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Sustainable Human Life, KEY: Video: Public Health Disaster Preparedness…

- - - - teach climate-related illnesses in our health-professional schools. (B)
        
        collect data on our patients' climate-related conditions by making sure there are billing codes to identify them. (B)
        
        conduct climate-related health research. (B)
        
        teach how to have green practices in homes. (B)
        
        advocate for our patient energy needs. (B)
        
        Help patients get safer homes. (B)
        
        help them get necessary equipment in homes when conditions worsen. (B)
        
        We can testify in front of lawmakers as to the findings (B)
        
        we can medically treat our patients' climate-related illnesses. (B)
        
        prepare our patients mentally and physically for the health challenges they will face, using a model of medicine that incorporates economic and social justice. (B)
  - - - 4 types of risk communication:
        
        Information and education
        
        Disaster warning and emergency notification
        
        Joint problem solving and conflict resolution
        
        Behavioral change and protective action (G)
      - Goal of Risk Communication is to creating an informed public that is:
        
        Involved, interested, reasonable, thoughtful, solution oriented, cooperative, and collaborative
        
        Appropriately concerned about the risk
        
        More likely to engage in appropriate behaviors (G)
      - Factors of Risk Perception (Risk=Hazard + Outrage)
        
        Cognitive factors: (gravity of events, media coverage, risk-mitigating measures)
        
        Affective factors: (emotions, feelings, moods)
        
        Contextual Factors: (Framing of risk information, availability of alternative information sources)
        
        Individual Factors: (Personal traits, previous experience, Age, gender) (G)
      - Challenges to effective Risk Communication: Media/News, Social media, Misinformation, Politics (G)
    - - Factors that influence risk perception
        
        Risk: Likelihood of harm in defined circumstances. Risk is always a probability influenced the level of exposure. (N)
        
        Familiarity means less risk (H)
        
        Lack of personal control perceived increases risk perception (H)
        
        Whether the exposure to the risk voluntary or involuntary (H)
        
        Dreaded vs non-dreaded outcome (H)
        
        Benefits decrease perceive risk, does the risk also give please (H)
      - Risk and perception of risk are not always aligned (N)
      - • Risk evaluation: How, Where, How Much, How long (N)
    - - Types of Prevention
        
        Primary Prevention: interventions prior to development of health outcome(s) (J)
        
        Secondary Prevention: Early detection of a health problem (J)
        
        Tertiary Prevention: Identification of disease, treatment, and efforts to prevent disability or death (J)
      - Principles of Prevention
        
        Precautionary Principle: Lack of scientific certainty shall not be used as a reason for postponing cost-effective measures to prevent environmental degradation (J)
        
        The "Polluter Pays" Principle: The notion that those who cause and profit from pollution should pay the price for cleaning it up (J)
        
        Intergeneration Equity: The right to development must be fulfilled so as to equitably meet developmental and environmental needs of present and future generations (J)
        
        Integrated Decision Making: Environmental considerations need to be incorporated into decision-making processes at all levels (J)
    - - Evaluating and combining evidence from multiple sources: 1) Toxicology 2) Epidemiology 3) Occupational Health (L)
        
        4 Elements of Risk Assessment: (L)
        
        • Hazard Identification: identifying and selecting environmental agents and health effects for assessment (L)
        
        • Dose-Response Assessment: describing the quantitative relationship between exposure and risk (L)
        
        • Exposure Assessment: estimation or measurement of the magnitude, duration and timing of exposures to agents of concern (L)
        
        • Risk Characterization: combining the information from previous steps to estimate the level of response needed (L)
        
        De minimus risk: the idea that some risks are so small that they are acceptable or insignificant from a societal perspective (L)
        
        Decision Analysis: evaluating the different decisions and implications of those decisions (L)
        
        Cost-Benefit Analysis: legally required (L)
        
        Risk-Benefit Analysis: the balancing act between beneficial exposures that may also have inherent risks (L)
      - The "Precautionary Principle": serious risks should be avoided or mitigated when possible, even when those risks are unlikely or uncertain (L)
  - - - Why people garden
        
        Intrinsic Motivations: behaviors are those that are engaged in for their own sake or for the pleasure and satisfaction of performing them (e.g. Mental health well-being, Intergenerational learning) (K)
        
        Extrensic Motivation: Economics, Community Enhancement and Building Relationships, Store-Bought Food Quality (K)
      - Exposure Assessment by gardeners: Awareness and Understanding off Historical Land Use (K)
  - - - Environmental Health Bill State Tracking
        Database: https://www.ncsl.org/research/environment-and-natural- resources/environmental-health-legislation-database.aspx (O)
        
        Search: Pesticides, Missouri, 2021
        
        SENATE SUBSTITUTE NO. 2 FOR SENATE BILL NO. 26, 101ST GENERAL ASSEMBLY, 2021, enacted 7.14.21 https://custom.statenet.com/public/resources.cgi?id=ID:bill:MO2021000S26&ciq=ncsl7&client_md=73672882149df78ddbef3912545d8566&mode=current_text (P)
        
        Has nothing to do with pesticides for the first part and then… Established rules for: obtaining pesticide applicator license, license renewal process, rules for application of pesticides, Determines designees, Establishes what and where pesticide application in regulated, Established a governing body that will certify applicants and enforce and evaluate rules. (P)
    - - Bill for First Responders from 9/11 passed 97 - 2, only Mike Lee and Rand Paul voted against. It also extended the length of the bill to a 75 year term. (S)
    - - Ambient standards: limiting concentrations of toxic agents in the air (O)
      - Emissions standards: limiting discharges from pollution sources (O)
      - Technology standards: specifying use of an engineering design (landfills designed to be lined with clay and plastic liners) (O)
      - Product standards: permissible materials of a given item (O)
      - Work practice standards: procedures to limit pollution and/or exposures (O)
      - Exposure standards: limiting levels of individual exposure (radiation badges) (O)
- - - - • Floods
      - • Extreme Precipitation
      - • Rising Temperatures
      - • Wildfires
      - Heat Waves
        
        Heatwave Deaths Attributable to Climate Change: a) climate change is affecting the frequency, intensity, and duration of heatwaves and b) exposure to high ambient temperatures is associated with excess morbidity and mortality (D)
        
        “3HEAT” study is a three-city study of Detroit, Phoenix, and Atlanta. The study aims to advance methodological innovation in the development of heat exposure metrics; quantify mortality and morbidity based on individually-experienced temperatures; link regional climate and building energy models, residential building stock, and grid infrastructure data; and compile data on current and future climate conditions. (E)
        
        In US cities, disparities in health impacts related to extreme heat exist among racial, ethnic, and socioeconomic groups. These disparities are often exacerbated by environmental conditions, with low-income, urban communities of color disproportionately impacted by neighborhood characteristics that contribute to urban heat islands and higher temperatures that can threaten health (E)
      - • Drought
      - • Cold Waves and Winter Storms
      - Rising sea Levels
        
        Miami: communities that were kept from the waterfront are now being priced out of the high ground where they were placed originally as people move away from the coast. (F)
        
        South Louisiana is losing land at one of the fastest rates on the planet (F)
      - • Hurricanes (C)
      - Disease Spread
        
        Spread of the tick vector has been associated with steadily increasing numbers of Lyme disease cases, confirming that the ecological phenomenon of climate change-driven spread of the tick, accompanied by B. burgdorferi transmission cycles, has had clear public health consequences in Canada (D)
        
        The observed increase in cases of Vibrio infections in the Baltic Sea can be attributed to an increase in SST, which in turn can be attributed to global climate change. (D)
    - - Detection and Attribution (D&A): basis for better evidence-based risk management to reduce current and plan for future climate change-related health burdens, and to inform advocacy for actions to mitigate green- house gas emissions. (D)
        
        • Multi-step attribution links separate single-step approaches that a) attribute an observed change in a variable of interest to a change in climate or other environmental variable, and b) attribute the change in climate to external drivers (e.g., greenhouse gas emissions). (D)
        
        • Single-step attribution uses a single comprehensive statistical model that detects a significant change in the variable of interest and compares the observed change with that expected if climate change had not occurred. (e.g Weather data: example, temperature and heat-related mortality) (D)
      - community-based participatory research (CBPR): partnership approach to research that equitably involves community members, organizational representatives, researchers, and others in all aspects of the research process, contributing expertise and sharing decision making and ownership of data between community members and academic investigators (E)
        
        Factors that facilitate successful CBP: 1) early involvement of community partners at the conceptual stages of a project 2) agreed upon guiding principles and operating norms to enhance equity, processes to overcome stereotypes held by community partners 3) academic researchers, acknowledgement of differences in how community-based organizations and academic institutions view research 4) agreed upon objectives that address the priorities of both community and academic partners (E)
- - - - Penalizes the movement of people, usually through exploited labor and usually through criminalization. (F)
      - Forces people to relocate away from the social and economic systems that they need to survive. (F)
      - When damaged homes are now "green built," but now have a higher value, outpricing people who want to return home (F)
  - - - Snope.com: debunking website (I)
  - - - Cadmium (Cd) is a nonessential metal, a food-chain contaminant, and a constituent of cigarette smoke and polluted air (IPCS 1992). Diet is a major source of Cd exposure for nonsmokers, while cigarette smoke is an additional source for smokers (M)
        
        Adverse outcomes associated with Cd exposure in longitudinal studies: Breast Cancer, Mortality from heart and vascular disease, cancer mortality. Mortality from Liver-related diseases, Cancer Mortality, Mortality from Alzheimer’s disease (M)
        
        In the general population, blood Cd is considered a good estimate of body burden because population blood Cd levels correlate with urine Cd levels (M)
        
        A maximally permissible concentration (MPC) for Cd in foods should be set as low as reasonably achievable. Persistence of Cd in the environment, coupled with its high soil-to-plant transfer rates, requires long-term management of Cd in the environment (soil, air, and water), and in agriculture, where consideration should be given to leafy salad vegetables, such as spinach and lettuce, which are known to be hyper accumulators of Cd. In the absence of non-toxic chelating agents to reduce Cd tissue burden, maintenance of the lowest Cd levels in food crops is pivotal. (M)
  - - - Restricted analyses identified 1072 cancers in 999 responders, with elevations in cancer incidence for all cancer sites combined. Cancer incidence was not associated with any WTC exposure index for all cancer sites combined or for prostate cancer (R)
      - Statistically significant elevations in cancer incidence for all cancer sites combined and for prostate and thyroid cancers and leukemia. Multivariable analyses show no association with magnitude or type of exposure. (R)