NPCC

New York City Panel on Climate Change

NPCC4: Climate change and New York City’s health risk

Introduction

Heat and flooding represent the largest present climate-related health risks to New Yorkers.

Without continued adaptation, climate change will exacerbate health risks from hotter summers and the increasing frequency and severity of flooding. Other climate-sensitive exposures harmful to human health include: 1) outdoor and indoor air pollution, including aero-allergens; 2) insect vectors of human illness; 3) waterborne infectious and chemical contaminants.

This chapter considers climate health risks, vulnerabilities, and resilience strategies in New York City’s unique context and provides an update on evidence since the last NPCC health assessment in 2015. It also addresses climate-related health risks and vulnerabilities that have emerged in New York City since 2015.

The chapter discusses health risks associated with flooding and heat in detail and provides an overview of health risks from air quality, insects that carry illnesses, water quality, and other public health emergencies (e.g., pandemics) that may worsen climate-related health risks.

Flooding (left) & Heat (right) Health Impact Pathways & Vulnerabilities

This chapter also addresses compound health risks from simultaneous extreme weather events, infrastructure failures, or other public health emergencies, such as the COVID-19 pandemic and evaluates evidence-informed strategies to reduce risks to health from climate change.

Photo Credit: East River Pedestrian Path: City of New York Mayor’s Office of Climate and Environmental Justice

Read the Chapter

Authors

Thomas Matte, MD, MPH Mailman School of Public Health, Columbia University, New York, NY

Kathryn Lane, MA, MPH New York City Department of Health and Mental Hygiene, New York, NY

Jenna Tipaldo, Doctoral Student CUNY Graduate School of Public Health and Health Policy and CUNY Institute for Demographic Research, New York, NY

Janice Barnes, Ph.D. Climate Adaptation Partners, New York, NY

Kim Knowlton, DrPH. Mailman School of Public Health, Columbia University, New York, NY

Emily Torem, MA City of New York, Department of Health and Mental Hygiene, New York, NY

Gowri Anand, City of New York, Department of Transportation, New York, NY

Liv Yoon, Ph.D. School of Kinesiology, The University of British Columbia, Vancouver, BC

Peter Marcotullio, Ph.D. Department of Geography and Environmental Science, Hunter College, CUNY, New York, NY

Deborah Balk, Ph.D. Marxe School of Public and International Affairs, Baruch College, New York, NY, CUNY Institute for Demographic Research, City University of New York, New York, NY. 

Juanita Constible, MSc. Natural Resources Defense Council, New York, NY

Hayley Elszasz, Ph.D. City of New York, Mayors Office of Climate and Environmental Justice, New York, NY

Kazuhiko Ito, Ph.D.  New York City Department of Health and Mental Hygiene, New York, NY

Sonal Jessel, MPH. WE ACT for Environmental Justice, New York, NY

Vijay Limaye, Ph.D. Natural Resources Defense Council, New York, NY

Robbie Parks, Ph.D. Mailman School of Public Health, Columbia University, New York, NY

Mallory Rutigliano, MPA New York City Mayor’s Office of Management and Budget, New York, NY

Cecelia Sorenson, MD Global Consortium on Climate and Health Education, Columbia University, New York, NY, Natural Resources Defense Council, New York, NY, Department of Emergency Medicine, Columbia University Irving Medical Center, New York, NY

Ariel Yuan, MPH New York City Department of Health and Mental Hygiene, New York, NY

 

Summary

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  • Key Message 1

    Climate change-related health risks are a threat to all New Yorkers, but especially those most vulnerable because of age, poor health, racial and social inequities, and social isolation.

    Inequities in household and neighborhood physical environments also mediate vulnerability to climate-health impacts. Addressing key environmental and social drivers of vulnerability is an essential adaptation strategy. Many current NYC policies and strategies, (e.g., improving access to residential air conditioning, tree planting), aim to accomplish this. These efforts can be informed and evaluated using data on climate-health vulnerabilities, such as components of the heat vulnerability index (HVI) and a flooding vulnerability index (FVI) under development (VIA Interim Report).

  • Key Message 2

    Heat waves are, on average, the deadliest type of extreme weather in NYC and in much of the US. Even hot, but not extreme, summer weather causes serious illness, death, and other harms to wellbeing.

    Because of climate change, NYC will experience more dangerous hot weather. Most heat-related deaths are due to exacerbation of chronic health conditions, such as cardiovascular disease. Indoor exposures can be especially deadly for people without air conditioning who have one or more physical or mental health conditions, are energy insecure, are older adults, or have jobs exposing them to unsafe indoor or outdoor temperatures. These risk factors can be consequences of structural racial, social, and economic inequities. Adaptive measures are needed that protect vulnerable populations from season-long heat-health risks, including from non-extreme but hot weather. Evidence-informed strategies include enhanced access to air conditioning, reducing energy insecurity, engaging community and health provider networks to reach vulnerable populations, and augmenting tree canopy cover.

  • Key Message 3

    Public health can be impacted before, during, and after flooding, which exposes New Yorkers to risks of drowning and other injuries, stressful evacuation, short- or long-term displacement from home, and exposures from clean up, repair, water contaminants, and mold from water damage.

    Climate projections for NYC anticipate an increase in extreme precipitation days and sea level rise contributing to more frequent flooding over wider areas. Socioeconomic disadvantage, racial inequities, pre-existing health conditions, and flood-vulnerable housing and infrastructure amplify health impacts of flooding. Adaptation strategies that modify these factors can reduce future flooding impacts on health.

  • Key Message 4

    Hotter weather can increase concentrations of harmful air pollutants, including fine particles and ground-level ozone, by increasing emissions of precursor pollutants and the formation of ozone on warm, sunny days.

    These pollutants are harmful to health for all New Yorkers, but especially for the very young and old, people with certain chronic health conditions, those without residential air conditioning, and those living where emissions from buildings and traffic are concentrated. Most of these vulnerability factors are more common among Black, Latino, and low-income households. Despite a warming climate, air quality has improved in New York City because of reduced local and regional emissions. Recent wildfire smoke plumes affecting much of the eastern US indicate the potential to reverse a trend of improving air quality. Efforts to further reduce emissions and exposures of vulnerable populations can prevent or mitigate climate-related air quality impacts.

  • Key Message 5

    Nationally, pollen monitoring data shows that climate change is causing an earlier, longer, and possibly more intense plant pollen production season, but this trend is less evident in the northeast.

    Within New York City, pollen from several common tree species, ragweed, and grasses contribute to seasonal allergic rhinitis and asthma exacerbations. The burden of asthma exacerbations from any cause is greatest in communities with less access to health care and more household asthma triggers leading to less well-managed asthma. Ambient pollen levels are influenced by local weather, allergenic plant density, and species composition. Air conditioning and filtration can reduce indoor pollen exposure. Attention to local tree cover density and species composition along with improved access to care, evidence-based asthma management, and patient education can reduce pollen exposure, vulnerability, and future allergic illness.

  • Key Message 6

    In the northeast, changes in climate, landcover, habitat, and host animal ranges continue to shift the spatial and seasonal distribution of mosquitos and ticks that are current or potential vectors of human illness.

    Within New York City, the spatial distribution of these vectors and potential for human infection and serious illness varies with differences in the built environment, natural habitat and host animal abundance, human behaviors, and population vulnerability. Seniors, those with chronic illnesses, and people who are homeless are more susceptible to complications from West Nile virus (WNV) infection. Lyme disease risk among New Yorkers is increased among those engaged in outdoor activities mostly outside the city, but also in Staten Island and a limited area in the Bronx. Vector-borne disease (VBD) risk is also increased by international travel to and immigration from disease-endemic areas. Disease surveillance, vector monitoring and control, and public and clinician awareness can reduce future risks in a changing climate.

  • Key Message 7

    Climate change may increase risk of exposure to water-borne pathogens in surface waters and wastewater in and around New York City and could threaten its drinking water sources and distribution system.

    Increased flooding can cause exposure to contaminants from household sewage backups and in surface waters from combined sewer overflows (CSOs). Rising temperatures facilitate the growth and spread of pathogens such as bacteria that cause gastrointestinal illness, Legionnaire’s disease, and a range of illnesses from harmful algal blooms. Extreme weather and climate change impacts on New York City’s source and distribution infrastructure could compromise water quality and quantity. Continued maintenance and adaptation of infrastructure along with coordinated surveillance of water quality, human, and animal health can help prevent and control quality impacts on health.

  • Key Message 8

    Climate risks can be compounded when they disrupt lifeline infrastructure systems or overlap with non-climate public health emergencies.

    Examples include power outages during recent extreme heat events and the COVID-19 pandemic creating potential disease transmission risks in cooling centers and other publicly accessible indoor spaces. The health risks from compound hazards can be reduced through investing in lifeline and other critical infrastructure and building mechanical systems that are adapted to extreme weather, redundant, and flexible. Rapid, flexible, collaborative, multi-sectoral responses are needed to respond to pandemics and other unanticipated compound hazards.