Coastal Impacts, Adaptation, and Vulnerabilities - Climate ...

88 Coastal Impacts, Adaptation, and VulnerabilitiesUnderpinning the extent of the human health impact of climate change are the socialstructure, which could include close family or community ties; the cultural context,which includes socio-economic status, cultural traditions, family and communitydynamics, gender, and religion; and the economic and political context, which includepopulation demographics, and the roles of community and political leaders. In additionto long-term oceanographic and biological data, social and public health data includingemergency room visits, reported illnesses, recreational usage of beaches and coastalwaters, livelihood and economic growth data, and household income is needed. The followingdiscussion outlines the potential direct and indirect environmentally mediatedimpacts of climate change on human health and well-being as well as sentinel speciesand habitats that can serve as integrative indicators of ecosystem level risks to humanhealth.Direct ImpactsHeat and HEAT WAVES. Health outcomes from increasingly frequent and severeheat events include heat exhaustion, heat stroke, severe cramps, and death. Exposureto increased average temperatures alone may exacerbate pre-existing conditions relatedto chronic respiratory, neurological, or cardiovascular diseases (Luber, 2008). Duringthe 2006 California heat wave, over 160 Californians died, and 16,166 excess emergencyroom visits and 1,182 excess hospitalizations occurred statewide. Children aged 0-4years of age and adults over 65 years of age were at greatest risk. Emergency room visitsalso showed significant increases for acute renal failure, cardiovascular diseases, diabetes,electrolyte imbalance, and nephritis (Knowlton, 2006). Chronically ill individuals 65and older are more susceptible to heat effects than the general population. As coastalpopulations increase, and the demographics include higher risk populations, the healtheffects from prolonged heat exposure can be expected to increase as well. This is welldemonstrated in coastal urban environments such as New York City, but additional researchis needed to further differentiate expected impacts specifically in coastal environments(Knowlton et al., 2008).Drought and FLOOD. In a recent report, the CDC (2010) noted that drought effectscan be manifested in a number of health-related impacts including compromised qualityand quantity of potable water and food, diminished living conditions, increased risksassociated with recreation, impacts to mental health, increased incidence of disease,and additional stress on vulnerable populations. In addition, drought leads to parchedhabitats, and some coastal areas may be more prone to forest fires, which can exacerbateasthma and other aero-allergenic and respiratory diseases. In addition to the impacts tohuman development discussed in the preceding sections, flooding events pose the directrisk of death. Longer term human health impacts are related to infrastructure--ensuringthat hospitals and urgent care facilities are accessible to the local population during extremeevents, that evacuation plans are in place and successfully communicated, andthat emergency personnel and first responders are prepared.Hurricanes and STORM Surge. Coastal storm-related health outcomes includechanges in heat-related illness and death, injury and death from hurricane and storm