Droughts, Agriculture, and Public Health
JESSE BELL, Claire M. Hubbard Professor of Water, Climate and Health, Department of Environmental, Agricultural, and Occupational Health, University of Nebraska Medical Center, School of Natural Resources, University of Nebraska–Lincoln; Director of Wat
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11/22/2024
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Dr. Jesse E. Bell is the Claire M. Hubbard Professor of Water, Climate, and Health in the Department of Environmental, Agricultural, and Occupational Health at the University of Nebraska Medical Center and the School of Natural Resources within the Institute of Agriculture and Natural Resources at the University of Nebraska-Lincoln. He is the director of the Water, Climate and Health Program at UNMC and the director of Water, Climate and Health at the University of Nebraska’s Daugherty Water for Food Global Institute. The mission of these programs is to develop interdisciplinary research, education and collaborative solutions to public health challenges associated with environmental issues in Nebraska and around the world. As the founding director, he has helped grow these programs to over 25 faculty, staff, and students. His expertise and research are focused on understanding how human and natural processes are connected to changes in the environment and climate. Before coming to UNMC, Dr. Bell developed and served in an interagency position between the National Oceanic and Atmospheric Administration (NOAA) and the Centers for Disease Control and Prevention (CDC). During his time in this role, his work built the foundation for novel and innovative approaches to use climate data to assist with health research. He was able to unite each organization's efforts toward better understanding the impact of climate change on health. He has authored more than 70 scientific articles and technical reports, including serving as a lead author for the U.S. Global Change Research Program report “The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment” that was released by the White House in 2016 and an author of Human Health chapter for the congressionally mandated Fifth National Climate Assessment. Dr. Bell is a native Nebraskan and received his Ph.D. is from the University of Oklahoma.
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- [00:00:00.320]The following presentation is part of the Agronomy and Horticulture Seminar Series at the University of Nebraska-Lincoln.
- [00:00:07.720]Alright, good morning everyone. Thank you for being here.
- [00:00:11.680]Before we get started, a few housekeeping items. We have fruit and little pinwheel lavishes in the back, water, coffee.
- [00:00:18.820]Make sure to get you some of that.
- [00:00:20.760]Also, we have people online as we live stream, so when we get to questions, just raise your hand.
- [00:00:27.760]I will bring the mic around, and you can use the mic.
- [00:00:30.660]You notice we don't hear it in the room here, but folks online will need the mic to be able to hear you and your questions so that they can be involved in the conversation today.
- [00:00:40.240]So today, it's my honor to introduce Jesse Bell, our seminar speaker on droughts, agriculture, and public health.
- [00:00:47.000]As you can tell from Jesse's first slide right here, he wears many hats, many different roles here.
- [00:00:51.720]He is the Clarion Hubbard Professor of Water, Climate, and Health in the Department of Environmental Agriculture.
- [00:00:57.720]and Occupational Health at the University of Nebraska Medical Center.
- [00:01:01.720]He's also a professor in the School of Natural Resources here at UNL.
- [00:01:05.720]At the Medical Center, he's the Director for the Water, Climate, and Health Program.
- [00:01:11.720]And also at DWFI, he is the Director of Water, Climate, and Health there too.
- [00:01:16.720]In those programs, he's been able to build up to over 20, 25 individuals in between faculty, staff, and students for those programs.
- [00:01:24.720]Previously, and what I think is particular,
- [00:01:27.720]particularly worth noting is that before coming into these roles,
- [00:01:32.720]Jesse had helped develop and served in an interagency position with NOAA,
- [00:01:40.720]the National Oceanic and Atmospheric Administration, and the CDC, the Centers for Disease Control and Prevention,
- [00:01:47.720]which he helped build the foundations for the use of climate data to assist with health research.
- [00:01:54.720]He's also been the lead author for the U.S.
- [00:01:56.720]Global Change Research Program Report titled The Impacts of Climate Change on Human Health in the United States,
- [00:02:02.720]a Scientific Assessment, which was released by the White House in 2016.
- [00:02:07.720]He's also been one of the authors for the human health chapter on the congressional mandated fifth National Climate Assessment.
- [00:02:13.720]And anyone who's had a few moments to enjoy Jesse's company, you'll know that he's also quite the great storyteller.
- [00:02:20.720]So with that, I'm going to turn it over to him to tell his story.
- [00:02:24.720]All right. Well, thank you so much.
- [00:02:25.720]I really appreciate it. And thank you for inviting me to be here today.
- [00:02:30.720]So I'm going to talk a little bit about some of the work that we've been doing with the Water, Climate and Health Program and with what we're trying to do with engagement in communities, Nebraska, and then also across the world as well.
- [00:02:42.720]And so, yeah, like Aaron was saying, I've been here since 2018.
- [00:02:50.720]And then in 2020, we started the Water, Climate and Health Program.
- [00:02:54.720]And I'm going to talk about that in a little bit more depth here in just a bit.
- [00:03:01.720]There we go. All right. So I want to talk a little bit about some of the work that we're doing.
- [00:03:06.720]Before that, I'm sure many of you are familiar with public health and basic concepts behind public health.
- [00:03:13.720]Like was mentioned, I used to work at the Centers for Disease Control and Prevention.
- [00:03:17.720]I worked in that interagency position between NOAA and CDC. I did that for about six years before coming here.
- [00:03:23.720]It was the first time that that position was actually created between those two federal entities.
- [00:03:31.720]It was a great experience. It was allowing me to bring in those environmental observations from NOAA over to CDC
- [00:03:38.720]so that we could figure out ways to integrate those into better public health decision making.
- [00:03:43.720]With public health, this is basically one of the definitions of public health.
- [00:03:48.720]It's the science of protecting and improving the health of people and their communities.
- [00:03:52.720]And public health does that through education of the public.
- [00:03:56.720]It does engagement, contributing to public dialogue,
- [00:03:59.720]because making sure that they're actually a part of decision making and decision making process,
- [00:04:03.720]enhancing monitoring, understanding what are the threats that communities are facing,
- [00:04:07.720]and then also research itself.
- [00:04:10.720]Public health does a lot of research, and we do a lot of research with a group that we're a part of.
- [00:04:16.720]And so if you've seen me give a talk before, I might have talked about this guy.
- [00:04:21.720]John Snow. I bring this up.
- [00:04:25.720]One, I love the history of science. Science is fascinating. Science builds upon science.
- [00:04:30.720]As Isaac Newton said, "If I've seen further, it's by standing on the shoulders of giants."
- [00:04:35.720]And that's the whole premise behind making sure that we understand,
- [00:04:39.720]keep in context of some of those histories or the history of science as well.
- [00:04:44.720]So John Snow was a fascinating individual. I love this story. I love talking about him just in general.
- [00:04:50.720]So he's a medical doctor that was in London, the Soho region of London.
- [00:04:54.720]And with being a medical doctor back in the 1800s, he was a very inquisitive and intelligent individual.
- [00:05:02.720]And he was doing a lot of different things. He's considered one of the founders of public health,
- [00:05:07.720]what we think of public health and epidemiology today.
- [00:05:10.720]He also is very well known for bringing anesthesia into medical practices,
- [00:05:19.720]surgery. If anybody ever knows about this, before anesthesia,
- [00:05:26.720]medical surgery was a very brutal process. They literally held somebody down,
- [00:05:32.720]fully aware of what was going on, and started cutting.
- [00:05:36.720]The first person to actually start using anesthetic in somewhat medical-type healthcare practices
- [00:05:44.720]was actually an American. It was a dentist. They were using ether, knocking people out
- [00:05:48.720]and pulling teeth, teeth extractions. Jon Snow saw this and heard about this and said,
- [00:05:53.720]"We should probably be doing this also for surgery."
- [00:05:56.720]And so he actually started doing experiments to try to better understand how they could use ether
- [00:06:01.720]to sedate patients and make it a much more pleasant process for the person that's being operated on.
- [00:06:08.720]Most surgeries were, the individuals died during the surgery back at that time.
- [00:06:13.720]Well, he's also very well known for understanding cholera.
- [00:06:17.720]And this plays kind of a pivotal conversation as we move forward with the presentation I'm going to be talking about.
- [00:06:26.720]There's a very famous story behind this.
- [00:06:28.720]Back in the 1800s, we didn't understand the germ theory when John Snow was looking at cholera and cholera outbreaks.
- [00:06:35.720]At that time, they thought it was vapors in the air.
- [00:06:38.720]And so people were walking around London, and they thought that they were breathing in this bad air,
- [00:06:42.720]and they were getting cholera, and that's why they were getting sick.
- [00:06:46.720]And John Snow looked at it, and he said, "I don't think that's right."
- [00:06:50.720]He used science, and he was looking at it, and he goes, "I think it's water.
- [00:06:56.720]I think it's the consumption of water that's potentially leading to these cholera outbreaks."
- [00:07:01.720]Well, it's a fascinating story. If you haven't read about it, I 100% recommend reading about it and looking into it.
- [00:07:07.720]There was a cholera outbreak that happened in the Soho region of London.
- [00:07:11.720]Each of these little black boxes that are up here is,
- [00:07:15.720]from that original case, where they were able to see where somebody died or contracted cholera in those households.
- [00:07:24.720]They were able to determine throughout this region. They found a number of cases in this outbreak in this region.
- [00:07:30.720]Jon Snow was looking into it and was able to identify that there was a pump in the middle of that.
- [00:07:36.720]This was the first time that they used maps in trying to identify where outbreaks occur
- [00:07:44.720]and what was the potential source of the outbreak as well.
- [00:07:47.720]There's a lot more to that story. I won't go into all the details of it.
- [00:07:51.720]Snow put his hypothesis forward, he put his thesis forward,
- [00:07:58.720]and a lot of people in the medical establishment said, "Baloney. You're wrong. It's air vapors."
- [00:08:05.720]There were other people as well, and one of them was Reverend Whitehead.
- [00:08:10.720]Reverend Whitehead served that community in the Soho region.
- [00:08:13.720]He said, "I don't think you're right, John."
- [00:08:17.720]John's like, "Fine." He shows up, gives him his thesis, and he's like, "Read it."
- [00:08:21.720]Reverend Whitehead reads this thing, and he goes, "I think this guy's on to something."
- [00:08:27.720]With Reverend Whitehead, they actually started going into those different households and trying to understand what was going on.
- [00:08:34.720]Actually, they even potentially identified the point source of where that outbreak first occurred.
- [00:08:42.720]We wouldn't remember John Snow today if it wasn't for Reverend Whitehead.
- [00:08:48.720]John Snow would not have been able to get into that community to try to address this issue.
- [00:08:54.720]There's also a John Snow Society in London, or it's actually across the world.
- [00:09:01.720]They have an entire little ceremonial thing that they do.
- [00:09:04.720]There's this pump head that's in the SoHo region of London today.
- [00:09:08.720]They go, and they put the pump handle on, and they take the pump handle off.
- [00:09:11.720]That was one of the things that happened at the time.
- [00:09:14.720]They took the pump handle off. They said, "Don't use this pump anymore."
- [00:09:18.720]People protested and were upset, so they put the pump handle back on, and people started using the water again,
- [00:09:23.720]which also speaks to the complexity of whenever you're talking about any environmental-related issue,
- [00:09:29.720]especially in the context of public health and how you need to address it.
- [00:09:33.720]One of the reasons we wouldn't even know about Jon Snow if it wasn't for Reverend Whitehead was,
- [00:09:40.720]Jon Snow, his ideas about cholera were kind of thrown off into the ethers of science.
- [00:09:49.720]And then, I think it was an Italian scientist who created the microscope,
- [00:09:56.720]and one of the first things that they were able to identify was cholera in water.
- [00:10:01.720]And they said, "Whoa, now we've got something. There's a concept that started the development of the germ theory."
- [00:10:07.720]And Reverend Whitehead said, "Whoa, whoa, whoa, whoa!
- [00:10:09.720]You're forgetting about my buddy, John Snow."
- [00:10:13.720]Because John Snow had already died. John Snow died in his forties.
- [00:10:18.720]And he goes, "John Snow actually put this hypothesis forward, and showed supporting evidence behind this,
- [00:10:27.720]before we could even use microscopes to look what was in our water."
- [00:10:35.720]And so, I come away with this story with multiple different things,
- [00:10:38.720]especially in that context of public health.
- [00:10:41.720]One, we need to understand and observe patterns, because I think about John Snow,
- [00:10:45.720]and how he was able to look into that community, and understand patterns that they were seeing,
- [00:10:49.720]and using mapping, and understanding of the environment that people were living in,
- [00:10:54.720]to understand the outbreak of a disease.
- [00:10:59.720]You need local champions. You need people that can help bridge that gap with the communities that you engage with.
- [00:11:05.720]Because, John Snow, nobody would have listened to him,
- [00:11:07.720]if it wasn't for Reverend Whitehead.
- [00:11:11.720]Public health challenges extend beyond determining the cause of any health issue.
- [00:11:15.720]We saw that with COVID, right? Everybody is very aware of this.
- [00:11:19.720]It isn't just about identifying the issue. Same with John Snow.
- [00:11:22.720]They realized that there was an issue with the water. They took the pump handle off.
- [00:11:25.720]People protested. They put the pump handle back on.
- [00:11:28.720]People were potentially drinking contaminated water, and there were more people dying.
- [00:11:33.720]But,
- [00:11:36.720]one of the issues that happened, they didn't really find them a second source of water.
- [00:11:40.720]It's one thing to say, "You shouldn't drink that water." It's another thing to say,
- [00:11:43.720]"You shouldn't drink that water, and now we need to find a solution to that problem as well."
- [00:11:47.720]Perseverance is key. These issues are obviously quite complex.
- [00:11:53.720]John Snow, for example, was kind of forgotten and actually ridiculed within the medical community
- [00:12:00.720]because of his ideas about how water quality was potentially impacting
- [00:12:05.720]the health of the people, especially in London. It was air vapors.
- [00:12:09.720]Medical establishment just said, "Oh, you're full of it, John."
- [00:12:13.720]And it wasn't until we actually better understood the science,
- [00:12:17.720]and it wasn't until we actually moved forward with our scientific understanding of things
- [00:12:23.720]that some of those hypotheses that John Snow was putting out,
- [00:12:27.720]that we actually could provide that supporting evidence.
- [00:12:30.720]But also that these challenges require a lot of perseverance to make sure that we're working
- [00:12:34.720]with communities to understand the challenges that they face
- [00:12:37.720]and trying to help them address them as well.
- [00:12:40.720]So I start that off to kind of set the stage of like a basic story
- [00:12:45.720]of a little bit of the history of public health, the history of epidemiology,
- [00:12:51.720]but also the history of the environment that we live in
- [00:12:55.720]and how it potentially impacts our health.
- [00:12:59.720]So in 2020, we started the Water, Climate, and Health program.
- [00:13:03.720]That started within the University of Nebraska Medical Center,
- [00:13:07.720]but it also was part of the Doherty Water for Food Global Institute,
- [00:13:10.720]and I'll talk about that in just a second.
- [00:13:12.720]Basically, the whole premise of the Water, Climate, and Health program
- [00:13:17.720]is to develop interdisciplinary research, education, and collaborative solutions
- [00:13:21.720]to public health challenges associated with water and climate in Nebraska and around the world.
- [00:13:26.720]And we're working on this in a variety of different ways.
- [00:13:29.720]We're an academic center, obviously, so research is our foundation.
- [00:13:32.720]It's what we're doing. That's like the majority of the work that we do.
- [00:13:35.720]But we're also very much about education, engagement.
- [00:13:39.720]I don't know why that one didn't pop up. We'll see how this goes through the rest of it.
- [00:13:42.720]But policy development as well.
- [00:13:46.720]Because, and that was one of the reasons I became interested in why,
- [00:13:49.720]when I was transitioning from CDC and NOAA, I came to a college of public health.
- [00:13:55.720]Because I didn't want to just do research.
- [00:13:57.720]I wanted to do work that had community engagement that served
- [00:14:01.720]a bigger, more applied science purpose.
- [00:14:08.720]It's not supposed to look like that.
- [00:14:10.720]But we'll work through it.
- [00:14:12.720]And so I'm sure many of you are familiar with DWFI.
- [00:14:16.720]This got added on to DWFI in 2020.
- [00:14:20.720]And so this was bringing public health into DWFI's mission and DWFI's work.
- [00:14:28.720]And so then I came on as a director of public health
- [00:14:30.720]and then as a director of water climate and health at DWFI.
- [00:14:34.720]DWFI basically, the way I kind of summarize it, is water security for food security.
- [00:14:41.720]And so with the mission of DWFI, obviously they do research, policy engagement, collaboration.
- [00:14:51.720]They provide student fellowships, and then they also have faculty fellows.
- [00:14:57.720]DWFI, I believe, has somewhere between 30 to 50.
- [00:14:59.720]Faculty and staff that work within it.
- [00:15:02.720]And then there's, oh, I forget how many, well over 100 faculty fellows across the university that help support DWFI's mission as well.
- [00:15:15.720]And then we have our water climate and health program.
- [00:15:18.720]And so this, both within the bubble of DWFI, but over at the University of Nebraska Medical Center, is our faculty and staff
- [00:15:28.720]that support the water climate and health program.
- [00:15:31.720]And so like I said, this started in 2020.
- [00:15:33.720]Now we're up actually over 30 faculty, staff, and students that are being supported through the program in some capacity.
- [00:15:40.720]We have different expertise in a variety of different areas.
- [00:15:44.720]Everything from people that are doing epidemiology, statistics, programmatic support, data science,
- [00:15:52.720]people that are more classically trained in environmental epidemiology, toxicology.
- [00:15:57.720]We have a number of postdocs that are working on different projects, data analysts.
- [00:16:02.720]We work with Extension for education and outreach around some of these issues.
- [00:16:07.720]And then we have communications, and we have people embedded within Nebraska DHHS as well.
- [00:16:17.720]And then we support a number of students.
- [00:16:20.720]Masters of Public Health students, right now we have one, but we're probably going to be expanding on this.
- [00:16:24.720]We actually even have undergrads.
- [00:16:26.720]I didn't add them in here.
- [00:16:28.720]Being at the University of Nebraska Medical Center, we're only a graduate-serving institution,
- [00:16:33.720]so we don't have undergraduates on campus.
- [00:16:35.720]And so any of the undergrads that we work with have either been through UNL or UNO.
- [00:16:40.720]We have a program with medical students, and so we have a number of medical students that have been working with us,
- [00:16:46.720]and then also PhD students in a number of areas as well.
- [00:16:53.720]And so, a little funky.
- [00:16:55.720]There's a little translation between Mac and, I'm guessing, PC.
- [00:16:59.720]But we have some core areas that we're working on: water quality and health, climate change and health,
- [00:17:05.720]extreme heat and health, flooding and extreme weather, and then air quality and health as well.
- [00:17:13.720]And so, just to kind of kick it off, I'm going to talk a little bit about climate change and health.
- [00:17:17.720]Like I said, this is one of the big areas that I've been focused on.
- [00:17:21.720]As was mentioned in the introduction,
- [00:17:24.720]one of the reports that I was a lead author on that came out in 2016.
- [00:17:30.720]This is one of the first scientific assessments that brought together the climate community and the health community
- [00:17:36.720]to understand how climate and climate change was impacting human health.
- [00:17:40.720]This report was very comprehensive.
- [00:17:45.720]It's still available, and I think it's still a really nice report
- [00:17:49.720]that kind of illustrates all the different ways that climate can impact human health.
- [00:17:53.720]And there's a number of key findings out of there,
- [00:17:57.720]but there are two main key findings that I always point to.
- [00:18:01.720]This was one of the most comprehensive documents that I've ever been a part of,
- [00:18:05.720]and especially being in a lead role within that document as well.
- [00:18:09.720]We had representation from basically every federal agency,
- [00:18:13.720]whether it was the Defense Department, CDC, NOAA, NASA.
- [00:18:17.720]You mentioned it.
- [00:18:19.720]They were probably involved in some capacity.
- [00:18:21.720]Not only that.
- [00:18:22.720]It went through agency reviews.
- [00:18:24.720]So every one of the agencies had to review this document.
- [00:18:27.720]It also went through the National Academies of Sciences,
- [00:18:30.720]National Academy of Medicine, National Academy of Engineering,
- [00:18:33.720]and then it went through public and external reviews as well.
- [00:18:37.720]This was a route to get through.
- [00:18:41.720]And we had medical doctors, public health scientists, physicists, you name it.
- [00:18:47.720]And two of the key findings that came out of this report at the very beginning
- [00:18:51.720]was climate change is a significant threat to the health of the American people,
- [00:18:54.720]and every American is vulnerable to the health impacts associated with climate change.
- [00:19:02.720]And this, I think, kind of illustrates this in some capacity.
- [00:19:08.720]These are billion-dollar climate and weather-related disasters that NOAA,
- [00:19:14.720]the National Oceanic and Atmospheric Administration, has been monitoring since 1980,
- [00:19:19.720]so over a 40-plus year period.
- [00:19:20.720]Every year, whenever a climate or weather-related disaster occurs,
- [00:19:25.720]they try to estimate what is the financial cost of that,
- [00:19:29.720]what is the economic burden, insurance cost, et cetera.
- [00:19:33.720]And one of the things that you'll notice is that we've been seeing more of these
- [00:19:37.720]billion-dollar climate and weather-related disasters,
- [00:19:40.720]and there's a number of different reasons for that.
- [00:19:42.720]But one, we're seeing more of these disasters.
- [00:19:45.720]This is also adjusted for cost and change in cost over time.
- [00:19:49.720]When 2020 happened, it was a record-setting year
- [00:19:56.720]for climate, weather, billion-dollar disasters,
- [00:19:58.720]and being somebody that was working within public health,
- [00:20:01.720]I kept saying, you know, we still need to talk about climate.
- [00:20:04.720]We still need to make sure we're talking about extreme weather events
- [00:20:07.720]and the impacts that they're having on our society.
- [00:20:09.720]And a lot of times in the medical and public health community,
- [00:20:13.720]they're like, we're over-inundated.
- [00:20:15.720]All we can talk about is COVID right now.
- [00:20:18.720]And I said, well, that's fair.
- [00:20:20.720]And I understand that because we only spend about 1% to 5%
- [00:20:26.720]of our spending on health in the United States.
- [00:20:30.720]1% to 5% is on public health.
- [00:20:33.720]Everything else is on end-of-pipe, health care.
- [00:20:38.720]On prevention, it's 1% to 5% in the United States.
- [00:20:41.720]So we spend very little on actually trying to prevent disease.
- [00:20:45.720]We spend a lot more money on treating it.
- [00:20:47.720]After you contract disease.
- [00:20:50.720]So understanding, like, resources are strained, people are strained.
- [00:20:54.720]There is less resources available to be able to try to combat something like COVID in 2020.
- [00:21:00.720]But I also mentioned to him, I was like, that was a record-setting year in the United States for climate and weather-related disasters.
- [00:21:08.720]We had COVID and climate just kept coming.
- [00:21:11.720]And then 2023 happened.
- [00:21:13.720]And that broke a new record.
- [00:21:16.720]And we'll see how 2024 ends up.
- [00:21:18.720]But it looks like it's probably going to break at least some records itself.
- [00:21:24.720]And so when we say that everybody in the United States is vulnerable and has significant health impacts associated with climate change, you might be saying, well, what are those pathways?
- [00:21:39.720]And so here in this figure, which actually comes from CDC, you have a rise in temperature.
- [00:21:45.720]You have more extreme weather, rise in sea level, rise in CO2.
- [00:21:49.720]That changes our environment in a variety of different ways.
- [00:21:52.720]Everything from air pollution, allergens, water quality, quantity, food impacts, land degradation, extreme heat events, extreme weather, and vector ecology.
- [00:22:03.720]And then those things impact our health.
- [00:22:07.720]That's the pathways for how a climate, just climate and extreme weather events by themselves can potentially impact human health.
- [00:22:14.720]It's like how a change in our climate system can potentially manifest into human health outcomes.
- [00:22:21.720]I put this figure up because I want to make sure that we emphasize, especially if we're going to be talking about this in the context of public health.
- [00:22:33.720]So this is basically that circular figure that was kind of neat that CDC created where you got the climate drivers up at the top.
- [00:22:41.720]You have the change in the environment.
- [00:22:43.720]That second circle that was around it, and then the health outcomes, which were on the outside.
- [00:22:49.720]I put this figure up because of the environmental institutional context and the social and behavioral context.
- [00:22:54.720]Those gray boxes are incredibly important, especially when we're talking about health.
- [00:22:59.720]Climate impacts these gray boxes, but these gray boxes impact this pathway, which leads to human health outcomes.
- [00:23:07.720]And when I say social and behavioral context, that in medicine, a lot of times we refer to those
- [00:23:12.720]as the social determinants of health. That is the people that live within the community.
- [00:23:19.720]So what is the age, gender, race, ethnicity, poverty, education, discrimination, access to health care issues, pre-existing health conditions?
- [00:23:26.720]All of the things that make up the individuals that live in that community.
- [00:23:30.720]And then you have the environmental institutional context. That's the land use change, ecosystem change, infrastructure, geography.
- [00:23:37.720]What is the agriculture in the area?
- [00:23:41.720]And so if a, for example, extreme heat event happens in Lincoln, Nebraska, an extreme heat event happens in Omaha, or it happens in Phoenix or Miami, you're going to see different outcomes.
- [00:23:55.720]And those different outcomes are due to these factors here.
- [00:23:59.720]The environment that people live in, how they're used to living in that environment, and then what are the risks that those individuals experience on an individual basis.
- [00:24:10.720]And I always say this: when I first started working on climate change, I always thought it was kind of interesting because, and there still is some debate, but it was like, you know, is climate change real?
- [00:24:23.720]And it seems like the conversation has moved away from that, but now I almost feel like at times people talk about, like, okay, it's happening, there's nothing we can do.
- [00:24:33.720]And I'm very much about how do you build preparedness, how do you build resilience within systems?
- [00:24:39.720]How do we prepare and respond influences our outcomes? And I'll talk about that in a bit, and I'll give an example.
- [00:24:45.720]So like I said, all populations are vulnerable, but certain populations are of higher concern than others.
- [00:24:50.720]In the United States, communities of color, older adults, low-income communities, and children, that's going back to those gray boxes I was talking about.
- [00:24:57.720]What is the physical environment that they're living in?
- [00:25:00.720]And so more affluent communities typically sometimes don't face some of these same challenges, like living in a floodplain.
- [00:25:08.720]If you're an older adult, you might have pre-existing health conditions that can determine health outcomes.
- [00:25:14.720]Same with children, and then also people of color in the same context.
- [00:25:20.720]And so I want to talk about drought. That's one of the big areas that I focus on.
- [00:25:25.720]I became fascinated with this with that climate and health report that came out back in 2016.
- [00:25:33.720]I just saw that there wasn't a lot of information in the United States
- [00:25:37.720]on how drought was impacting human health.
- [00:25:39.720]And I was like, well, this seems like an opportunity to kind of better understand this.
- [00:25:42.720]But we understand these impacts internationally.
- [00:25:45.720]Drought has likely led to more deaths than any other climate or weather-related disaster.
- [00:25:50.720]And since a lot of you work in ag systems, I'm sure you can probably imagine why that is.
- [00:25:55.720]Famine and malnutrition, a lack of food.
- [00:25:59.720]When droughts happen, you don't have food.
- [00:26:01.720]When you don't have food, you have adverse human health outcomes.
- [00:26:06.720]But drought manifests itself in a variety of different ways.
- [00:26:09.720]And so these are news stories from across the globe about different drought events and the impacts that they've had on human health.
- [00:26:17.720]And so you have everything from like bone disease in India that was potentially linked to drought,
- [00:26:22.720]higher suicide rates in the Murray-Darling Basin,
- [00:26:27.720]drought in Somalia killing people, and a number of potential human health outcomes.
- [00:26:33.720]Drought can manifest itself in a variety of different ways.
- [00:26:35.720]And lead to a variety of different health outcomes.
- [00:26:39.720]And we're still trying to understand some of these relationships.
- [00:26:43.720]And so I look at drought kind of in the same way I look at climate change.
- [00:26:47.720]It's a threat multiplier.
- [00:26:49.720]Drought intensifies heat waves.
- [00:26:51.720]It can lead to conditions that can be more prone to wildfires.
- [00:26:55.720]Reduction of water quality and water quantity.
- [00:26:57.720]Air quality impacts and then vector-borne disease impacts as well.
- [00:27:04.720]This is where I find drought challenging but also exciting from a research standpoint.
- [00:27:10.720]Because health surveillance systems are not designed well for any natural disaster or any disaster.
- [00:27:17.720]Let alone drought.
- [00:27:19.720]Drought manifests slowly.
- [00:27:21.720]Where typically we think of a lot of other disasters.
- [00:27:24.720]Hurricanes, for example.
- [00:27:26.720]Heat waves.
- [00:27:27.720]You can see those impacts right away.
- [00:27:30.720]Drought kind of sneaks in on you.
- [00:27:33.720]Because it evolves slowly.
- [00:27:35.720]The impacts are not immediate.
- [00:27:37.720]Like if you saw what was happening with the hurricanes that recently happened.
- [00:27:40.720]You can see those impacts right away.
- [00:27:42.720]Drought, you don't see it like that.
- [00:27:44.720]And then it can require multiple steps.
- [00:27:46.720]Delayed or indirect impacts on human health.
- [00:27:49.720]So surveillance systems are not designed to capture this well.
- [00:27:52.720]Which makes it complex.
- [00:27:54.720]But from a scientific standpoint, it makes it an interesting challenge.
- [00:27:58.720]And so I put this figure up to kind of illustrate that same kind of relationship.
- [00:28:02.720]Here's all the different ways that drought can manifest.
- [00:28:05.720]And then that can impact the environment in a variety of different ways.
- [00:28:09.720]That threat multiplier.
- [00:28:11.720]And then you have the human health outcomes on the outside.
- [00:28:15.720]And again, in that same way, when we talk about it,
- [00:28:19.720]it kind of works that same way as that climate diagram that I showed before.
- [00:28:22.720]Where you have a drought event to the human health impacts and the change in the environment.
- [00:28:27.720]We need to make sure that we're understanding those social and behavioral contexts.
- [00:28:30.720]And the infrastructural.
- [00:28:31.720]And environmental as well.
- [00:28:34.720]And so we're working on a variety of different things.
- [00:28:40.720]I didn't want to add all of the work that we're doing in here.
- [00:28:43.680]here, but I'll just kind of touch on a few little things
- [00:28:46.180]that builds into some of the drought work in particular.
- [00:28:49.120]Extreme heat.
- [00:28:50.220]We're very interested in extreme heat events.
- [00:28:52.580]I said internationally, drought likely
- [00:28:54.660]results in more deaths than any other climate or weather
- [00:28:57.000]related disaster.
- [00:28:59.940]In the United States, heat is likely the number one killer
- [00:29:04.500]in the US.
- [00:29:05.240]And when I started doing this originally,
- [00:29:11.280]and I was looking at how drought was impacting human health,
- [00:29:14.100]there was very little literature,
- [00:29:16.280]especially in the United States, on those relationships.
- [00:29:18.720]But the one place where I could find it
- [00:29:20.340]was within this billion-dollar disaster report from NOAA.
- [00:29:24.340]And they said drought led to, over the 40-plus year period,
- [00:29:30.960]about 4,500 deaths of direct deaths.
- [00:29:34.320]And I was like, oh, that's interesting.
- [00:29:35.820]And it was number two behind--
- [00:29:37.680]I think it's--
- [00:29:41.100]severe storm-- no, cyclones.
- [00:29:45.280]But I was like, why is that?
- [00:29:47.020]And so I started digging into it.
- [00:29:48.480]Now they report it down here.
- [00:29:49.760]It's heat waves.
- [00:29:51.860]Drought event, heat wave, and then
- [00:29:54.400]finding those relationships of adverse human health outcomes.
- [00:29:58.220]And those are direct deaths, which I can go into that
- [00:30:01.100]if you wanted me to.
- [00:30:02.660]And so we're doing work around this.
- [00:30:04.280]We're doing a number of different projects.
- [00:30:05.640]We're looking at who are some of the most at-risk populations,
- [00:30:10.920]especially Nebraska, associated drought events.
- [00:30:14.040]We're working with the state of Nebraska around heat events.
- [00:30:18.040]And then one of the areas that we're also interested in
- [00:30:20.340]is urban heat island.
- [00:30:21.960]And so as you go to the urban center,
- [00:30:24.240]there's less green space, more blacktop, more asphalt.
- [00:30:27.160]It's hotter.
- [00:30:29.280]And I won't go too in-depth on this,
- [00:30:30.900]but we did a project on this in Douglas County in Omaha.
- [00:30:35.340]And we found that during one of the heat events,
- [00:30:38.520]in some of those areas of Douglas County,
- [00:30:40.740]where there's more asphalt, more of that urban heat island
- [00:30:44.880]impact, it's almost, it's like nine to 10 degrees warmer
- [00:30:48.380]in those areas compared to the surrounding neighborhoods.
- [00:30:52.560]And we also found that some of our most at-risk populations
- [00:30:57.620]are in the areas that are hottest as well.
- [00:31:01.120]Air quality, especially in the context of drought.
- [00:31:07.060]This is an area that we're very interested in.
- [00:31:08.900]We're doing work looking at wildfires,
- [00:31:10.560]wildfire smoke.
- [00:31:11.560]We're definitely familiar with this from--
- [00:31:13.740]was it last year, where the wildfire smoke was carrying
- [00:31:16.080]across the United States and having significant impacts
- [00:31:19.140]on air quality, especially here.
- [00:31:21.640]We're also looking at dust.
- [00:31:25.140]I was driving in today.
- [00:31:26.540]There's definitely some dust out right now.
- [00:31:29.320]A colleague of mine that I work with, Daniel Tong from George
- [00:31:32.060]Mason University, has been doing work
- [00:31:33.860]to show that there's been an increase in dust and dust
- [00:31:36.420]storms, especially in the west and the southwestern part
- [00:31:38.820]of the United States.
- [00:31:40.380]This is one of the papers we wrote looking at all the impacts
- [00:31:43.320]that we could find, synthesizing all the impacts of dust
- [00:31:46.080]on human health, a variety of different pathways.
- [00:31:49.020]But one of the things I just want to point out,
- [00:31:51.060]all these red dots was over--
- [00:31:53.040]I forget how many years--
- [00:31:54.760]maybe a 20-year period of a fatal traffic accident that
- [00:31:58.600]was associated with a dust storm.
- [00:32:00.100]And as you can see in Nebraska, we
- [00:32:02.560]have seen some of those as well.
- [00:32:03.840]And then we're looking at, like I said, some of the complex
- [00:32:10.200]complexity of some of these health outcomes as well.
- [00:32:13.840]And so we've been looking at how changes in air quality
- [00:32:18.800]associated with drought is impacting human health.
- [00:32:22.780]And I'll summarize this in just a bit.
- [00:32:26.240]But basically, we have all the mortality records
- [00:32:28.360]for the entire United States going back
- [00:32:30.440]about a 20-plus year period.
- [00:32:32.540]And we're able to look at extreme drought events.
- [00:32:35.240]One of the things that we found was under extreme drought
- [00:32:37.700]events, we see an increase in respiratory
- [00:32:40.020]related mortality.
- [00:32:42.240]But then we also found that certain populations
- [00:32:44.400]were more at risk.
- [00:32:46.120]Women were more likely to die of respiratory related mortality
- [00:32:50.280]during drought events over the last 20-plus years.
- [00:32:53.640]And both men and women, but women more so.
- [00:32:58.500]And then we found that rural populations
- [00:33:00.260]were more impacted by respiratory related mortality
- [00:33:02.760]during drought events as well.
- [00:33:05.500]So just to kind of summarize that,
- [00:33:07.400]we saw both males and females had an increase in respiratory
- [00:33:09.840]related mortality.
- [00:33:12.000]Under extreme drought events, females had a larger effect.
- [00:33:14.940]Respiratory mortality increased in metro and non-metro areas,
- [00:33:18.080]but non-metro areas had a larger effect.
- [00:33:22.320]And we've looked at a variety of other things as well.
- [00:33:25.400]All-cause mortality, we've seen relationships
- [00:33:27.440]of drought, mental health, and I'll
- [00:33:29.900]talk about that in a little bit.
- [00:33:31.300]And then respiratory mortality, obviously,
- [00:33:33.260]but also cardiovascular mortality.
- [00:33:35.000]We saw an increase in cardiovascular mortality
- [00:33:37.200]with drought events.
- [00:33:39.180]We're also interested--
- [00:33:39.660]We're interested in water contamination,
- [00:33:42.040]associated with drought, and changes in the climate system
- [00:33:44.740]as well.
- [00:33:45.400]And there's some work that we're doing on that.
- [00:33:46.680]I won't show it yet, because it's not ready.
- [00:33:49.320]But this was a really nice article
- [00:33:51.180]by a colleague of mine that showed an increase in arsenic
- [00:33:54.120]across the United States during drought events in groundwater.
- [00:33:57.980]Farmers-- this was a study that we did and published
- [00:34:04.280]a couple of years ago, where basically,
- [00:34:06.680]in short, we saw that farmers were more
- [00:34:09.480]likely to report feeling stressed during drought events
- [00:34:12.740]than if they were physically injured.
- [00:34:16.060]We also have some research that shows
- [00:34:18.080]we find an increase in suicide in farmers.
- [00:34:20.900]We haven't published this yet during drought events.
- [00:34:24.280]Like I said, we're not just about identifying problems.
- [00:34:29.240]We're also trying to figure out solutions.
- [00:34:31.060]And so this is one example I want to just kind of run
- [00:34:33.460]through real quick.
- [00:34:34.580]So we're doing research and looking
- [00:34:35.960]at these relationships between drought and health,
- [00:34:38.080]but we're also doing engagement.
- [00:34:39.300]We did workshops across the country with public health
- [00:34:43.280]departments to understand what are their needs on messaging
- [00:34:46.620]and engaging on health issues associated with drought.
- [00:34:51.040]We create a strategy document based off
- [00:34:53.580]of some of this information for NOAA, NIDIS, the National
- [00:34:56.760]Integrated Drought Information System, on how to better
- [00:34:59.840]integrate health into some of their drought work
- [00:35:03.920]and resilience plans and preparedness plans.
- [00:35:06.980]And then we started developing tools,
- [00:35:09.120]such as this one, which is a drought and health messaging
- [00:35:11.960]toolkit for public health officials.
- [00:35:16.000]This is basically a step-by-step guide
- [00:35:17.960]of helping public health officials understand
- [00:35:20.560]what are the health threats, what is drought in just general,
- [00:35:24.840]but then also how do you message to the community
- [00:35:27.420]and message to the people that are potentially
- [00:35:29.500]at risk to some of these events as well.
- [00:35:31.560]And so when we talk about what it
- [00:35:36.880]means living in a change and changing
- [00:35:38.940]climate, or changed and changed climate,
- [00:35:42.200]this was from the last National Climate Assessment, where they
- [00:35:45.660]just said, looking at some of these trends in extreme weather
- [00:35:48.600]and climate events, and they say a person born in 2020
- [00:35:51.780]will experience more climate-related hazards
- [00:35:54.300]during their lifetime on average than a person born in 1965.
- [00:35:58.860]Drought, for example, is somewhere around 1.4 to 2.1
- [00:36:05.400]as many times of these events than somebody born
- [00:36:08.760]in 1965.
- [00:36:11.680]So that's why it's important that we understand
- [00:36:13.640]some of these relationships, understand
- [00:36:15.380]some of these different pathways to make sure
- [00:36:18.340]that we continue to engage around some of these issues
- [00:36:22.020]as well.
- [00:36:22.560]And like I said, we're going to continue
- [00:36:24.220]doing research, and especially around air quality and water
- [00:36:28.440]quality and the impacts on drought and health.
- [00:36:30.880]This is one of the tools that we are developing
- [00:36:32.880]for the state of Nebraska for the DHHS so that those
- [00:36:38.580]health departments are better understanding of who
- [00:36:40.680]their at-risk populations are and where their at-risk areas
- [00:36:43.260]are as well.
- [00:36:44.800]And so I'm going to really quickly just burn
- [00:36:48.960]through some of the water quality.
- [00:36:50.580]I know that many of you have heard about some of this work.
- [00:36:53.400]And so I won't go into all the details here.
- [00:36:55.980]Basically, I'm sure a lot of you know
- [00:36:57.900]nitrate is a potential problem.
- [00:36:59.520]And one of the reasons it's a problem
- [00:37:00.980]because of its impacts on human health.
- [00:37:05.900]The reason that we know or we make
- [00:37:08.400]that relationship between nitrate in drinking water
- [00:37:12.300]and adverse human health outcomes
- [00:37:14.320]is because of this potential, this pathway here.
- [00:37:17.960]When you have nitrate and it meets with the oral bacteria,
- [00:37:22.020]especially of certain individuals,
- [00:37:23.600]nitrate can turn into nitrite.
- [00:37:25.580]Nitrite, then when it gets into this stomach acid,
- [00:37:29.240]can turn into these NOC compounds,
- [00:37:31.020]which is an N-nitroso compound.
- [00:37:33.040]And it's known that these compounds are carcinogenic.
- [00:37:36.880]And so that's where we--
- [00:37:38.220]we potentially can see that relationship
- [00:37:40.240]with nitrate and cancer.
- [00:37:43.520]And there also seems to be some interplay with diet as well,
- [00:37:47.480]whether or not you have more of a smoking, high meat diet,
- [00:37:50.740]or if you have a diet that consists of more antioxidants,
- [00:37:55.720]such as vitamin C. And so the regulatory limit
- [00:38:00.780]for nitrate in drinking water, as you probably know,
- [00:38:03.140]is set for met hemoglobinemia at 10 parts per million.
- [00:38:06.200]It's not set for cancer or any
- [00:38:08.040]of these other potential adverse human health outcomes.
- [00:38:11.800]There's been a decent amount of research
- [00:38:14.040]that's been going into trying to understand,
- [00:38:16.560]what are these relationships?
- [00:38:17.940]And one of the things that we know
- [00:38:19.280]is that nitrate in drinking water
- [00:38:20.820]has been linked to adverse human health outcomes.
- [00:38:22.920]Some of the health outcomes is minor health ailments,
- [00:38:25.860]met hemoglobinemia, preterm birth issues, birth defects,
- [00:38:29.040]pediatric cancer, and adult cancers.
- [00:38:30.720]Public health, who are our most at risk populations?
- [00:38:36.620]And how do we make sure that we're
- [00:38:37.860]communicating with them?
- [00:38:39.180]And then again, understanding these pathways,
- [00:38:42.020]especially with these factors, the social and behavioral
- [00:38:45.420]contexts and the environmental institutional context.
- [00:38:50.100]So why are we concerned about Nebraska?
- [00:38:52.480]Nebraska has one of the highest rates of pediatric cancer
- [00:38:54.560]in the country.
- [00:38:56.280]And so now I want to make this very clear.
- [00:38:59.100]Not every case of cancer in Nebraska
- [00:39:01.640]is because of nitrate.
- [00:39:04.500]I can't even tell you what percentage it is.
- [00:39:07.680]But I can say that it is a potential risk.
- [00:39:11.340]And that's why it's of an area of concern
- [00:39:13.860]from a public health standpoint.
- [00:39:17.560]And there has been some work that's
- [00:39:19.060]been done by colleagues that I work with and others that
- [00:39:21.780]have shown in Nebraska and nationally and internationally
- [00:39:25.240]as well that higher rates of cancer,
- [00:39:29.580]you can find correlations with areas
- [00:39:31.900]that have more contaminants of things
- [00:39:33.540]like nitrate and atrazine in the water.
- [00:39:37.500]I won't go into that in any depth.
- [00:39:39.800]And then it has a financial impact as well.
- [00:39:42.660]Financial burden cancer treating center is in Omaha.
- [00:39:47.160]And it's not in--
- [00:39:48.880]and so if you or somebody, especially
- [00:39:50.880]if there's a pediatric cancer, they
- [00:39:52.560]usually have to move to Omaha to seek treatment.
- [00:39:55.920]And if you live in Scotts Bluff, for example, that's
- [00:39:58.200]what, a nine-hour drive.
- [00:39:59.460]If you're from where I'm from, Bloomfield, Nebraska,
- [00:40:01.800]it's like a three to four-hour drive, depending.
- [00:40:04.920]So if somebody in your household gets
- [00:40:07.320]cancer, you're twice as likely to experience bankruptcy.
- [00:40:12.600]Wisconsin did an interesting study
- [00:40:14.520]looking at what are the potential impacts of water
- [00:40:17.940]contamination on the financial impacts in their state.
- [00:40:23.540]And the confidence interval is huge on this,
- [00:40:25.780]but it's $250,000 to $1.5 billion
- [00:40:28.980]in medical expenditures.
- [00:40:31.260]And then loss of productivity, based off some of those things
- [00:40:33.840]that we were talking about, $1.3 to $6.5 billion loss.
- [00:40:37.140]So for me, from a public health standpoint,
- [00:40:42.160]it's how do we identify at-risk areas and people?
- [00:40:45.360]How do we find low-cost and no-cost solution?
- [00:40:47.360]How do we get people to make sure
- [00:40:48.780]that they're testing their wells
- [00:40:50.520]and maintaining these systems so that we reduce exposure
- [00:40:55.140]and reduce risk in the populations that
- [00:40:57.100]are potentially most at risk?
- [00:41:00.100]But I want to make sure nitrate isn't our only issue.
- [00:41:03.800]We have other issues of environmental exposures.
- [00:41:06.960]So obviously, there's other factors
- [00:41:08.840]that we should be looking at as well
- [00:41:11.440]with some of our adverse human health
- [00:41:13.820]outcomes, especially in context of pediatric cancer.
- [00:41:18.500]And so we're doing outreach and engagement around this.
- [00:41:20.920]And we've got a number of different things
- [00:41:22.720]that we're doing, everything from developing high school
- [00:41:25.520]lessons for kids to better understand this, which
- [00:41:28.280]I love this one.
- [00:41:29.200]If you ask me a question about it,
- [00:41:30.580]I'll tell you more about it.
- [00:41:31.700]Trainings for health care professionals,
- [00:41:33.600]engagement with public health, doing research, and then
- [00:41:36.780]also trying to help with monitoring and providing
- [00:41:39.960]free testing kits to individuals that are interested
- [00:41:46.020]in looking at what's in their water,
- [00:41:47.460]and then providing that as a way of engagement as well.
- [00:41:51.040]And so like I said, we're working with Extension.
- [00:41:53.540]They're out on the ground talking
- [00:41:55.200]about a lot of this stuff and trying
- [00:41:56.780]to help build those bridges, better understanding what
- [00:41:58.900]are some of these threats.
- [00:42:01.040]We've got our science lesson that we
- [00:42:02.940]did with the College of Education
- [00:42:06.600]and Communication.
- [00:42:07.700]I don't want you-- you don't have to watch that.
- [00:42:09.980]And then just trying to make sure
- [00:42:11.360]that we have a presence within the community
- [00:42:13.360]to continually try to build a dialogue around this as well,
- [00:42:18.260]including working with the state of Nebraska on this.
- [00:42:21.700]So I'll just flip through this real quick,
- [00:42:23.460]so in case you have any questions.
- [00:42:25.160]So opportunities moving forward, building partnerships,
- [00:42:28.560]collaboration, doing more communication and outreach,
- [00:42:31.440]building interdisciplinary research and applications,
- [00:42:34.080]and learning from our communities
- [00:42:35.420]to make sure that we're not--
- [00:42:36.420]pushing them in a direction, but we're learning from them
- [00:42:38.800]so that we can help guide them in the right way
- [00:42:41.820]and make sure that we're a part of that community as well.
- [00:42:45.220]And so that, in short, is some of the work that we're doing.
- [00:42:50.980]If we have time, I'd be happy to take any questions.
- [00:42:54.420]Thank you very much, Dr. Bell.
- [00:42:56.340]Let's give him a round of applause.
- [00:43:00.400]Any questions in the room here?
- [00:43:06.240]I'm particularly interested in the secondary results from wildfires.
- [00:43:15.640]I work with the grape and wine industry, so the smoke changing the quality, and in
- [00:43:23.940]some cases, illuminating harvests, and then wildfires in Canada.
- [00:43:36.060]Smoke clouds down through Michigan and upstate New York, and to some degree, Nebraska, as
- [00:43:42.840]I understand it.
- [00:43:43.640]Yeah.
- [00:43:43.980]What can be done?
- [00:43:47.000]It didn't look to me as though that was reflected in your data, but is it the deaths that you're
- [00:43:56.700]talking about, those people getting impacted by, you mentioned dust causing traffic fatalities.
- [00:44:05.880]Smoke as well could, I'm sure.
- [00:44:07.900]So I'm just touching two or three bases and I wonder what your thoughts might be in relation
- [00:44:15.580]to wildfires and especially smoke taint and smoke drift.
- [00:44:20.940]Yeah.
- [00:44:21.800]It's a huge issue.
- [00:44:23.220]You know, I talked to some of the people within the state public health department and some
- [00:44:31.400]of the Douglas County health department as well.
- [00:44:35.700]Typically, we have pretty good air quality in Nebraska for the most part.
- [00:44:39.720]You know, there's days like today where there's a little bit more dust in the air.
- [00:44:43.620]But last year with the wildfires and the smoke that was traveling across, we had a lot of
- [00:44:52.580]it was, don't quote me on this, but it was something like close to like a month of air
- [00:44:58.940]quality where our ozone was concerning to a hazardous level.
- [00:45:05.520]And that was likely due to the smoke coming across the plains from the fires that were
- [00:45:13.100]burning up in the mountains and having impacts on our air quality here.
- [00:45:16.760]We're still trying to do investigations around what does that actually mean in terms of human
- [00:45:23.920]health outcomes here in the state.
- [00:45:26.380]And we're working with the state to try to better understand that and see if we saw a
- [00:45:30.460]change in hospitalizations, asthma-related hospitalizations.
- [00:45:35.340]And also mortality.
- [00:45:36.480]We are working with the National Cancer Institute out of NIH.
- [00:45:43.300]And we have a study.
- [00:45:44.840]We haven't published it.
- [00:45:45.720]We're in the process of wrapping up.
- [00:45:47.580]Showing wildfire smoke and the impacts that it has on increase in mortality away from
- [00:45:55.900]the fire event, just from the smoke itself.
- [00:45:57.780]And showing that there is an increase in mortality in certain populations due to just exposure
- [00:46:04.140]to smoke overall.
- [00:46:05.320]In the U.S.
- [00:46:06.980]And so that's some of the areas from the research standpoint and also from the standpoint of
- [00:46:14.140]how it impacts the health of people in the state, or the air quality within the state.
- [00:46:19.300]Now as far as what we're trying to do around that, we're in the early stages, one, we've
- [00:46:27.400]worked with the state to set up monitors across the state of Nebraska.
- [00:46:32.380]I didn't put that up there, but we actually have put...
- [00:46:35.300]Nebraska didn't have very much information as far as air quality.
- [00:46:38.720]If you want to know what the air quality was, there's a sensor that was in Douglas County,
- [00:46:43.740]and then there was like one or two other sensors throughout the state of Nebraska.
- [00:46:47.200]And so a lot of times people would be like, "Well, how's the air quality?"
- [00:46:49.280]And you're like, "Well, Douglas County's fine."
- [00:46:51.020]But if you're living in Scotts Bluff or Kearney, you weren't really getting a good picture.
- [00:46:55.800]So we actually worked with the state of Nebraska, and we set up air quality monitors across
- [00:47:00.360]the state, and now there's a better footprint for the entire state, and we're gonna continue
- [00:47:05.280]to expand this as well.
- [00:47:07.060]And we're working with the local health departments, and we're helping them figure out where they
- [00:47:11.820]wanna put those sensors, so that they, like a lot of them put them at schools, 'cause
- [00:47:16.520]they wanna make sure that they can, those most at-risk populations, and communicate
- [00:47:19.900]those risks to those populations as well, but, so putting those where they want 'em,
- [00:47:24.180]and working with them, and then their next step is developing some tools and resources
- [00:47:28.280]so that they can actually better and more effectively communicate within their community
- [00:47:32.980]as well around some of these threats.
- [00:47:35.260]So, hopefully we're building our understanding, and we've done some research already.
- [00:47:40.540]Like for example, Nebraska has one of the highest rates of asthma-related mortality
- [00:47:45.560]in the U.S., but we don't have one of the highest rates of asthma.
- [00:47:52.320]Why is that?
- [00:47:53.320]Still don't know.
- [00:47:55.240]Do we have, you know, less access to care, or more access to care issues here?
- [00:48:02.260]Less warning?
- [00:48:03.260]Whatever it is, we need to make sure that we're understanding something.
- [00:48:05.240]Some of those threats, so that we can reduce those risks.
- [00:48:08.120]And we also, we can identify which populations are most at risk as well.
- [00:48:12.240]I have a quick question here before we wrap up.
- [00:48:19.020]And this kind of pertains mostly to rural communities with droughts.
- [00:48:23.520]And you mentioned how drought is a multiplier effect.
- [00:48:25.880]Many things spur off of that.
- [00:48:27.480]Some of them perhaps more acute.
- [00:48:31.260]Some of them chronic or long-term items.
- [00:48:33.660]And I'm kind of thinking dust.
- [00:48:35.220]Respiratory maybe being the acute or what can be seen as the more immediate thing.
- [00:48:41.940]But then I always, being in water quality, I view droughts as the precursor to nitrate
- [00:48:47.120]losses when the water does come back.
- [00:48:50.040]And that's a long-term thing by the time it gets down to the aquifer and has impact.
- [00:48:54.440]So my question is, given these acute and long-term consequences of drought on rural communities,
- [00:49:00.740]is there any clear way from a public health standpoint of approaching
- [00:49:05.200]which one to prioritize with such low percentage of investments in that 1% to 5% in the prevention?
- [00:49:13.120]That's a great point because most times with public health, unfortunately, a lot of times it's the more acute versus the chronic.
- [00:49:24.800]But the chronic is of concern.
- [00:49:28.200]If you talk about water quality, for example, we're definitely much more focused on acute water quality issues
- [00:49:35.180]than the chronic water quality issues.
- [00:49:40.420]Even to some extent, like you look at blue baby syndrome versus pediatric cancer.
- [00:49:45.080]Pediatric cancer, like that's probably longer term exposure, whereas blue baby syndrome,
- [00:49:50.600]like it's also a long term exposure, but it's over a very set time frame.
- [00:49:55.340]And then when you talk about adverse human health outcomes, it's much easier to message around an acute issue than a chronic issue.
- [00:50:05.160]But we do it in the U.S. I mean, smoking, for example, you'll see billboards, you'll see signs, you'll see all that stuff.
- [00:50:12.720]Whenever we talk about like people smoking and the potential harmful outcomes from that.
- [00:50:18.080]But that's harder to do and it's harder to message around that.
- [00:50:21.920]And so unfortunately, we've we spend most of our time focused on some of those more acute kind of topics.
- [00:50:32.820]And I believe. Yes.
- [00:50:35.140]We've got one online. OK, I have a question for you from Daniel Shockman.
- [00:50:44.140]Two questions. OK, first one, do we need to be concerned about our water quality in Lincoln if on city water?
- [00:50:51.940]Oh, that's a that's a wonderful question. So I would say no.
- [00:51:00.260]In the context that municipal, especially large municipal water systems,
- [00:51:05.120]are monitoring at a very high level. Right. And so you have filtration processes.
- [00:51:11.420]You have systems in place. They have to meet the EPA standards for a safe drinking water act.
- [00:51:17.600]And so from that standpoint, like if you were to test, I would imagine if we tested the tap,
- [00:51:23.300]especially in the context of nitrate, if you tested the tap right now, it's probably close to zero.
- [00:51:31.340]The area where it's of higher concern for me is those
- [00:51:35.100]smaller municipal water systems that are, you know, they're regulated, but they don't have the resources.
- [00:51:41.860]And then private wells by far are the areas of highest concern as far as making sure that there's regular testing.
- [00:51:51.420]Now, I will say, you know, there's the things that we test for and we know of,
- [00:51:55.600]and there's the things that we don't test for that we don't know of, the unknown unknowns or whatever, to quote Rumsfeld from a while back.
- [00:52:05.080]And so with that, there's always more opportunity there to better understand some of the other exposures like PFAS is now a big thing that people are more interested and concerned about.
- [00:52:16.520]But there's less testing, and it's partially because it's expensive to test that for that too.
- [00:52:21.040]He also says I've lived for over 10 years in Australia and seen what excellence in public health looks like. Where's the USA going with developing a functional public health effort infrastructure.
- [00:52:35.060]Our lack of public health infrastructure was very evident during COVID.
- [00:52:39.560]Yeah, that's a good. That's a good point.
- [00:52:41.820]So I'll tell one an anecdotal story about working with Australia that it's one of my favorite stories ever.
- [00:52:49.400]So, talking about heat.
- [00:52:51.860]We had a visitor from Australia come up to talk about their heat warning system in Australia, when I was at CDC, and this individual told a story about how they would issue heat warning.
- [00:53:05.040]And he said, him and his colleagues who were in charge of the Met service there would open up the newspaper and they were like, we issued a heat warning yesterday.
- [00:53:13.340]How many people didn't listen to us and see how many people died from heat?
- [00:53:17.560]And they're like, it's kind of a thing.
- [00:53:19.560]And then one day he stopped and he goes, this is morbid.
- [00:53:23.400]We should be doing better communication and engagement around this issue and not pointing fingers at the public for not listening to us.
- [00:53:32.100]And so then they changed their process.
- [00:53:35.020]And trying to engage the public.
- [00:53:36.400]And so, one, I love that story from the context of there's a way of doing this where you make sure that you're doing better effective messaging.
- [00:53:45.960]And we're never going to be perfect, but we should always be striving to be closer to perfect.
- [00:53:50.500]Two, I would say public health in the United States is always going to be a challenge.
- [00:53:57.740]Because we live in a political system that decisions are not always made by science.
- [00:54:05.000]And decision makers are sometimes influenced by politics.
- [00:54:10.340]And I don't know how we get around that system.
- [00:54:13.480]But I hope that we learn lessons from things like COVID to figure out how we can do better.
- [00:54:21.020]And making sure that we can continue to build trust.
- [00:54:23.580]Because I think we lost a lot of trust as well as public health and science in general during that COVID pandemic.
- [00:54:32.620]And so we need to be doing.
- [00:54:34.980]A better job moving forward on how we can build better trust.
- [00:54:38.820]And make sure that we're working with communities and people on the ground.
- [00:54:42.940]To more effectively sell that messaging.
- [00:54:45.560]And I don't know if we're there.
- [00:54:47.060]And I hope that we get there someday.
- [00:54:48.680]I wish I could give you a better answer.
- [00:54:51.460]I apologize.
- [00:54:52.000]Yes.
- [00:54:54.180]One last question here.
- [00:54:55.380]Andrea.
- [00:54:56.060]We're short on time too.
- [00:54:57.920]You'll have to keep it snappy.
- [00:54:58.880]So you're in a room with crop and soil scientists and other people in this realm.
- [00:55:02.960]So just hit it with us, Jesse.
- [00:55:04.960]We invited you here.
- [00:55:05.760]What do you think are some of the most important things we should be looking at that we're
- [00:55:10.540]not in terms of the work that we do for public health?
- [00:55:14.380]One, I would say with everything, I always say, you know, like when we talked about drought
- [00:55:21.060]and we started working on this drought stuff, there are a number of times where we would
- [00:55:25.000]show up and they were making drought plans for a state.
- [00:55:27.220]And we're like, have you ever worked with health departments or health in any capacity?
- [00:55:31.440]And then you'd watch crickets or you listen to just crickets.
- [00:55:34.940]And they're like, no, we've never.
- [00:55:36.520]And I've done this internationally as well.
- [00:55:38.260]I'm like, how many of you?
- [00:55:39.020]And raise your hands.
- [00:55:40.160]And it would be like one person maybe.
- [00:55:41.420]So one, I think if you can find pathways to connect with health and public health to better
- [00:55:48.480]understand how what you're doing actually has an impact on human health in some capacity
- [00:55:53.340]and where those benefits are, because there's two things that can happen at that point,
- [00:55:57.900]right?
- [00:55:58.140]Is one, public health can then be a more effective messenger on the ground, but then also
- [00:56:04.920]being like, well, we're still seeing this problem.
- [00:56:07.100]Can you help us find solutions?
- [00:56:08.920]And whenever I talk about like the water quality issue, I never dive into the agricultural
- [00:56:14.260]solutions to that.
- [00:56:15.980]That's not my realm.
- [00:56:17.360]And I learned that through a variety of different channels.
- [00:56:21.940]I'll talk about public health solutions, but I need to work with individuals like you to
- [00:56:29.280]help figure out what are the long-term solutions on the ground.
- [00:56:31.620]And that's where we need to do more interdisciplinary.
- [00:56:34.900]Collaboration and engagement between both sides, because otherwise, like I can be over
- [00:56:40.380]here singing all my tunes, but if we're not working in collaboration in some way, we can
- [00:56:46.400]potentially be pulling against each other.
- [00:56:48.220]And I don't like that scenario in any capacity because that goes back to like the loss of
- [00:56:53.360]trust in our, in our institutions as well.
- [00:56:56.780]I don't know.
- [00:56:58.620]Is that, is that an answer?
- [00:56:59.980]Yeah, that was excellent.
- [00:57:02.940]And thank you for being here today and helping.
- [00:57:04.880]See some of this information on public health to us so we can create these
- [00:57:09.320]connections and future works together.
- [00:57:11.100]So thank you for being here today.
- [00:57:12.560]We greatly appreciate it.
- [00:57:13.820]And, uh, remember for everyone else that keep checking out the seminar
- [00:57:17.240]series throughout the semester.
- [00:57:18.920]Thank you.
- [00:57:19.380].
- [00:57:26.040]you
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