State of Change: A Capacity for Health

“The best means of fending off any changes for the worse due to climate change are similar to those already in place: ensuring that changes in disease patterns can be detected, investigating as needed, and mounting an appropriate public health response as soon as possible.”
–Oregon Climate Assessment Report

PORTLAND, Oregon – Some time after paddling the pristine inlets of Vancouver Island in British Columbia, a kayaker came down with a severe headache. Within months the 45-year-old woman was blind and bedridden. She died of a massive brain infection in 2002.

Health workers traced her illness to a strain of deadly fungus called Cryptococcus gattii, once found only in hot spots like Australia, Asia and South America. When inhaled, C. gattii’s tiny spores can lodge in the lungs, attacking respiratory and neurological functions. Over the past dozen years, it has sickened nearly 200 people in the region and killed more than 40. One survivor, a robust Portland outdoorsman named Bob Lewis, told NPR that he’s “one of the lucky ones,” even though his heart, lungs and kidneys were permanently damaged when he was stricken by one of Oregon’s earliest cases in 2007.

Experts point to climate change as a likely culprit for C. gattii’s emergence in the moist soils and decaying trees of the Northwest. As greenhouse gasses warm the region, scientists expect once-tropical fungi and other hot-weather pathogens to migrate northward. “The pathogen emerged as the cause of an outbreak on the east coast of Vancouver Island beginning in 1999,” writes Oregon Public Health Division Director Mel Kohn in a recent article, “Climate Change and Communicable Diseases in the Northwest,” in Northwest Public Health, a University of Washington publication. “Environmental sampling … unveiled an ecological berth among several tree species there, notably our beloved Douglas fir. The researchers hypothesized that the establishment of the fungus in this area may have been due to climate changes.”

Longer summers and hotter temperatures are giving a leg up to other communicable diseases, such as West Nile fever and Lyme disease, according to Kohn, who served with OSU’s Mark Abbott on the Oregon Global Warming Commission and the Governor’s Climate Change Integration Group. That’s because many viruses, bacteria, protozoa, funguses and parasites can survive longer in warmer climates, shifting and expanding their ranges in response.

Heat Islands

Communicable diseases are just one health threat linked to climate change. Others include “heat islands” — patches of concrete and asphalt devoid of greenery — that concentrate solar energy and pollutants to create ground-level ozone. That’s why city dwellers are especially vulnerable to asthma and other lung maladies. In small towns and woodland communities, wildfires can create physical and mental stress. Laborers who harvest crops in the blazing sun risk heat-related illnesses. Floods can contaminate drinking water and displace families.

The young, the old, the sick, the poor and the disabled suffer disproportionately during heat waves, storms and other climate-related events. And linguistic and cultural minorities face extra obstacles. Kari Lyons-Eubanks ranks social justice as a top priority in her role as a policy analyst for Multnomah County Environmental Health Services. She likes to paraphrase the “father of environmental justice,” Robert Bullard, saying: “Sustainability cannot be simply a green or environmental concern.”

So Lyons-Eubanks, who coordinates the public-health piece of the agency’s local climate action plan, pays close attention to the full array of needs across the entire spectrum of neighborhoods — food, transportation, housing, heating, cooling, emergency preparedness — in short, anything that impinges on human health and well-being.

“We need to really engage the impacted communities,” says Lyons-Eubanks, whose background includes HIV prevention work in Kenya, Zimbabwe and Portland’s Somali-Bantu community.

Reaching Out

Making sure human health is folded into climate-change planning initiatives is taking on new urgency for the health division. “Public health has a huge role that often is overlooked,” says Julie Early-Alberts, Office of Environmental Public Health. “It’s important to have a public-health professional at the table, someone who has that lens.”

Of eight states to receive climate-adaptation grants in 2010 from the Centers for Disease Control and Prevention, Oregon is one of four to get a “Category 2” grant for higher levels of implementation. That’s because Oregon is a frontrunner in building “climate-resilient communities,” says Lauren Karam, former grant coordinator. “Some states are just getting started laying the groundwork,” she says. “We already have a lot of the baseline data.”

Early-Alberts and her colleagues have held “Ready for Change” workshops for public-health workers and emergency-preparedness personnel in Hillsboro, Newport, Bend and Grants Pass to gauge readiness for local climate impacts and help lay the groundwork for future planning. Also, five Oregon locales — Multnomah, Benton, Crook and Jackson counties, along with the north-central region of the state — have gotten “mini-grants” for two-year pilot projects. The idea is to raise awareness and build local capacity for keeping residents healthy during climate-related events.

Science — particularly science pertaining to Oregon’s unique mix of ecological and climatic niches — underpins the division’s outreach. For that reason, OCCRI’s Oregon Climate Assessment Report is a key document informing the workshops. The report also is highlighted on the division’s climate-change website. “We see OCCRI as a key partner,” says epidemiologist Mandy Green. “As we work with local public health departments, the localized data collected by OCCRI will be essential for them.”