preventing disasters: disaster risk reduction as a sustainable adaptation to climate change 1
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Preventing Disasters: Disaster Risk Reduction as a Sustainable Adaptation to Climate Change 1. Centers for Disease Control and Prevention. Mark Keim, MD, MBA. 1 Keim ME. Preventing Disasters. Disaster Med Public Health Prep. 2011 Jun;5(2):140-8. A story of disaster risk reduction…. - PowerPoint PPT PresentationTRANSCRIPT
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Preventing Disasters: Disaster Risk Reduction as a
Sustainable Adaptation to Climate Change1
Centers for Disease Control and Prevention
Mark Keim, MD, MBA
1 Keim ME. Preventing Disasters. Disaster Med Public Health Prep. 2011 Jun;5(2):140-8.
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A story of disaster risk reduction…
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15 years later…
December 1981
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1982 Memorial Day holiday
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Evacuation path
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All deaths occurred during the impact phase
May 1982Duclos PJ, Ing RT. Injuries and Risk Factors for Injuries from the 29 May 1982 Tornado, Marion, Illinois. International Journal of
Epidemiology 1989,18: 213-219.
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Global climate change is predicted to increase the probability of extreme
weather events• High precipitation
disasters– Storms – Floods– Landslides
• Low precipitation disasters– Heat – Drought– Wildfire
2 IPCC Working Group II, Impacts, Adaptation and Vulnerability, 2007 http://www.ipcc.ch/SPM13apr07.pdf
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8
Public health consequences of extreme weather events
• Death• Injuries• Loss of clean water• Loss of shelter• Major population
movements• Loss of sanitation• Loss of routine hygiene• Disruption of solid
waste management
• Public concern for safety• Increased pests & vectors• Damage to health care
system• Worsening of chronic
illnesses• Loss of electricity• Toxic exposure• Loss of food supply
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Disasters are increasing worldwide…
• …due to increasing vulnerability of populations at risk.
• Interventions must therefore address the causes of vulnerability not merely the response
Center for Research on the Epidemiology of Disasters : URL:http://www.unisdr.org/we/inform/disaster-statistics
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An evolution in approaches
Response
Preparedness
Risk Management
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Disaster Risk Management
Definition– “The systematic
process of using administrative directives, organizations, and operational skills and capacities to implement strategies, policies and improved coping capacities in order to lessen the adverse impacts of hazards and the possibility of disaster”.
Components– Risk assessment– Risk avoidance– Risk reduction– Risk transfer– Risk retention
UNISDR 2009, http://www.unisdr.org/eng/terminology/terminology-2009-eng.html
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Risk Management vs. Risk Reduction
• Risk Management– Prevention– Mitigation– Preparedness– Response – Recovery
• Risk Reduction– Prevention– Mitigation
Risk Reduction
lessens
the likelihood
of disaster
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Causes Effects
Hazard Exposure
Vulnerability
Mortality
Displace-ment
Morbidity
Loss of liveliho
od
Prevention
Mitigation
Preparedness, Response
& Recovery
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Disaster Risk Reduction (DRR) for Health
What is DRR? Preventing
disaster-related adverse health impact before it happens
Deals with the root cause
Why DRR? More effective in
reducing mortality• Majority of disaster
deaths occur during impact phase
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Definition of risk Risk is the
probability that an event will occur.
In epidemiology, it is most often used to express the “probability that a particular outcome will occur following a particular exposure”
Last JM, ed. A dictionary of epidemiology. 4th edition. New York: Oxford University Press, 2001.
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Factors affecting disaster risk
RISK
Capacity
Vulner-ability
Hazard/ Exposure
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Health-related disaster risk occurs as the result of
convergence of 4 key factors:• The presence of a
health hazard associated with the occurrence of natural or man-made danger
• The degree of exposure to the hazard sustained by the person (or population)
• The degree of vulnerability of the person (or population) to that particular health hazard
• The degree of capacity of the person (or population) in order to avoid or lessen harm
From: Keim M. Disaster Risk Management for Health. In Ed., David S. Textbook of Emergency Medicine. Lippincott) New Dehli 2012
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– “A dangerous phenomenon, substance, human activity or condition that may cause loss of life, injury or other health impacts, property damage, loss of livelihoods and services, social and economic disruption, or environmental damage”
Definition of a hazard
UNISDR 2009, http://www.unisdr.org/eng/terminology/terminology-2009-eng.html
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Examples of hazards
Floods
TornadoesTyphoons
Earthquakes
Radiation
Outbreaks
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Definition of vulnerability“The characteristics
and circumstances of a community, system or asset that make it susceptible to the damaging effect of a hazard” UNISDR 2009
Or simply put…
Likely to incur physical or emotional illness or injury
UNISDR 2009, http://www.unisdr.org/eng/terminology/terminology-2009-eng.html
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Public health vulnerability
• Certain populations are more vulnerable to disaster-related morbidity and mortality
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Definition of exposure– “People, property,
systems, or other elements present in hazard zones that are thereby subject to potential losses”
• Example of exposure– Living in an area
that floods
UNISDR 2009, http://www.unisdr.org/eng/terminology/terminology-2009-eng.html
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Definition of capacity
– “The combination of all the strengths, attributes and resources available within a community, society or organization that can be used to achieve agreed goals” ‡
• Also known as absorptive capacity ‡‡
What is the difference between capacity vs. capability?
‡ UNISDR 2009, http://www.unisdr.org/eng/terminology/terminology-2009-eng.html
‡‡ Sundnes K, Birnbaum M, Birnbaum E, eds. Health Disaster Management Guidelines for Evaluation and Research in the Utstein Style. USA: Prehospital and Disaster Medicine; 2003
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Countering disaster risk
Hazard /Exposure andVulnerability
Increase Risk
Decreases
Risk
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Reducing exposures
• Floodplain management– Dams, levees, weirs
• Population protection measures– Evacuation– Mass care
• Land use planning and regulation
• PPE, sanitation/hygiene
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Reducing vulnerability
• Health promotion• Health care• Poverty reduction• Community
planning• Immunization
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Mapping human vulnerability
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National Prevention Strategy Identifies goals, priorities,
recommendations, and measures for improving health through prevention
Grounds recommendations in evidence-based practice
Aligns and focuses federal prevention and health promotion efforts, including existing national efforts Healthy People 2020 National Quality Strategy First Lady’s “Let’s Move!” campaign America’s Great Outdoor Initiative
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National Prevention Strategy
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Building capacity
We build capacity by improving:
– Preparedness– Response – Recovery
Societal actions that build emergency health capacity• Public health & safety• Healthcare• Education• Poverty reduction
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Examples of environmental health programs that reduce the risk of disaster-related
morbidity and mortality
Reducing exposures (Healthy
communities) Healthy buildings Built environment Population protection
measures Risk assessment Industrial hygiene Waste management
Reducing vulnerability(Healthy people) Water, sanitation,
hygiene Food safety Pest control Environmental
psychology Environmental justice
and ethics Climate change
adaptation
Cross-cutting programs: GIS, Risk communication, Public policy, Community involvement
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NCEH DRR for Health: Expected Outcome
The substantial reduction in morbidity and mortality
Strategic Goals
Integrate health-related disaster reduction into multi-sector approach
Building resilience to health hazards
Incorporate risk reduction approaches into preparedness, response and recovery programs
Priorities for Action Promote
disaster risk reduction as a national and a local priority
Identify, assess and monitor
disaster risks and enhance early warning
Use knowledge innovation and
education to build a culture of resilience
at all levels
Reduce the underlying risk
factors
Strengthen disaster
preparedness for effective
response at all levels
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National Center for Environmental HealthAgency for Toxic Substances and Disease Registry
Email • [email protected]
LinkedIn.com: • www.linkedin.com/in/disasterdoc/• Disaster Risk Reduction for Health
Discussion Group
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For more information please contact Agency for Toxic Substances and Disease Registry or the Centers for Disease Control and Prevention
ATSDR:4770 Buford Highway NE, Chamblee, GA 30341 Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348E-mail: [email protected] Web: http://www.atsdr.cdc.gov
CDC:1600 Clifton Road NE, Atlanta, GA 30333Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348E-mail: [email protected] Web: http://www.cdc.gov
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention or the Agency for Toxic Substances and Disease Registry
National Center for Environmental HealthAgency for Toxic Substances and Disease Registry
Thank You