planning. Key terms related to climate variability and change as they are applied in the health sector are defined in Box 5.1. This is followed by sections describing health risks, vulnerabilities, and resilience strategies for coastal storms and extreme heat events. We then briefly discuss the interactions of climate change with air pollution, pollen, vector-borne diseases, and water- and food-borne diseases. We conclude with recommendations for research and resiliency planning. Box 5.1 Definitions of key cross-cutting terms in the health context Adaptation Initiatives and measures to reduce the vulnerability of natural and human systems against actual or expected climate change effects. Various types of adaptation exist, such as anticipatory and reactive, private and public, and autonomous and planned. For health, physiological adaptation is also relevant.