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Assessing Potential Impacts of Sea Level Rise on Public Health and Vulnerable Populations in Southeast Florida and Providing a Framework to Improve Outcomes


Abstract and Figures

In recent years, ongoing efforts by a multitude of universities, local governments, federal agencies, and non-governmental organizations (NGOs) have been focused on sea-level rise (SLR) adaptation in Florida. However, within these efforts, there has been very little attention given to the potential impacts of sea-level rise on human health. The intent of this project is to identify populations in Southeast Florida that are most vulnerable to sea-level rise from a topographic perspective, determine how vulnerable these population are from a socio-economic perspective, identify potential health impacts, develop adaptation strategies designed to assist these communities, and produce an outreach effort that can be shared with other coastal communities. The location of socially-vulnerable and health-vulnerable populations are correlated, but at present they are not generally in the geographically-vulnerable areas. Projections indicate that they will become at risk in the future but the lack of data on emerging diseases makes public health assessments difficult. We propose a redefinition of "who is vulnerable?" to include health indicators and hard infrastructure solutions for flood and property protection. These tools can be used to help protect water resources from the impacts of climate change, which would, in turn, protect public health via drinking water supplies, and efforts to address social issues.
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Assessing Potential Impacts of Sea Level Rise on
Public Health and Vulnerable Populations in
Southeast Florida and Providing a Framework to
Improve Outcomes
Frederick Bloetscher 1, *, Colin Polsky 2, Keren Bolter 2, Diana Mitsova 3,
Kristin Palbicke Garces 4, Roderick King 4, Isabel Cosio Carballo 5and Karen Hamilton 5
Department of Civil and Environmental Engineering, Florida Atlantic University, Boca Raton, FL 33431, USA
2Center for Environmental Studies, Florida Atlantic University, Boca Raton, FL 33431, USA; (C.P.); (K.B.)
3School of Urban and Regional Planning, Florida Atlantic University, Boca Raton, FL 33431, USA;
4Florida Institute for Health Innovation, West Palm Beach, FL 33407, USA; (K.P.G.); (R.K.)
5South Florida Regional Planning Council, Hollywood, FL 33021, USA; (I.C.C.); (K.H.)
*Correspondence:; Tel.: +1-239-250-2423
Academic Editors: William D. Shuster, Audrey L. Mayer and Ahjond S. Garmestani
Received: 12 January 2016; Accepted: 25 March 2016; Published: 31 March 2016
In recent years, ongoing efforts by a multitude of universities, local governments, federal
agencies, and non-governmental organizations (NGOs) have been focused on sea-level rise (SLR)
adaptation in Florida. However, within these efforts, there has been very little attention given to
the potential impacts of sea-level rise on human health. The intent of this project is to identify
populations in Southeast Florida that are most vulnerable to sea-level rise from a topographic
perspective, determine how vulnerable these population are from a socio-economic perspective,
identify potential health impacts, develop adaptation strategies designed to assist these communities,
and produce an outreach effort that can be shared with other coastal communities. The location of
socially-vulnerable and health-vulnerable populations are correlated, but at present they are not
generally in the geographically-vulnerable areas. Projections indicate that they will become at risk
in the future but the lack of data on emerging diseases makes public health assessments difficult.
We propose a redefinition of “who is vulnerable?” to include health indicators and hard infrastructure
solutions for flood and property protection. These tools can be used to help protect water resources
from the impacts of climate change, which would, in turn, protect public health via drinking water
supplies, and efforts to address social issues.
Keywords: sea level rise; vulnerable populations; groundwater; vector- and waterborne diseases
1. Introduction
Climate change impacts are felt globally, but some areas and populations are recognized as being
particularly vulnerable [
]. The Southeast Florida region, with its low-lying coasts, subtropical
climate, porous geology, and distinctive hydrology, has been identified as one of the world’s most
vulnerable areas [
]. Due to these unique conditions, sea-level rise is the principal long-term,
permanent impact of climate change for the region, threatening both its natural systems and its densely
populated and highly diverse built environment [
]. With 6.6 million people, the region constitutes
Sustainability 2016,8, 315; doi:10.3390/su8040315
Sustainability 2016,8, 315 2 of 18
one-third of the state’s total population, one third of the state’s economy, over $4 trillion in property
value, and among the highest rates of projected population growth in the state [5].
The mean sea level is expected to rise up to three feet (1 m) by 2100 due increased rates of thermal
expansion, glacier mass loss, groundwater losses, and discharge from land-based
ice-sheets [1,611].
The U.S. Army Corps of Engineers used Key West tidal data from 1913 to 1999 to calculate a projected
sea-level rise. Results suggested that the sea-level rise in Southeast Florida will rise one foot from
the 2010 baseline by 2040, and could raise two feet (0.65 m) by 2060 [
]. Figure 1shows the
current projections and the uncertainty associated with same which comport with the medium 2013
IPCC projections.
Figure 1. Projected sea level rise.
Much of the research focus has been on coastal communities due to the direct threat of sea level
rise (SLR). Bloetscher, et al. [13], Bloetscher and Romah [14], and Romah [15] noted that groundwater
levels in Southeast Florida are intrinsically linked to the sea level and, thus, while coastal populations
are particularly at risk due to erosion, inundation, and storm surge, interior populations are also
susceptible to rising water tables and extended periods of inundation. Chang, et al. [
] describes
an overall “lifting process” by which there is a 1:1 ratio in water table elevation that correlated to
sea-level rise. Higher groundwater levels mean reduced aquifer storage, thereby lessening the capacity
of soil to absorb precipitation, and thereby increasing the risk of groundwater flooding [
Due to the associated loss of soil storage capacity caused by sea level rise, more intense storms will
overwhelm the current storm water infrastructure. Projections indicate the potential for severe damage
to Southeast Florida’s energy systems, transportation infrastructure, water infrastructure, agricultural
lands, and the Everglades ecosystem [18,19].
Much of the current work on adaptation to sea-level rise (SLR) focuses on understanding the
physical and economic vulnerability of infrastructure, as well as on developing adaptation strategies
for the natural and built environments using new infrastructure systems [
]. Long-term
decisions which consider a systems approach that includes population, economics, and environmental
conditions, are essential as local governments and businesses examine long-term viability, particularly
in respect to investment decisions related to location. Property values are also dependent upon the
Sustainability 2016,8, 315 3 of 18
maintenance of transportation and utilities, especially storm water, wastewater treatment, and water
supply. The insurance industry, which has traditionally been focused on a one year vision of loss risk,
is beginning to discuss long-term risks of losses. If the insurance industry takes a longer view of risk,
there will be an accompanying impact on lending practices. Where properties are at risk, lending
options may be reduced by insurance limitations—i.e., if the insurance industry sees the potential for
significant losses from sea level rise within 30 years, the mortgage industry will limit the length of
loans and increase interest rates due to insurance risk, thereby increasing costs to buyers and reducing
the attractiveness of the purchase for sellers. The result may be declining property values and slower
sales. Hence, it is in the community’s interest to develop a planning framework to adapt to sea-level
rise and protect vulnerable infrastructure through a long-term plan.
Climate change also has the potential to create a serious public health threat that affects human
health outcomes and disease patterns [
]. Although preventative and adaptive strategies for climate
change will help lessen negative health impacts, human health will continue to be affected from present
climate change conditions [
]. It is expected that climate change will both aggravate existing
human health risks and conditions and create new ones. Health impacts will vary and have both
direct and indirect effects [
]. Populations with combined health, socio-economic, and place-based
vulnerabilities will be most affected [
]. The health impacts will be felt to different degrees depending
on action taken to adapt [20,22,30,31].
Due to the inevitability of sea-level rise in Southeast Florida and in other low-lying coastal regions
as a consequence of climate change, the focus of this research was to identify the communities most
at risk, evaluating potential nexus points for three factors: (1) areas that will be most vulnerable to
sea-level rise using United States Army Corps of Engineers (USACE) projections; (2) locations of
populations that are socially and economically vulnerable; and (3) locations of increased health risk.
Socially-vulnerable populations that reside in these low-lying areas and already have predisposed
health vulnerabilities and economic limitations lack the resources and capacity to mitigate sea-level
rise impacts. In this investigation, current conditions were compared against incremental increases
of 0, 1, 2, and 3 feet of sea-level rise based on actual data. The increments work as threshold values
by allowing planners to know ahead of time where the next set of vulnerable areas will be, thereby
permitting an opportunity for a proactive response approach.
2. Materials and Methods
2.1. Sea Level and Groundwater Mapping
Prior to compiling data, the local community needs were assessed in order to define an acceptable
level of service (LOS) for the community. In Southeast Florida, the king tides occur annually,
in September and October. Storms may alter this pattern slightly, but these are atypical and temporal
events that may cause significant damage and disruption to the community, but do little to affect the
long-term trends for sea level rise. Hence, storm related impacts were not considered. Figure 2shows
tidal data, graphed from highest to lowest, illustrating how the highest tides are much higher than the
average. The LOS should indicate how often it is acceptable for flooding to occur in a community on
an annual basis. The failure to establish an acceptable LOS is often the cause of a loss of confidence in
public officials at a later point in time. The effects of sea-level rise on the LOS should be used to update
the mapping in terms of demonstrating changes in vulnerability and increased flooding frequency.
For example, a 1% flooding frequency translates to four flood days per year.
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Figure 2. Using the six years of tides, the 99th percentile for the City of Miami Beach which was used
as a test case—four days flooding per year is shown in the red line. If sea-level rises one foot, the line
will move downward one foot (dashed red line).
Once the level of service was defined, a unique method of vulnerability assessment was performed.
The purpose of sea-level rise vulnerability modeling is to evaluate the future vulnerabilities of
infrastructure, buildings, and facilities on public and private property based on their topography.
Development of the surface topography included high resolution LiDAR, “ground-truthing” by tying
it to local benchmarks and transportation plans, and USGS groundwater and NOAA tidal data from
local monitoring stations to modeled groundwater surfaces.
Groundwater was examined similarly with respect to the sea-level rise scenarios.
The groundwater levels are the result of investigating all USGS monitoring wells and those other
monitoring wells with at least 30 years of data to determine the critical junctures that would increase
vulnerability to surface flooding. While the goal of this effort was not to model groundwater flow,
the concept was to consider more than just static elevation to determine sea-level rise vulnerability.
Groundwater levels fluctuate with rainfall, but given distinct wet (summer) and dry (winter) seasons,
and the end of the wet season coinciding with the highest tides, groundwater levels are generally
highest at the end of the wet season. In addition, groundwater levels generally increase as one
moves inland. By matching actual groundwater levels to tidal conditions, a groundwater surface can
be developed.
As the greatest vulnerability to flooding occurs when the groundwater was closest to the surface,
the 99 percentile (4 days/year) water levels from the wells data were interpolated ordinarily to match
the 99 percentile tidal data. The topographic LiDAR layer and the groundwater maps were used
to find the difference between land height and peak groundwater elevation, essentially indicating
whether the soil can absorb water or is saturated and will pool or run off. As this layer may be adjusted
for soil—sand versus clay to decrease the soil storage capacity, it is a robust data layer that was used
in the modeling as a physical risk sub-index. This type of modeling is termed a “modified bathtub
model.” The three classifications delineate where the difference between topography and groundwater
is organized into levels of: vulnerable (below 0 ft), potentially vulnerable (0–2 ft), and not vulnerable
(>2 ft). The term “potentially vulnerable” is used for areas that need further investigation to deal with
the uncertainty of drainage and storm water improvements that might affect the situation.
2.2. Southeast Florida Vulnerability Index
The modified bathtub model demonstrates that SLR not only affects coastal regions, but it can
affect low lying regions inland by affecting ground water levels which lead to localized flooding.
South Florida’s climate makes these low lying, inland areas that are flooded a primary target for
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the negative effects of disease especially from waterborne, foodborne, and vector-borne diseases.
Unlike most of the country, South Florida provides optimal conditions for viruses, bacteria, ticks,
and mosquitoes year around. Therefore, it is important that the potential consequences of sea-level
rise be reviewed in order to mitigate the effects.
As a part of the project, indices for health and socio-economic impacts were developed. Such
indices build upon recent developments in measures seeking to quantify various aspects of community
vulnerability. The index was created using the z-score approach. A z-score approach is an appropriate
technique for variable sampling distributions that satisfy the normality assumptions. A z-score
indicates how much a particular observation deviates from the mean relative to the standard deviation,
and is calculated as follows:
The Kolmogorov–Smirnov test and other statistical techniques will be used to test the hypothesis
that the observed data approximate a normal distribution. Data transformation and/or windsorization
(i.e., trimming of the tails to the 97.5th percentile) is performed if outliers or extreme values that distort
the distribution are present [
]. Truncation can also be used to remove the effects of the outliers on
the mean and the standard deviation [
]. Truncation to the 99th percentile will preserve the extreme
values in the tails of the distribution, allowing them to still represent “best” and “worst” practices,
but reduces their undue effect on the aggregation algorithm.
Few of the existing indices have accounted for the health status of the affected populations.
In addition, there is growing attention to the anticipated health risks, such as waterborne diseases
resulting from prolonged ponding conditions related to the effects of floods and sea-level rise [
The emphasis for this project was on health and social denominators to fill this gap by developing
a composite measure to quantify health-related vulnerability, such as the incidence of chronic and
acute health conditions, in conjunction with socio-economic variables and physical exposure to the
anticipated effects of sea-level rise. For those diseases with only a few cases reported during the
observation period, as in the instance with the diseases reviewed in this study, rates may be unreliable
and could be difficult to interpret. This may also occur when there are no cases reported for a given
location during the period of interest. The FDOH used relative standard error (RSE) as a way of
measuring the reliability for statistical estimates. This is calculated by dividing the standard error of
the rate by the rate itself and then multiplying by 100 to convert it to a percent. For rates, this calculation
can be simplified to taking the inverse of the square root of the total number of cases and multiplying
by 100. When the RSE is large, it indicates that the rate is imprecise. The FDOH chose a cut-point of 30,
such that rates with an RSE greater than 30 in this report should be considered unreliable. This is a
cut-off used by several CDC programs. The FDOH suppressed all crude rates as well as case counts for
strata with an RSE > 30. All health data were collected and completed by the FDOH. A more detailed
explanation is presented in a companion paper.
2.3. Statistical Analysis
Ultimately, policy-makers will need more information to prioritize resources and address the most
drastically needed improvements. For example, a major goal to reduce economic vulnerability requires
identifying where economic activity occurs and where potential jobs are. At-risk populations, valuable
property (tax base), and emergency response may be drivers for policy decisions, which means data
from other sources must be considered. To better understand the differences between the subareas,
the collected data were compiled, summarized, and analyzed using an EXCEL add-on element called
(Addinsoft, New York, NY, USA). Correlation analysis was used to indicate whether the
variables are related to other variables on an individual basis. However, correlation analysis works
best when there are a limited number of variables (as opposed to the 24 variables here). Exploratory
factor analysis in XLStat
(Addinsoft, New York, NY, USA) was employed to reveal the potential
existence of underlying factors within data containing a very large number of measured variables.
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Next, Principle Component Analysis (PCA) was used to reduce the number of variables by
consolidating similar correlated variables into factors, preferably two or three that explain most of
the data. PCA uses a multivariate statistical parameter called an eigenvalue, which is a measure
of the amount of variation explained by each principal component [
]. With the PCA analysis,
all factors in excess of one are kept. It is desirable that the factors represent at least 70 percent of the
resulting eigenvalues. A scree plot is used to visualize the total variance fraction explained by each
principal component.
3. Results
3.1. Sea-Level Rise Mapping
The sea-level rise vulnerability maps for the four counties, Broward, Miami-Dade, Palm Beach,
and Monroe, are shown in the following figures. Figure 3shows the vulnerable and potentially
vulnerable areas in Palm Beach County. Many believe that Palm Beach County is far less at risk
from sea-level rise than other southeast Florida counties as a result of higher elevations. However,
the groundwater levels in Palm Beach County show that these impacts are already a challenge. Figure 4
shows the same information for Miami-Dade and Broward Counties. Each of these figures shows that
the impacts of sea-level rise and groundwater is significantly higher than the bathtub models project.
Figure 3. Cont.
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Figure 3.
Palm Beach County Vulnerability at 0, 1, 2, 3 ft SLR at 99 percentile groundwater/tidal
elevations (ignoring current infrastructure).
Figure 4. Cont.
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Figure 4.
Miami-Dade and Broward Counties—vulnerability at 0, 1, 2, 3 ft SLR at 99 percentile
groundwater/tidal elevations (ignoring current infrastructure).
3.2. Results from the Statistical Analysis
Using XLStat
(Addinsoft, New York, NY, USA) an add-on to EXCEL
(Microsoft, Redmond,
WA, USA), statistical analysis was conducted for the sea-level rise potential, demographic data and
disease incidences. First, sea-level rise data were analyzed, for the current, 1, 2, and 3 foot sea-level rise
scenarios, showing the vulnerable and potentially vulnerable land. Figure 5compares these numbers
directly, illustrating that more land is vulnerable as sea-level rises.
Figure 5.
Average land area vulnerable and potentially vulnerable in the four county area for the
current, 1, 2, and 3 foot sea-level rise scenarios. (
) vulnerable property percentage; (
) potentially
vulnerable property percentage.
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Various analyses were undertaken. Exploring disease versus demographic characteristics, PCA
found that six factors explained 80% of the variation in the data. For all analyses, there was strong
correlation between social and health vulnerability as measured by lower income, percent of minority
populations, lower educational attainment, lack of fluency in English, low penetration of medical
services, disability status, and age. Figure 6shows a varimax PCA plot of social and health indicators
versus income above the median. Not surprisingly, there was an inverse correlation between higher
income and social and health vulnerability. Figure 7indicates the result when income and social
indicators are compared to sea level rise vulnerability. This plot shows that a higher income level is
correlated with SLR vulnerability—the wealthier people live in more geographically vulnerable areas
(the coast and newer houses in the western areas) but that, with time, the vulnerability rotates toward
increased social and health vulnerability. The results indicate that an increase in vulnerable land area
affects a larger and more diverse population.
Figure 6.
Varimax rotation showing that disease and social vulnerability mostly lie together in
the graph.
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Figure 7. Varimax plot for sea-level rise and disease incidence.
3.3. Outreach
Outreach activities with local stakeholders from June through November of 2015 were focused on
discussions of some of the key findings of this study, including (i) the possible expansion of vulnerable
area over time; (ii) the lack of evidence that the most vulnerable land areas are currently correlated
with the most vulnerable populations; (iii) the lack of knowledge on future distributions of vector and
waterborne diseases; (iv) the need for incremental strategies as new data become available; (v) the need
for planning actions to reduce both socio-economic and place-based vulnerability; and (vi) the need
for better monitoring/reporting of disease. Other messages were that adaptation must be coordinated;
strategies must be incremental, and there is a need for a plan for impacts to both socioeconomically- and
geographically-vulnerable populations. In all, these issues are designed to raise awareness among
key stakeholders and policy-makers of the correlation between non-chronic health impacts and
socioeconomic and geographic vulnerable populations. It also permitted the research team to compile
framework tools of options that might be useful in dealing with the social and health vulnerability.
The South Florida Regional Planning Council initiated the dialogue with policy-makers and
planners. The Council reached out to the Southeast Florida Regional Climate Change Compact,
a seven-county organization focused on climate change. Within the next two years, the Southeast
Florida Regional Climate Change Compact will amend their action plan, and begin to prioritize areas
for adaptation implementation. This provided the opportunity for a Health Impact Assessment (HIA)
to be performed to ensure that human health is considered throughout the update and implementation
process [
]. In the screening phase, the HIA was designed to be timely such that its findings and
recommendations are able to assist jurisdictions and decision-makers in understanding the local health
implications of climate change in each of the six sections of the Climate Change Compact’s Action Plan.
Sustainability 2016,8, 315 11 of 18
4. Discussion
4.1. Proposed Frameowrks
Based on findings of the vulnerable areas, the next task involves the development of scenarios
whereby various options can be utilized to address community vulnerability. The goal is to identify
successful flood mitigation strategies used by other cities that face similar drainage and construction
problems based on identified vulnerabilities and cost effectiveness. These two issues are then combined
to develop a framework to evaluate the impacts of climate change on infrastructure and urban
development (as they are intrinsically intertwined). Figure 8outlines a simplified flow chart used as a
basis for the evaluation.
Figure 8. Analytical framework for toolbox development.
The strength of this framework lies in the proposed holistic and incremental approach to
addressing climate change impacts which entails understanding of combined social and health
vulnerabilities in the context of higher exposure of the physical infrastructure to hazards. As such,
it combines physical vulnerability with health indicators and social evaluation criteria, and conveys
the notion that a plan is not a fixed document, but rather a process that evolves with the changing
environment. The final two steps occur at regular intervals at the community level with associated
adjustments made to the initial plans for improvements to various infrastructure systems.
The final task was to develop a series of strategies that could be used to improve the regional
resiliency to sea level rise. The first set of strategies focuses on hard infrastructure systems. Roadways
are the first areas that will see more frequent flooding since roadways are traditionally built at
elevations lower than the finished floor of structures. In addition, most infrastructure systems are
co-located with roadways (water, sewer, storm water, power, etc.). As a result, there is a need
to prioritize where funds are spent on transportation infrastructure and other major investments.
Table 1outlines hard infrastructure solutions for flood and property protection. Catastrophic flooding
would be expected during heavy rain events because of reduced capacity of the drainage system.
The vulnerability of transportation infrastructure will require the design of more resistant and adaptive
infrastructure and network systems. This would, in turn, involve the development of new performance
measures to assess the ability of transportation infrastructure (e.g., roadways, bridges, rail, sea ports,
and airports) in preparation for sea-level rise and to enhance resiliency standards and guidelines
for design and construction of transportation facilities. Specifically, considerations must include
retrofitting, material protective measures, rehabilitation and, in some cases, the relocation of a facility
to accommodate sea-level rise impacts. As they are related, groundwater is, similarly, expected to have
a significant impact on flooding in these low-lying areas as a result of the loss of soil storage capacity;
yet, this continues to not be the focus of many planning efforts.
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Table 1. Hard Infrastructure Improvements.
Implementation Strategy Benefits Cost Barriers to Implementation Point When Action May Need to
be Abandoned
Exfiltration Trenches Excess water drains to aquifer,
some treatment provided $250/ft
Significant damage to roadways for
installation, maintenance needed,
clogging issues reduce benefits
If groundwater table is above
exfiltration piping, the exfiltatrion
efficiency diminishes quickly
Infiltration Trenches
Excess water gathered from soil
and drained to pump stations,
creating storage capacity of soil
to store runoff, soil treatment
$250/ft plus pump station
Significant damage to roadways for
installation, maintenance needed,
clogging issues, costs for
pump station
Complete inundation means pumps
run constantly and pump the same
water over and over
Install stormwater pumping
stations in low lying areas to
reduce storm water flooding
(requires studies to identify
appropriate areas, sites and
priority levels)
Removes water from streets,
reduces flooding
Start at $1.5 to 5 million each,
number unclear without
more study
NPDES permits, maintenance cost,
land acquisition, discharge quality
When full area served is inundated
(>3–5 ft SLR)
Added dry retention Removes water from streets,
reduces flooding $200,000/acre Land availability, maintenance of
pond, discharge location When full area served is inundated
Armoring the sewer system
(G7 program)
Keeps stormwater out of
sanitary sewer system and
reduces potential for disease
spread from sewage overflows.
Major public health solution
$500/manhole limited expense beyond capital cost none
Central sewer installation in
OSTDS areas
Public health benefit of
reducing discharges to lawns,
canals and groundwater from
septic tanks
$15,000 per household Cost, assessments against
property owners none
Raise roadways Keeps traffic above floodwaters $2–4 million/lane mile Runoff, cost, utility relocation When full area served is inundated
Class V gravity wells Means to drain neighborhoods $250,000 ea Needs baffle box, limited flow
volume (1 MGD) When full area served is inundated
Class I injection wells Means to drain neighborhoods,
15 MGD capacity $6 million Needs baffle box When full area served is inundated
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Table 1. Cont.
Implementation Strategy Benefits Cost Barriers to Implementation Point When Action May Need to
be Abandoned
Bioswales Means to drain neighborhoods,
provides treatment of water $0.5 million/mile land area, flow volume, maintenance When full area served is inundated
Raise sea walls Protects property $0.1–1 million/property Private property rights, neighbors n/a
Relocate wellfields
westward/horizontal wells
$20 million assuming locations
can be permitted in
Biscayne aquifer
$20 million assuming locations
can be permitted in
Biscayne aquifer
Cost, concern over saltwater
intrusion east and west, inundation
of wellfields, permitting by SFWMD
When well is inundated
Salinity/lock structures Keeps sea out, reduces
saltwater intrusion
Up to $10 million, may require
ancillary storm water pumping
stations at $2–5 million each
SFWMD, western residents, private
property rights arguments
n/a—solution to retard sea
encroachment and saltwater
Regional relocation of locks
and/or conversion to
pump stations
Creates regional system to use
coastal ridge to protect inland
property, keeps saltwater out
$200 million each SFWMD, western residents, private
property rights arguments
n/a—solution to retard sea
encroachment and protect property
which can exist at levels below
sea level
Pump to Tide huge volume of water can be
removed from urban area unknown
Water quality to reefs, sea grasses, etc.
When full area served is inundated
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A number of strategies can be considered for improving water supplies, although the applicability
will vary from one location to the other. Table 2summarizes the tools that can be used to help protect
water resources from the impacts of climate change, which would in turn protect public health by
protecting drinking water supplies. Table 3outlines efforts to address social issues. At the center
of these planning efforts should also be provisions for an adequate drainage system, designed to
accommodate increased volume of water from precipitation events and rising tides. This provision will
be critical in protecting the roadway base and the infrastructure beneath it. Since these systems will not
be viable as sea-levels rise, future storm water systems should be designed like sanitary sewers with
tight piping, with minimal allowances for infiltration, and adequately-sized pumping stations that
permit discharge points and means for associated treatment of the stormwater. Discharges of storm
water to water bodies may portend poorly to vital seagrasses and reefs, so some effort will be required
to determine the level of treatment needed to protect the ecosystem in the face of excessive water levels.
Drainage wells could be an essential component to improving drainage systems. These wells require
splitter boxes and filters to remove solids, regular inspections, and regular maintenance which would
all need to be included in budget considerations.
Table 2. Tools for Protection Water Resources from Climate Change Impacts (adapted from [1]).
Water Resource Adaptation Alternatives
Water conservation
Reducing requirements for additional treatment capacity and development of alternative water supplies (AWS)
Reducing the impact of sea-level rise on existing water sources
Hydrodynamic barriers: aquifer injection/infiltration trenches to counteract saltwater intrusion using treated
Horizontal wells
Salinity structures and locks control advance of saltwater intrusion
Relocation of wellfields when saltwater intrusion or other threats render wellfield operations impractical
Gaining access to alternative water resources
Desalination of brackish waters
Regional alternative water supplies
Capture and storage of stormwater in reservoirs and impoundments
Aquifer storage and recovery (ASR)
Wastewater reclaim and reuse
Irrigation to conserve water and recharge aquifer
Industrial use and for cooling water
Indirect aquifer recharge for potable water
Stormwater management
Reengineering canal systems, control structures and pumping
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Table 3. Soft Infrastructure Improvements.
Implementation Strategy Benefits Cost Barriers to Implementation Point When Action May Need
to be Abandoned
Increase Access to Health Care
Improved health care access should
reduce impacts, e.g., vaccinations
will not be possible for all
climate-related conditions, because
of the state of the art in vaccines
unknown Cost, ongoing operations Would occur only if the entire
region was abandoned.
Reduce potential for
forced migration
Lessens risk of socially-vulnerable
people moving out vulnerable areas
unknown Pressure from developers, rental
properties at risk n/a
Redevelopment control
ordinances and policies
reduces competition for land by
removing land from redevelopment
Pressure from developers, rental
properties at risk, property
rights issues
Would occur only if the entire
region was abandoned
Assessments for hard
provides funding to support
social efforts see Tables 1and 2Public resistance or public support Would occur only if the entire
region was abandoned
Public acquisition of at
risk property
reduces potential for migration to
vulnerable property by taking
property out of circulation
various land regulatory tools:
land lease, outright purchase,
condemnation; may provide
short-term income
Public resistance or public support n/a
Vaccinations reduces risk n/a Public resistance or public support n/a
Risk Communication improves communication to
residents about their vulnerability unknown Public awareness n/a
Outreach improves communication to
residents about vulnerability unknown Public awareness n/a
Sustainability 2016,8, 315 16 of 18
4.2. Needs
To address the gaps in knowledge a number of tools could be developed. Models of population
migration should be reviewed to determine if sufficient data exists to probabilistically evaluate potential
patterns of migration. A second effort may be to develop a probabilistic model that combines sea-level
rise (as it affects the amount of livable property, the projected increases in population, the project
property values, and projected growth in economic activity in the future). Such an effort might be
useful as a predecessor to population migration as a means to address the tipping point. A third
effort would be to evaluate current data overseas regarding disease incidence and develop predictive
models of growth in Southeast Florida. Limited data might suggest another Bayesian exercise, but the
application would need further evaluation given altered conditions that exist in Southeast Florida.
A fourth effort would be to develop tools to assess the impacts of sea level rise to chronic conditions
given that little impacts could be discerned in this project. There is insufficient evidence to determine if
chronic conditions are exacerbated by sea level rise, so an effort should be developed to engage health
practitioners in developing long-term data on disease incidence, long-term strategies to address the
effects of climate change, and a means to communicate these strategies to the public.
5. Conclusions
This study has found that, at present, there is a strong correlation between vulnerability associated
with a number of health indicators and social vulnerability in the study area. Spatially, the most
vulnerable populations are not found in the most physically vulnerable areas at present, but exposure
will increase with time. However, the lack of data on emerging diseases makes future projections
regarding the health impacts of sea level rise a challenge.
Preliminary results from this study indicate that the future effects of sea level rise requires a
multidimensional perspective which incorporates the need to address physical, social, and health
vulnerabilities conjointly and in a cohesive manner. An outcome of this study is a series of options
to assist decision-makers in addressing the anticipated vulnerabilities based on more detailed local
studies. In this context, it is ever more important to continue research in climate change and sea-level
rise and its impacts on the natural and built environment.
Sea level rise will decrease available land, increase competition for development, and will require
additional infrastructure and costs. Given the growing population and the constraints on land
availability, altered redevelopment patterns will increase competition for lower prices and higher
ground, challenging the ability of socially-vulnerable populations to respond to the impacts of sea-level
rise. Processes of migration will likely lead to an increase of the number of people at risk. A better
understanding of future trends in mosquito-spread diseases like Zika, dengue fever, or chikungunya,
or waterborne diseases, like giardia and cryptosporidium, is also necessary to adequately address
the challenges posed by climate change. Adaptation strategies depend on funding, and preliminary
assessment of availability of resources is needed to address social and infrastructure needs in the future.
Community involvement is critical as adaptation efforts will be organized and shaped by challenges at
the neighborhood, rather than regional, scale.
Acknowledgments: The authors would like to acknowledge the Kresge Foundation which funded this project.
Author Contributions:
Frederick Bloetscher was the primary author of the paper, developed the sea level rise
methodology and maps and conducted the statistical analysis. Colin Polsky is the Director for the Center
for Environmental Studies at Florida Atlantic University. His contribution was the review, organization and
coordination of work products and this paper. Keren Bolter and Diana Mitsova performed the research, accessed,
organized and contributed the social data sources. Keren Bolter edited the paper. Kristin Pablicke Garces
performed the research to generate the health data. Roderick King was responsible for the design of the research.
Isabel Cosio Carballo and Karen Hamilton organized and facilitated the public outreach portion of the project that
led to Table 3. All authors have reviewed and approved the paper.
Conflicts of Interest: The authors declare no conflict of interest.
Sustainability 2016,8, 315 17 of 18
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... Since its recognition, several studies have been executed to evaluate the impacts of sea level rise and climate change on coastal communities and to establish adaptation strategies, mainly from the point of view of future planning and infrastructure, resources and socio-economic impact (Bates et al., 2008;Bloetscher et al., 2000;FOCC, 2010;Hanson et al., 2011;SFRCC, 2015;Tebaldi et al., 2012). However, until recently the implications over public health were not fully considered (Ebi et al., 2009;Crimmins et al., 2016;Swaminathan et al., 2017;Veenema et al., 2017), and few practical adaptation strategies focused on health risk prevention have been developed (Bloetscher et al., 2016;Boguszewski, 2015;Craig, 2010;FIHI, 2016;FPHI, 2014;Ramasamy and Surendran, 2011;Ramasamy and Surendran, 2012;SFRCC, 2015). Therefore, the objectives of this manuscript are to describe possible changes in the transmission of water-related diseases in response to sea level rise in coastal communities, as well as to describe potential engineering solutions to mitigate the transmission of these diseases. ...
... In particular, over the last 20 years the rate of increase is 300% over the prior rate, at around 3.2 mm/y for global mean sea level rise (IPCC, 2014). Much of the available data supports evidence that the rate of sea level rise is likely to increase in the upcoming decades, while no evidence currently proves that it could possibly have a steadying or even decreasing future trend (Bloetscher et al., 2016;FOCC, 2010;Gregory, 2013;IPCC, 2014). ...
... South Florida is of special interest when considering the possible impacts of continuing sea level rise, since it is considered one of the world's most vulnerable areas (Bloetscher et al., 2016). It is believed that in this region sea level rise will probably become higher than the global average, due to predicted changes in ocean currents such as the Gulf Stream which, runs along the Atlantic coastline of eastern Florida (SFRCC, 2015). ...
Sea levels are projected to rise in response to climate change, causing the intrusion of sea water into land. In flat coastal regions, this would generate an increase in shallow water covered areas with limited circulation. This scenario raises a concern about the consequences it could have on human health, specifically the possible impacts on disease transmission. In this review paper we identified three categories of diseases which are associated with water and whose transmission can be affected by sea level rise. These categories include: mosquitoborne diseases, naturalized organisms (Vibrio spp. and toxic algae), and fecal-oral diseases. For each disease category, we propose comprehensive adaptation strategies that would help minimize possible health risks. Finally, the City of Key West, Florida is analyzed as a case study, due to its inherent vulnerability to sea level rise. Current and projected adaptation techniques are discussed as well as the integration of additional recommendations, focused on disease transmission control. Given that sea level rise will likely continue into the future, the promotion and implementation of positive adaptation strategies is necessary to ensure community resilience.
... The review highlighted that people in a vulnerable situation (e.g., living in poverty or unstable dwellings, lack of access to health care) are at an increased risk for mortality and morbidity. For instance, among residents in Southeast Florida, rising sea levels were particularly dangerous for those who are low-income, lower education levels, non-English speaker, older age, visible minority, or those with disability [41]. ...
... Such "place effects [46]" and their potential mediating role between climate change and health are being increasingly discussed in the literature [46,47]. [35][36][37][38][39][40][41][42], identified, direction and nature of the relationships between indicators of climate change and varying movement behaviors and/or health outcomes are indicated using arrows (direction) and colored lines (blue lines indicate favorable associations and orange lines indicate unfavorable associations). Furthermore, thick solid lines indicate consistent associations (consistent findings in ≥ two reviews) while thick dotted lines (one review) indicate suspected associations. ...
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Technical Report
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The following report provides information and guidance on the application of tools and decision processes developed by NRMRL and ORD supporting communities faced with making risk-based decisions fostering community health and resilience to environmental challenges.
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... Sea level rise and associated erosion are already being experienced in some low-lying communities, especially during severe storms and extreme high tides. Where infrastructure hardening (Bloetscher et al. 2016) and related adaptation measures are impractical or cost-prohibitive, some small island and coastal communities are now adapting to their new reality by managed retreat or planned relocation before their communities become uninhabitable. Many of these communities are in isolated settings and are home to indigenous populations with few resources (Maldonado et al. 2013). ...
Full-text available
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Many coastal Florida real estate developments were created by draining wetlands, dredging the land to create canals, and using the dredged sediments to create homesites at elevations only slightly above sea-level. Some of the original developers had idealistic intentions of creating garden communities, but most were trying to maximize profits by creating as much waterfront property as possible. Current residents of these communities are now living in areas susceptible to a combination of subsidence and sea-level rise. This chapter reviews the origins of four such communities: Apollo Beach, Cape Coral and Punta Gorda, on the Gulf Coast, and Hollywood on the Atlantic Coast. Each is highly vulnerable to flooding primarily because of the way the land was created and platted and each is therefore “vulnerable by design.”
“Resiliency” for communities at risk from sea level rise and its effects means preserving as much property and associated economic activity as possible without disrupting current activity or expending funds on projects that provide limited long-term utility or social value. Of interest is how the coincidence of these events impacts the need for storm water improvements and the financial obligations they will entail. This research project focused on the impacts of a non-coastal, groundwater influenced southeast Florida community and the long-term funding they will need to reduce flooding in the community using GIS. This research involved defining surface elevations and groundwater levels, assessing the impacts of sea level rise on groundwater, assessing impacts to storm water from rainfall, identifying likely improvements, and assessing the scale for improvements. The analysis used three extreme rainstorm events under the 0-, 1-, 2-, and 3-foot sea level rise scenarios to determine the magnitude of the cost of the improvements. For a 35-square mile community, our research estimated that the cost could exceed $300 million. For a community not directly adjacent to the coast, the magnitude of these costs should be of interest to similarly placed communities.
Globally, sea level is rising and it represents a serious concern. The trends are indisputable, and the predictions indicate that sea level will continue to rise for the coming centuries. Sea level rise is a consequence of human-induced climate change and has significant implications for low-lying coastal communities around the world. The impacts are felt with increased coastal flooding during storms and higher frequency of tidal flooding. In many countries, local drainage infrastructures were not designed to consider the mean of sea level rise observed in the past couple of years. Consequently, outlet pipes are often inundated and covered at high tide, reducing the efficiency of drainage in the event of heavy rain. With continued population growth and many people living in high-risk, coastal locations, the potential exists for significant physical, health, social, economic, and environmental consequences on both individuals and communities especially in developing countries.
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We have coupled the FAMOUS global AOGCM (atmosphere-ocean general circulation model) to the Glimmer thermomechanical ice-sheet model in order to study the development of ice-sheets in north-east America (Laurentia) and north-west Europe (Fennoscandia) following glacial inception. This first use of a coupled AOGCM-ice-sheet model for a study of change on long palæoclimate timescales is made possible by the low computational cost of FAMOUS, despite its inclusion of physical parameterisations similar in complexity to higher-resolution AOGCMs. With the orbital forcing of 115 ka BP, FAMOUS-Glimmer produces ice caps on the Canadian Arctic islands, on the north-west coast of Hudson Bay and in southern Scandinavia, which grow to occupy the Keewatin region of the Canadian mainland and all of Fennoscandia over 50 ka. Their growth is eventually halted by increasing coastal ice discharge. The expansion of the ice-sheets influences the regional climate, which becomes cooler, reducing the ablation, and ice accumulates in places that initially do not have positive surface mass balance. The results suggest the possibility that the glaciation of north-east America could have begun on the Canadian Arctic islands, producing a regional climate change that caused or enhanced the growth of ice on the mainland. The increase in albedo (due to snow and ice cover) is the dominant feedback on the area of the ice-sheets and acts rapidly, whereas the feedback of topography on SMB does not become significant for several centuries, but eventually has a large effect on the thickening of the ice-sheets. These two positive feedbacks are mutually reinforcing. In addition, the change in topography perturbs the tropospheric circulation, producing some reduction of cloud, and mitigating the local cooling along the margin of the Laurentide ice-sheet. Our experiments demonstrate the importance and complexity of the interactions between ice-sheets and local climate.
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Increasing sea level has the potential to place important infrastructure we rely on every day at risk, yet we lack good data to make decisions on what to do, when, and with what priority. The objectives of the research were to develop a method for estimating the time scales for various increments of sea level rise (SLR) throughout the 21st century, develop an accurate methodology for predicting impacts of SLR at the local level, and develop recommendations as to how existing data sources can be utilized to identify infrastructure vulnerable to SLR. The methodology was applied to southeast Florida using data from the Florida Department of Transportation, the United States Geological Survey, the National Oceanic and Atmospheric Administration and other sources, integrated with low resolution light detection and ranging data, topographic data, and aerial photographic maps to identify potentially vulnerable infrastructure. Overlaying high resolution light detection and ranging data onto a base map enabled creation of mapping tools to evaluate potentially vulnerable infrastructure. Using these recommendations, a protocol was developed to use groundwater adjusted models in southeast Florida which indicated potential underestimation of the risk of damage to public infrastructure and private and public buildings.
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Global climate change stressors downscale to specific local vulnerabilities, requiring customized adaptation strategies. Southeast Florida has a high likelihood of sealevel rise impact to due to the low-lying porous limestone geology. High risk is coupled with high exposure due to high-valued coastal properties, productive ecosystems, and dense populations. Coastal populations are particularly at risk due to erosion, inundation and storm surge, but interior populations are also susceptible to rising water tables and extended periods of inundation. All of these impacts are amplified by sea-level rise. Robust sea-level rise adaptation options require significant economic costs. If perceived risk does not adequately line up with actual risk, lack of funds and preparation will prevent implementation of the most effective strategies. This study aimed to compare perceived risk to actual risk to sea-level rise in residential areas of Broward County, Florida. Perceived risk of residents was measured via an online survey and subsequently layered over actual risk in terms of flooding, storm ix surge, and loss of property. Using GIS, a composite vulnerability index was constructed for the actual risk and paralleled to survey responses. A spatial and statistical analysis identified the key factors influencing perceived risk. Results characterize the accuracy of risk perception in Broward County by determining if individual respondents overestimate, underestimate, or correctly estimate risks from each impact. Other distinct concerns of residents, voiced through open-response question, were evaluated qualitatively. Results suggest that perceived vulnerability is misaligned with actual vulnerability to the sea-level rise impacts explored here. Spatial patterns show that moving from north to south in the county, a shift from low to high-risk parallels a shift from overestimating to underestimating risk of property loss and storm surge. For groundwater flooding, a similar shift occurs, but the trend from overestimating to underestimating risk moves from east to west. Many concerns of residents were financial, but most related to personal experience. There are many opportunities for resilience that require communication, preparation and adaptation. Results show that effective risk communication should be tailored to the audience, and it is first and foremost to direct outreach towards low income populations in southeastern Broward County.
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Sound policies for protecting coastal communities and assets require good information about vulnerability to flooding. Here, we investigate the influence of sea level rise on expected storm surge-driven water levels and their frequencies along the contiguous United States. We use model output for global temperature changes, a semi-empirical model of global sea level rise, and long-term records from 55 nationally distributed tidal gauges to develop sea level rise projections at each gauge location. We employ more detailed records over the period 1979–2008 from the same gauges to elicit historic patterns of extreme high water events, and combine these statistics with anticipated relative sea level rise to project changing local extremes through 2050. We find that substantial changes in the frequency of what are now considered extreme water levels may occur even at locations with relatively slow local sea level rise, when the difference in height between presently common and rare water levels is small. We estimate that, by mid-century, some locations may experience high water levels annually that would qualify today as ‘century’ (i.e., having a chance of occurrence of 1% annually) extremes. Today’s century levels become ‘decade’ (having a chance of 10% annually) or more frequent events at about a third of the study gauges, and the majority of locations see substantially higher frequency of previously rare storm-driven water heights in the future. These results add support to the need for policy approaches that consider the non-stationarity of extreme events when evaluating risks of adverse climate impacts.
The objective of this research was developing a methodology for assessing the potential impacts of sea level rise (SLR) on Florida’s state transportation infrastructure to assist the state with transportation planning. The proposed approach integrates the Florida Department of Transportation (FDOT) information system, satellite imagery, local roadway and hydrologic data with existing topographical and geographical data to generate SLR projections to facilitate i) the evaluation of current and projected SLR impacts on transportation infrastructure located along Florida’s coastline and low-lying terrain areas, and ii) the identification of the physical transportation infrastructure components that are vulnerable given the United States Army Corps of Engineers’ scenario-based methodology to project the timing of future low, intermediate and high rates of sea level change. A detailed case study in Dania Beach, Florida and a comparative example in Punta Gorda, Florida were used to evaluate the soundness of the methodology. Further research was performed to develop a preliminary evaluation of the impact of groundwater levels as an exacerbating factor with respect to sea level rise. Storm surge with SLR is a future, more difficult area of investigation.
Climate change effects are expected to substantially raise the average sea level. It is widely assumed that this raise will have a severe adverse impact on saltwater intrusion processes in coastal aquifers. In this study we hypothesize that a natural mechanism, identified here as the “lifting process,” has the potential to mitigate, or in some cases completely reverse, the adverse intrusion effects induced by sea-level rise. A detailed numerical study using the MODFLOW-family computer code SEAWAT was completed to test this hypothesis and to understand the effects of this lifting process in both confined and unconfined systems. Our conceptual simulation results show that if the ambient recharge remains constant, the sea-level rise will have no long-term impact (i.e., it will not affect the steady-state salt wedge) on confined aquifers. Our transient confined-flow simulations show a self-reversal mechanism where the wedge which will initially intrude into the formation due to the sea-level rise would be naturally driven back to the original position. In unconfined systems, the lifting process would have a lesser influence due to changes in the value of effective transmissivity. A detailed sensitivity analysis was also completed to understand the sensitivity of this self-reversal effect to various aquifer parameters.
Recently published work estimates that global sea level rise (SLR) approaching or exceeding 1 m by 2100 is plausible, thus significantly updating projections by the Fourth Assessment of the Intergovernmental Panel on Climate Change. Furthermore, global greenhouse gas (GHG) emissions over the 21st century will not only influence SLR in the next ∼90 years, but will also commit Earth to several meters of additional SLR over subsequent centuries. In this context of worsening prospects for substantial SLR, we apply a new geospatial dataset to calculate low-elevation areas in coastal cities of the conterminous U.S.A. potentially impacted by SLR in this and following centuries. In total, 20 municipalities with populations greater than 300,000 and 160 municipalities with populations between 50,000 and 300,000 have land area with elevations at or below 6 m and connectivity to the sea, as based on the 1 arc-second National Elevation Dataset. On average, approximately 9% of the area in these coastal municipalities lies at or below 1 m. This figure rises to 36% when considering area at or below 6 m. Areal percentages of municipalities with elevations at or below 1–6 m are greater than the national average along the Gulf and southern Atlantic coasts. In contrast to the national and international dimensions of and associated efforts to curb GHG emissions, our comparison of low-elevation areas in coastal cities of the conterminous U.S.A. clearly shows that SLR will potentially have very local, and disproportionate, impacts.
Sea level rise is perhaps the most damaging repercussion of global warming, as 150 million people live less than one meter above current high tides .Using an inverse statistical model we examine potential response in coastal sea level to the changes in natural and anthropogenic forcings by 2100. With six IPCC radiative forcing scenarios we estimate sea level rise of 0.6-1.6 m, with confidence limits of 0.59 m and 1.8 m. Projected impacts of solar and volcanic radiative forcings account only for, at maximum, 5% of total sea level rise, with anthropogenic greenhouse gasses being the dominant forcing. As alternatives to the IPCC projections, even the most intense century of volcanic forcing from the past 1000 years would result in 10-15 cm potential reduction of sea level rise. Stratospheric injections of SO2 equivalent to a Pinatubo eruption every 4 years would effectively just delay sea level rise by 12 -20 years.