Transcript Document

Contra Costa
Health Services
Getting Ready :
Health, Planning and Climate Change Readiness
Overview
•
•
•
•
Climate Change, Vulnerabilities and Health
Public Health and Medical Risk Assessment
County Excessive Heat Plan
Concluding Thoughts
Current Disparities in Health: Income
Current Disparities in Health: Race
Current Disparities in Health:
Education
Other Health Disparities
•
•
•
•
Heart Disease
Cancer
Stroke
Asthma
Vulnerable Populations Experience
Health Disparities
•
•
•
•
•
•
•
•
•
Income
Race
Education
Gender/Sex
Linguistic Isolation
Age
Chronic Conditions
Disability
Geography
– Access to Resources
– Access to Health Promoting Destinations
(Health Care, Healthy Food, School, Family, Etc.)
– Neighborhood Cohesion
– Proximity to Toxins
Vulnerability
Vulnerability
Vulnerability
Vulnerability
Vulnerability
Climate Change Exacerbates Existing
Health Disparities
Climate Impacts:
•
•
•
•
•
•
•
•
Health Impacts:
Extreme Heat
Increased Average Temperatures
Air Pollution
Wildfire
Severe Weather/Storms
Agricultural Disruptions
Drought
Sea Level Rise
• Death
• Cardiovascular Stress
and Failure
• Illnesses such as Heat
Stroke, Heat Exhaustion
and Kidney Stones
Groups Most Impacted:
•
•
•
•
•
•
Elderly
Children
Farm/Outdoor Workers
Diabetics
Low-Income Urban Residents
People with Respiratory Diseases
Climate Change Impacts:
Geographically Uneven
Climate Change Exacerbates Existing
Disparities
Climate Impacts:
•
•
•
•
•
•
•
Health Impacts:
Extreme Heat
Increased Average Temperatures
Air Pollution
Wildfire
Severe Weather/Storms/Sea Level Rise
Agricultural Disruptions
Drought
•
•
•
•
Displacement
Drowning
Injuries
Water and Food-Borne
Disease from Failing
Infrastructure
Groups Most Impacted:
•
•
•
•
Coastal Residents
Elderly
Children
Low-Income People
Climate Change Impacts:
Geographically Uneven
Risk-Based Initiative
Contra Costa County
Bay Area Risk-Based Pilot Project
• CDC selected 10 Metropolitan Statistical Areas in
the U.S. to participate in a Risk-Based Pilot
Project
• San Francisco/Oakland Metropolitan Statistical
Area (Bay Area MSA) was one of the 10
• Bay Area MSA has over 4 million residents
Bay Area Risk-Based Pilot Project Cont’d
• Six Bay Area Health Departments participating
in the Project:
•
•
•
•
•
•
Alameda
Contra Costa
Marin
San Francisco
San Mateo
City of Berkeley
• UCLA contracted to conduct PH & Medical
Hazard Risk Assessment
Project Activities
• Establish a coordinated planning effort
• Conduct a Public Health and Medical
Hazard Risk Assessment
• Rank and prioritize threats (hazards)
• Propose mitigation strategies
• Develop an MSA risk mitigation plan
• Evaluate and measure plan
Public Health and Medical
Hazard Risk Assessment
Identification of potential hazards and risks
related to public health, medical, and
mental/behavioral health systems
Assessment of the potential loss or disruption of
essential services such as clean water, sanitation,
or the interruption of healthcare and public health
services
Public Health and Medical
Hazard Risk Assessment
Determine severity of hazards to human health,
and public health, medical, and
mental/behavioral health services and
infrastructure
Map at-risk populations
Engage stakeholders in determining hazard
mitigation
Severity is the magnitude of the hazard
minus surge capacity and existing
mitigation strategies.
Severity = hazard - mitigation
In hazard mitigation planning, as with
most other planning efforts, the actual
process of planning is as important as
the plan itself.
October 1, 2011
Categories of Mitigation Strategies
• Physical Infrastructure / Operational
• Organizational Infrastructure
• Social Infrastructure
Emergency Preparedness
in Contra Costa County
• Percent of residents who report they are NOT prepared for a
disaster
20 % in all residents
40 % in people living below 200% of the federal
poverty
level
• Among those that take medication, 11 % report they are NOT
prepared with enough medication for an emergency
Source: 2009 California Health Interview Survey
Emergency Preparedness
in Contra Costa County
• Percent of residents who report they are very or somewhat
confident that the public health system responds to major
disasters
68 % in all residents
63 % in people living below 200% of the federal
poverty
level
• Percent of residents who report they are very or somewhat
confident that the public health system responds fairly
85 % in all residents
68 % in people living below 200% of the federal
poverty
level
Source: 2009 California Health Interview Survey
“Adaption”, Eric Klinenberg,
New Yorker Magazine, January 7, 2013
• July 1995 – Chicago Heat Wave
• 739 deaths – 7 times as many as died in
Hurricane Sandy
• Working air conditioner reduced death by 80%
Eight of the 10 community areas with highest
heat wave death rates:
• Predominately African-American
• Pockets of concentrated poverty and violent
crime
• Older people
were at risk of
staying home and
dying alone during
the heat wave
Three of the 10 neighborhoods with the
lowest heat wave related deaths were
also poor, violent, and predominately
African American.
Men who identified themselves as Papa B, left,
and Cadillac Bob, find refuge from the heat in a
shaded lot between their homes Thursday, July
5, 2012 on Chicago's south side.
Englewood and Auburn Gresham, two adjacent
neighborhoods on the South Side of Chicago were
both ninety-nine percent African American, with
similar proportions of elderly residents.
Both had high rates of poverty, unemployment, and
violent crime.
Heat Wave Deaths:
• Englewood = 33 /100,000
• Auburn Gresham = 3 /100,000
Between 1960 – 1990
Englewood:
• Lost 50% of its residents
• Lost most commercial outlets and social cohesion
• Older people fearful of leaving their homes
Auburn Gresham:
• No population loss
• People walked to diners and grocery stores
• Neighbors participated in block clubs and church
groups
• Neighbors did door knocking wellness checks
“The key difference between
neighborhoods like Auburn Gresham and
others that are demographically similar
turned out to be the sidewalks, stores,
restaurants, and community organizations
that bring people into contact with friends
and neighbors.
During the severe heat waves…, living in a
neighborhood like Auburn Gresham is the
rough equivalent of having a working air
conditioner in each room.”
Risk-Based Initiative Current Efforts
• Earthquake Hazards
• Vulnerable Population: Medically Dependent
• Working with providers (services and equipment) to
identify real-time emergency response efforts
Timeline
Planning underway – 2013
Outcomes
Emergency response procedures
Mutual assistance agreements
Contra Costa County Climate
Leaders Workshop
CCC Operational Area
Excessive Heat Emergency Plan
February 28, 2013
Emergency Support Functions
•
•
•
•
•
•
•
1. Transportation
2. Communications
3. Public Works and Engineering
4. Firefighting
5. Emergency Management
6. Mass Care and Shelter
7. Resource Support
Emergency Support Functions
Continued
•
•
•
•
•
•
•
•
8. Public Health and Medical Services
9. Urban Search and Rescue
10.Hazardous Material Response
11. Agriculture & Natural Resources
12. Utilities
13. Public Safety and Security
14. Recovery and Mitigation
15. External Affairs
Heat Plan Overview
•
•
•
•
•
•
Identifies Partners
Describes Responsibilities
Criteria for Implementing
Public Information Material
Identifies those most vulnerable
EHSD Cooling Centers
• *Note: This plan is an Annex to the EOP
Partners
•
•
•
•
•
•
•
Employment and Human Services
American Red Cross / CBOs
Cal EMA
Health Services
CAO – Communications and Media
National Weather Service
City / Local Government
Responsibilities
Local Government Role
• Three Activation Levels
– Monitor
– Partial
– Full
• Gather and Analyze Information
• Coordinate Services
• Encourage Interagency Information Exchange
Responsibilities Continued
• Alert Partners to Implement their plans
• Monitor locations with power outages
• Ensure heat tips are posted on websites
Implementation Criteria
• 105 Degrees
• In Excess of 3 Days (Local and NWS)
• Night temperatures are 75 Degrees +
• Increase in Heat medical emergencies as identified
by the County Health Officer
• 105 Degrees accompanied by extended power
outages
Public Information
• Websites Heat Tips Posted
• Press Release Templates
• Media Outreach
• CCTV Videos
Cooling Centers
• Public
– Libraries
• Private
– Shopping Malls
– Book Stores
– Movie Theaters
• Community Based Organizations
– Community Centers
– Senior Centers
• City Buildings
• Request extended hours and lower admission rate to expand access
Gaps
• Heat Conference Call Updates with NWS and
Cal EMA
• Annual Readiness Campaign
– Public Education and Outreach
Special Considerations
• People with Disabilities and Access and Functional
Needs
– Have County Agencies serving at risk populations to do
phone check ups
• Immediate Outreach
• County Weatherization Programs
• Animals
– Pets
– Livestock
– Wildlife
Community Preparedness
• Build Cohesion
• Community Emergency Response Team (CERT)
– Encourage Neighbors, Families and Friends to check up on
one another
• Senior Outreach Friendly Visitor Program
• Survival Attitude and Effort
• Consider Rescheduling outdoor public events
Summary
• Clearly defined process
• Community Preparedness is key
• Public Education and Outreach
Contact Information
•
•
•
•
•
•
Marcelle Indelicato
Senior Emergency Planner
Office of the Sheriff
Emergency Services Division
[email protected]
925-313-9609
What Can We Do Prepare for Climate
Change and Reduce Health Disparities
• Physical Infrastructure / Operational
• Social Infrastructure—Social Cohesion
• Organizational Infrastructure
Physical Infrastructure:
Weatherization
Social Infrastructure:
Plan for Vibrant, Cohesive
Communities
• Neighborhood
Councils
• Community
Organizing
• Street Lighting
• Vibrant, Mixed Use
Neighborhoods
• Parks
• Empowering People
Organizational Infrastructure:
• Do you have organizational systems that are
designed to be resilient?
• Know and understand agency response plans?
• Who is responsible for emergency planning in
your city? Do you know? Do you work with them?
Work across disciplines!
• Outreach? Are you incorporating emergency
response into your public outreach?
• Other Ideas?
Planning Opportunities to Mitigate
Impacts:
•
•
•
•
•
•
•
Addressing Heat Islands
Tree Planting
Open Space Preservation
Strengthening Food Systems
Improving Indoor/Outdoor Air Quality
Working Towards Economic Security
Fostering Social Cohesion
What’s Next?
• We’re not totally sure. Trying to figure it our
ourselves. But we’ve started to assemble
some data (on vulnerability) and identify
impacts.
• Trying to figure out how to implement. Need
your help in thinking this through.
• Ask you to build a focus on people and their
health into your work.
Resources
http://cal-adapt.org
http://cchealth.org/built/
http://cchealth.org/healthdata/hospital-council/