Hearing Order OH-001-2014 File No. OF-Fac-Oil-T260-2013-03 02

IN THE MATTER OF TRANS MOUNTAIN EXPANSION PROJECT

Name of person bringing motion: L.D. DANNY HARVEY (the "Applicant")

AFFIDA VIT OF ERICA FRANK

I, ERICA FRANK, professor and research physician, of 6260 Logan Lane, in the City of Vancouver, Province of British Columbia, SWEAR (OR AFFIRM) THAT:

1. I have personal knowledge of the facts and matters hereinafter deposed to, save and except where same are stated to be made on information and belief, and where so stated, I verily believe them to be true.

2. Attached hereto and marked as Exhibit A to this my affidavit is a true copy of my current curriculum vitae.

3. I am a physician and a Master of Public Health, and have testified at Environmental Protection Agency hearings in the United States on climate change and health. I am a Professor and Canada Research Chair in Preventive Medicine and Population Health at the University of British Columbia, am the developer of NextGenU's Climate Change and Health course, and a published author and invited speaker on climate change, particularly in my role as a former Board member (1998-2009) and President (2008) of Physicians for Social Responsibility ("PSR"). -2-

4. I have been retained by the law firm of Farris, Vaughan, Wills & Murphy LLP to provide an opinion related to my area of expertise, as is set out in their letter dated July 17, 2014, a true copy of which is attached hereto and marked as Exhibit B to this my affidavit.

Is Climate Change a Threat to Human Health

5. Our team of scientists at PSR have created documents that summarize and explain the health impacts of climate change and also the clear relationship between climate change and increased disease and death from (a) insect-borne diseases, (b) heat-related health effects, (c) fire, (d) insufficient, excessive, or compromised water, and (1) famine. True copies of the PSR summaries are attached hereto and marked as Exhibit C to this my affidavit. I adopt these summaries as part of this opinion. I elaborate upon these relationships below.

6. I also base my testimony on the Intergovernmental Panel on Climate Change's ("IPCC")

Fifth Assessment Report, I especially chapter 11 which addresses Human Health Impacts. A true copy of Chapter 11 of the IPCC Fifth Assessment Report is attached hereto and marked as Exhibit D to this my affidavit. I adopt chapter 11 as part of my opinion.

7. Attached hereto and marked as Exhibit E to this my affidavit is a true copy of a PSR figure illustrating the mechanisms of action through which climate change affects health: the three major attributes of climate change contribute to the six impacts listed, each of which has health consequences. I adopt this figure as part of my opinion.

Insect Born Disease

8. In an article authored by Jonathan A. Patz, Diarmid Campbell-Lendrum, Tracey Holloway and Jonathan A. Foley titled "Impact of regional climate change on human health," Nature 438, 310-317 (November 17, 2005),2 Patz and colleagues reported over 150,000 climate-related deaths per year. This number has grown as the planet has continued warming. Climate change has produced and will predictably continue to produce ever-more-serious health impacts, such as the migration of infectious diseases and their insect and rodent hosts. This was particularly well-illustrated with the announcement on July 17, 2014 that Chikungunya (a

1 available online at http://www.ipcc.ch/report/ar5/index.shtml 2 available online at http://www.nature.com/nature/joumal/v438/n7066/full/nature04188.html -3- previously tropical zone disease caused by a virus that spreads through mosquito bites) had now been domestically transmitted in the U.S., following by merely one day the editorializing of its inevitability in the article by David M. Morens and Anthony S. Fauci, "Chikungunya at the Door - Deja Vu All Over Again?" (July 16,2014) New England Journall0:l056/pI408509.3

9. Many other insect-borne diseases, notably including other formerly exotic pathogens like West Nile Virus, Dengue and Malaria, have already begun a clear march away from merely peri-equatorial residence. These vector-borne health effects are well-described in the article by Amy Greer, Victoria Ng and David Fisman, "Climate change and infectious diseases in North America: the road ahead" (March 11, 2008) in the Canadian Medical Association Journal 178(6):715-22, a true copy of which is attached hereto and marked as Exhibit F to this my affidavit. I adopt this article as part of my opinion. This inevitable climate-change-driven progression in disease is also succinctly-illustrated in the 2013 IPCC report's Figure 11-4, the "Effect of rising temperatures on the area in which transmission of Schistosomiasis japonica may occur" (Exhibit D, page 66). In this climate-change-driven biological model illustration, the green area denotes the range of schistosomiasis in China in 2000, and the blue area shows the additional area expected by 2050 to have disease transmission.

10. Similarly, the article by John S. Brownstein, Theodore R. Holford and Durland Fish, "Effect of Climate Change on Lyme Disease Risk in North America" (March 2005) National Institute o/Health 2(1): 38-464 warns of the inevitable spread of Lyme disease in Canada and the U.S. as their tick host is increasingly able to survive in a warmed North America.

Heat-Related Health Effects

11. Heat is also one ofthe most obviously-directly-linked causes of climate change mortality. As the globe warms, extreme heat and its health manifestations are becoming increasingly frequent, of longer duration, and of greater magnitude, with health effects ranging from cramps to the delirium, convulsions, coma and even death from heat stroke, as exemplified by between 45,000 and 70,000 people dying from the 2003 European heat wave.

3 available online at http://www.nejrn.org/doi/fulJ/10.1056/NEJMpI408509 4 available online at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2582486/#!po=95.0000 -4-

Fire, Water, Famine

12. Beyond the direct effects of increased heat or more mosquito-friendly environments, there are many other health consequences of climate change, such as worsening of famine, fire and water (manifested as storms, rising sea level, flooding, ocean acidification and drought).

13. I certify that I am aware of my duty as an expert witness to assist the court, and not to be an advocate for any party. I have given this affidavit in conformity with that duty. If! am called on to give further testimony, it will be in conformity with that duty.

SWORN (OR AFFIRMED) BEFORE ME ) at Vancouver, British Columbia, on July 28, ) 2014 ) ) ) ~J0~~ ) ERICA FRANK )

AUSONM. LATIMER IkIrri8ter & Solicitor FAIRlI. VAUGHAN. WILLS &.MURPHY til 2500 .'00 West Georgia Street toO. Box 10026. Pacific Centra VIIUlOUVOI'. DC V7Y llU 1

Curriculum Vitae for Erica Frank, MD, MPH

Revised: June 10, 2014 E-mail: [email protected]

Titles and Affiliations: Academic Appointments since 2006 (at the University of British Columbia) Professor, School of Population and Public Health, and Department of Family Practice, Faculty of Medicine, 2006-present Tier I Canada Research Chair in Preventive Medicine and Population Health, 2006-present Fellow, University Sustainability Initiative, 2010-2012

Academic Appointments through 2006 (at Emory University) Primary Appointments (Department of Family and Preventive Medicine, School of Medicine) Assistant Professor (1993-99), Associate Professor with tenure (1999-2005), Full Professor with tenure (full time 2005-2006; Residency Senior Advisor role, 2006-present) Vice Chair for Academic Affairs (2001-06), Preventive Medicine Division Chief (2004-06) Joint, adjunct, and secondary appointments Assistant Professor, Department of Medicine, School of Medicine, 1993-2006 Assistant Professor, jointly appointed in Women's and Children's Health Center and Epidemiology, School of Public Health, 1995-2006 Member, Training Faculty, Program in Nutrition and Health Sciences, Graduate Division of Biological and Biomedical Sciences, 1999-2006 Member, Population Sciences and Cancer Control, Winship Cancer Institute, 2003-2006

Other major current and previous professional responsibilities Clinician (cholesterol management), Grady Neighborhood Health Centers and Emory Clinic, 1993- 2004 Co-Editor-In-Chief, Preventive Medicine, 1994-1999 Director, Preventive Medicine Residency Program, Emory University, 1997-2006 (now Senior Advisor to Program) Research Physician/Medical Epidemiologist/Medical Consultant at the U.S. CDC, in Cancer Control, Health Care and Aging, Injury Control, Nutrition and Physical Activity, Office on Smoking and Health, and STD Prevention, 1983-present Founder, President, Executive Director, Health Sciences Online and NextGenU.org, 2001-present Education Coordinator, WHO Health InterNetwork, 2002-2006 Research Director, Annenberg Physician Training Program in Addictive Diseases, 2005-present Senior Medical Scientist, Occupational Health and Safety Agency for Healthcare ofBC, 2006-2007 President, Physicians for Social Responsibility, 2008 (PSR then had 32,000 members, 31 chapters, 40 medical student groups, 21,000 e-activists, and a $5 million/year budget) Travel and work experience in over 50 countries Select major current or prior national/major Board memberships, Executive Committees, Founder status, and/or Presidencies: American College of Preventive Medicine, American Journal of Preventive Medicine, AMA Council on Long Range Planning, AMA Section on Medical Schools' Governing Council, Association of Teachers of Preventive Medicine Foundation, Center for Policy Analysis on Trade and Health, DuPont Epidemiology Advisory Board, DuPont Health Advisory Board, National Committee on Foreign Medical Education and Accreditation, Physicians for Social Responsibility, UBC President's Commission on Sustainabi1ity, University Neighborhood Association Board (City Council), Ulrich and Ruth Frank Foundation for International Health

This is Exhibit A referred to 'n the Affidavit of Erica Frank sworn (affirm before me t . 28 h day of..July, 2014 . 2 2

Current Licensure: Georgia, 1993-present (currently inactive, previously in CA, NY, and OH) Citizenship: U.S. citizen Permanent resident status in Canada

Specialty Board 1992, Board Certification: Preventive Medicine (General Preventive Medicine/Public Health) 1994, Fellowship Status: American College of Preventive Medicine

Education: 1982, BA, Honors and Independent Studies, Smith College, Northampton, MA 1984, MPH, Epidemiology and Health Education, Emory Univ. School of Medicine, Atlanta, GA 1988, MD, Mercer University School of Medicine, Macon, GA (Alpha Omega Alpha (U.S. Medical honor society) graduate)

Postgraduate Training: 1988-1989, Cleveland Clinic, Intern 1989-1990, Yale University School of Medicine, Preventive Medicine Resident 1990-1993, Stanford Center for Research in Disease Prevention, NIH Post-doctoral Research Fellow 1990-1993, Stanford University, Preventive Cardiology Clinic, Clinical Fellow

Primary foci with major current efforts in these areas: Major research focus: promoting physicians' personal and clinical prevention habits Principal Investigator of the Women Physicians' Health Study (WPHS), a national questionnaire- based study of 4,501 women MDs, and the first large study of their personal and professional characteristics, 1991-2006. Principal Investigator of the "Healthy Doc - Healthy Patient" project, a national study of the effect of encouraging medical students' healthy behaviors on their personal and clinical habits, in 17 medical schools and 4,847 medical students, 1997-present. Principal Investigator ofthe Canadian Physician Health Study (CPHS), a national questionnaire-based study of 3,213 MDs, and the first large study of their personal and professional characteristics, 2006- present.

Major educational focus: use of mass media in health professional education Founder, President, and Executive Director ofwww.NextGenU.org, the world's first portal to free, accredited higher education, established in 2001, first course launched 2012. Founder and Executive Director of Health Sciences Online (www.hso.info). which provides a free, high quality, comprehensive online library of health reference materials, courseware, and other e- learning opportunities to health professionals in training and practice, established in 2001, first library launched in 2008.

Major clinical focus: preventive cardiology Cholesterol consultant in indigent populations attending two Grady Neighborhood Health Clinics, 1993-2004, and at Emory Clinic, 1993-1997.

Committee Memberships: U.S. and International: American College of Preventive Medicine Forum for leadership in the specialty of Preventive Medicine, invited participant, 1992-1996 Science/Policy Committee, member, 1993-present Delegate to White House discussion of health care system reform, 1995 3 3

External Relations Committee Member, 1996-2003 Chair, 1997-2001 Board of Regents, member, 1997-2003 (two term maximum) Awards committee, member, 1998-present Representative, American Journal of Preventive Medicine, 1999-2005 Alternate ACPM Delegate to the AMA House of Delegates, 2001-2004 (was seated Delegate at three of five meetings); representative on Section Council on Preventive Medicine (l991-present) Global Health Committee, Chair, 2006-present

American Medical Association Section Council on Preventive Medicine, member, 1991-present Resident Physician Section, Alternate Delegate and Delegate, 1991-1993 Council on Long Range Planning and Development, member, 1991-1993 Young Physician Section, Alternate Delegate and Delegate, 1993-1997 Advisory Panel on Women Physician Issues, invited participant and workgroup leader, 1995 Section on Medical Schools, Emory delegate, 1997-2006, member at large, 2006-present; Member, Governing Council, 2003-2005 Women Physicians' Congress, representative for the American College of Preventive Medicine, 1998- 2008 Alternate ACPM Delegate to the AMA House of Delegates, 2001-2004 (was seated Delegate at three of five meetings) Member, AMA Healthier Lifesteps for Physician and Patient Health Committee, 2009-present

American Medical Women's Association Physicians' Health and Wellbeing Subcommittee Chair, 1993-2000 Publications Committee, member, 1994-2000 Publicity and Public Relations Committee member, 1994-2000

Association of Teachers of Preventive Medicine Foundation Committee on Trainee Awards, Chair, 1992-1997 Secretary/Treasurer, 1993-1994 President, 1994-1997 Publications Committee, member, 1993-2000 Education Committee, member, 1998-2000

Physicians for Social Responsibility Steering committee, Atlanta Physicians for Social Responsibility, member, 1997-2006, President, 2000-2006 National Board of Directors, member, 1998-2009 National Environment and Health Committee, member, 1998-present; Chair, 2006-2007 Chief Regional Director, Southeast Region, 2000-2002 Chapter Relations Committee, member, 2001-2002 Co-Chair, Student Committee, 2005-2007 Executive Committee, member, 2005-2009 Governance Committee, Chair, 2006-2009 National Board President-Elect, 2007; President, 2008; Immediate Past-President, 2009

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Other committee work/associations The Ulrich and Ruth Frank Foundation for International Health, Founder and President, 1988-present SPHERE (Society for global Physician Health Enhancement and Research), Founder & Chair, 1994- 2008 (now morphed into the International Alliance for Physician Health) Olympic Medical Support Group, 1996 Olympics, member, 1994-1996 Health Resources and Services Administration, peer reviewer for grant applications, 1995 Association of American Medical Colleges, Women's Liaison Officer for Emory, 1998-2002 American Association of Public Health Physicians, Board member, 1998-2002 Centers for Disease Control and Prevention, Preventive Medicine Residency Advisory Committee, member, 1999-present Environmental Protection Agency, national testimony given, 2000, 2003 AMSA/Robert Wood Johnson Foundation, Leadership Seminar Series Advisory Panel, Member, 2002 NIH review panel, Office of Research Integrity, Member, 2003 NIH review panel, Center for Scientific Review (Psychosocial Risk and Disease Prevention), Member, 2003 Center for Policy Analysis on Trade and Health, Board Member (2003-present) and Representative to the World Trade Organization, Cancun, Mexico, September 2003, and to the Free Trade of the Americas Agreement tribunal, Miami, Florida, November 2003 (also representing PSR and ACPM at these events) Brita Water Institute, Board member, 2003-2004 Dupont Health Advisory Board, Founding Member, 2003-2013 Music Inspires Health Initiative, Member, Advisory Board, 2003-2007 Environmental Advisory Board for Congressman John Lewis, Member, 2003-2005 Dupont Epidemiology Advisory Board, member, 2005-2008 Member, UBC-UNA Community Centre Planning Committee, 2006-2007 Internet2 Health Science Education Special Interest Group, 2006-2009 Annenberg Physician Training Program, Board member, 2006-present Member, Strata Council, Logan Lane (UBC Faculty-Staffhousing), 2006-2009 Member, Advisory Panel, Healthcare Information For All by 2015, 2007 -present Council Member (1 of 4 elected - and re-elected in 2009) of University Neighborhood Association Board (for 7,000 person UBC community), Chair of Sustain ability, Co-Chair of Emergency Preparedness,2007-present Volunteer Coordinator for response to Hurricane Gustav for City of New Orleans, September 2008 Chair (2012-2013), Vice Chair (2012), and Member (2008-2013), Research Advisory Council, Michael Smith Foundation for Health Research ($48 million per annum), 2008-present Reviewer, Yale University Women's Health Research Awards, 2009 Member, Expert Advisory Panel for the Education and Training arm of the Canadian Dementia Knowledge Translation Network, 2009-2013 Research Advisor, Federation of State Physician Health Programs, 2009-present Board Member, AS-IF (Art and Science In the Field), 2009-present Reviewer, Canadian Institutes for Health Research, Health Research Salary Awards Committee, 2010 Member, National Committee on Foreign Medical Education and Accreditation (appointment from U.S. Secretary of Education), 2010 Member, Knowledge Translation Expert Working Group, Michael Smith Foundation for Health Research, 201 O-present Reviewer, Canada Research Chair renewal program, 2011 Reviewer, new Canada Research Chair program, 2012 5 5

American Association of Public Health Physicians, Resolutions, Policy, and Legislation Committee, 2012-present.

Local and State in Georgia: Alumni Association, Mercer University School of Medicine, Board member, 1992-1995 Public Health Committee, Medical Association of Georgia, member, 1996-2002 Steering committee, Atlanta Physicians for Social Responsibility, member, 1997-2006, President, 2000-2005 Executive committee, American Medical Women's Association, Atlanta chapter, 1998-2001 Curriculum Committee, Mercer University School of Medicine, student member, 1985-1986

Institutional at Emory University: Committee to introduce problem-based learning into Emory medical school curriculum, member, 1993-1994 Emory representative to AMA Section on Medical Schools, 1997-2006 Dean's committee on the status of women in the School of Medicine, member, 1998-2002 Committee to revise nutrition curriculum, 1998-2000 Emory Women's Liaison Officer to the Association of American Medical Colleges, 1998-2003 Occupational Medicine Residency Advisory Committee, member, 1999-2005 Mary Lynn Morgan Lectureship on Women in the Health Professions Committee, member, 2000-2006 Executive Committee, Department of Family and Preventive Medicine, member, 2000-2006 Nominating Committee for the Charles R. Hatcher, Jr., MD Award for Excellence in Public Health, member, 2000-2006 Tobacco lecture series planning committee, Tobacco Technical Assistance Consortium (TT AC), member, 2003-2004 Predictive Health Strategic Planning Committee, 2005 School of Medicine Curriculum Planning Steering Committee, "Being a doctor" subcommittee, 2005

Institutional at University of British Columbia: Member, Advisory Committee to the Dean-Education on revising the 4th year curriculum, 2006-2007 Member, Advisory Committee to the Dean on reorganizing the medical school, 2006-2007 Coordinator, Undergraduate Medical Education for the School of Population and Public Health, 2006- 2010 Member, Dean's Task Force on Health in the Faculty of Medicine, and Leader, Research Group, 2006- 2010 Research Mentor, School of Population and Public Health, Undergraduate medical students, 2006- present Member, Committee on founding the M.P.H. program, 2007 Reviewer, Community-Based Clinician Investigator program, Department of Family Medicine, 2007 Member, School of Population and Public Health Faculty Appointments and Promotions Committee, 2006-present Member, Family Practice, Faculty Appointments and Promotions Committee, 2007-2009 Reviewer, UBC Canada Foundation for Innovation awards, 2008 Member, Dean's Gender Gap Working Group, 2008-2009 Lead, Task Force on Establishing Conjoint MD-MPH/MHSc/etc, 2008-2009 Founding member, President's Advisory Council on Sustainability (operations and administration working group), 2008-2010 Founding member, Advisory Board, National Core for Neuroethics, 2008-present

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Founder and Leader, Medical Student Activist Special Interest Group, 2008-present Co-sponsor, AMSA SeaCouver Health Care System Comparison Study Tour, 2008-2010 Member, President's Advisory Council Sustainable Academic Strategy Working Group, 2009 Member and representative to the Executive Committee, ad hoc committee on the new building for the School of Population and Public Health, 2009-20 10 Social, Ecological, and Economic Development Studies Advisory Committee, 2009-present Member, School of Public and Population Health Mentorship Committee, 2010-present Member, University Sustainability Initiative Regional Advisory Council, 201 O-present Reviewer. UBC Faculty of Medicine Summer Student Research Program, 2011 Member, Accessible Science Initiative Advisory Committee, 2011 Judge, UBC Undergraduate Medical Research Forum, 2011, 2012 Judge, Heartfelt Art Contest, Faculty of Medicine, 2012 Member, Sustainability Committee, School of Population and Public Health, 2012-present Faculty Representative, UBC Emergency Planning Steering Committee, 2012-present

Consultancies: Lab researcher and Writer, Biomedical Engineering Division, Hoffmann-La Roche, fulltime Summer 1979 Clinical Assistant and Writer, Labor and Delivery and Adolescent Gynecology Clinic, University of Medicine and Dentistry ofNJ., fulltime Summer 1980 Researcher, Medical Economics, Amherst Associates, fulltime 1982-1983 Co-Editor, Catalogue for Master of Public Health Program, Emory University School of Medicine, 1984 Legislative Assistant, Congressman J. Roy Rowland, MD (drafted 13 rural health care bills), Spring 1988 Editorial consultant, Project on the Homeless, Stanford University, 1990-1992 Editorial consultant, Los Angeles County DHS newspaper, 1991 Consultant, 1993 Surgeon General's Report on Smoking, 1992-1993 Tobacco data book, Office on Smoking and Health, Editorial consultant, CDC, 1994 Media consultant, Pritchett and Hull, 1994-1996, 2004 Media consultant, Foote, Cone, and Belding, 1997-1998 Consultant, CDC/WHO health professional tobacco survey, 1999 Editorial consultant, American Academy of Pharmaceutical Physicians, 2000-2001 Consultant, Robert Wood Johnson Foundation/American Medical Student Association assessment of best health practices in US medical schools, 2002-2003 Consultant, Robert Wood Johnson Foundation/Porter Novelli survey of consumers prompting physician counseling, 2002-2003 Consultant, NIH/Loma Linda University tobacco medical education project in Laos, Cambodia, and Thailand, 2002-2006 Consultant, Calcium for Life project, 2004 Consultant, McNeil Nutritionals, 2005 Consultant, Advocate Health System resident research initiative, 2005-2007 Consultant, Massachusetts MedicalSociety (medical student health research), 2005-2007 Research Director, Annenberg Physician Training Program, 2005-present Senior Scholar, Michael Smith Foundation for Health Research, 2006-2011 Senior Consultant, Medical Student's Lifestyles and Attitudes to Prevention Counseling, The George Institute for Global Health (China), 20 II-present 7 7

Editorships and Editorial Boards: The Courier (newsletter for MPH program at Emory), Founding Editor-in-Chief, 1983-1984 Pulse (medical student component of JAMA), Editor-In-Chief, 1987-1988 Cleveland Clinic Journal of Medicine, Editorial Committee Member, 1988-1989 American Journal of Preventive Medicine, Associate Editor and Resident/Fellow Governing Board Member, 1991; Editorial Board Member, 1992-1997; Governing Board Member, 1999-2005; Treasurer, 2000-2004; Secretary, 2001-2005 Preventive Medicine, Co-Editor-In-Chief, 1994-1999 The Open Medical Education Journal, Editorial Board member, 2008-present Canadian Medical Association Journal, Editorial Board member, 2008-present Founding Member, Cancer Commons Editorial Advisory Board, 201 O-present

Journal reviewer (with year of first review) JAMA,1989 American Journal of Preventive Medicine, 1991 American Journal of Clinical Nutrition, 1992 Western Journal of Medicine, 1993 Preventive Medicine, 1993 The Lancet, 1994 Archives of Family Medicine, 1994 The Journal of the American Medical Women's Association, 1994 American Journal of Obstetrics and Gynecology, 1998 Journal of Women's Health, 1998 Journal of General Internal Medicine, 1998 Annals ofInternal Medicine, 1998 U.S. Preventive Services Task Force, 2000 National Bioethics Advisory Commission, 2001 Annals of Epidemiology, 2001 Journal of Rural Health, 2001 Journal of Psychosomatic Research, 2001 Archives of General Psychiatry, 2003 New England Journal of Medicine, 2003 Maturitas, 2004 NASA/Keystone Center report on NASA's Project Prometheus, 2004 Teaching and Learning in Medicine, 2004 Depression and Anxiety, 2005 Medscape General Medicine, 2005 Ecohealth, 2007 Journal of the American Board of Family Medicine, 2007 Nutrition, 2008 Canadian Journal of Psychiatry, 2008 Scandinavian Journal of Public Health, 2009 Indian Journal of Medical Sciences, 2009 Public Health, 2009 Pediatrics, 2009 Journal of the American Dietetic Association, 2009 Archives of Internal Medicine, 2009

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BioMed Central Health Services Research, 2009 Perspectives in Biology and Medicine, 2009 BioMed Central Family Practice, 2010 International Journal of Medical Education, 2010 Health Education Research, 2010 Journal of Sports Science and Medicine, 2011 Open Medical Education Journal, 2011 Journal of Primary Prevention, 2011 BioMed Central Medical Education, 2011 Australian Veterinary Journal, 2011 Canadian Family Physician, 2012 British Journal of Sports Medicine, 2012 Emergency Medicine International, 2013 American Journal of Drug and Alcohol Abuse, 2013 BMC Psychiatry, 2013

Honors and Awards: Ciba-Geigy, Outstanding Medical Student Community Service Award (recipient for Mercer University School of Medicine), 1985-1986 AMA/Pettis Award (Outstanding U.S. medical student communicator, sole recipient), 1987 American Academy of Family Physicians' Student Research Grant (one of two U.S. sites), 1987 AMA/Burroughs Wellcome Leadership Award Program for Resident Physicians (one of fifty recipients nationally), 1992 American College of Preventive Medicine's "Rising Star Award," first year award offered, co- recipient, 1996 Called "One of the nation's most talented young investigators," American Medical Association Foundation Brochure, 1998 Outstanding alumnus award (sole recipient), Rollins School of Public Health, 1998 Best scientific presentation, Prevention '99 (annual meeting of the American College of Preventive Medicine/Association of Teachers of Preventive Medicine) Invited participant, Renaissance Weekend, March 2001, December 2001, December 2003, December 2004, December 2006 Residency Program (Emory, under my Directorship) receipt of#l in-service score (2001), and awarded Best Resident (2001,2007) and Rising Star (2003,2005,2006) and best scientific poster (2008) for the U.S. from the American College of Preventive Medicine, and the AMA's 2006 Paul Ambrose Award for Leadership Among Resident Physicians (as well as resident first-authored publications in NEJM, JAMA and other journals) Nominated by U.S. Congressman John Lewis and selected as U.S. National Library of Medicine "Local Legend", 2004 Selected for and participant in Master Teacher Program, Emory University, Spring 2005 Featured as an "ecoheroine" in Atlanta Woman magazine, and on their luncheon panel, 2005 Member, Alpha Omega Alpha (U.S. national medical honor society), 2005 Recipient, Michael Smith Foundation Senior Scholar Award (5 year funding and establishment award) and Senior Scholar designation, 2006-2011 Recipient, Tier I Canada Research Chair in Preventive Medicine and Population Health, 2006 Alumni Achievement Award (sole recipient), Princeton Day School, 2009 Director's Group Award, National Cancer Institute, NIH, for work on physician health, 2012 Distinguished Service Award (sole recipient), American College of Preventive Medicine, 2012 9 9

Organization of National or International Conferences: Program Planning Committee for Preventive Medicine (annual meeting of the American College of Preventive Medicine and formerly also of the Association of Teachers of Preventive Medicine), member, 1993-1994, 1996-1997, 1997-1998,2005-2006 Program Planning Committee for the Council of Science Editors 2006 Annual Meeting, 2005-2006 Abstract Review Committee, AMA-CMA International Conference on Physician Health, 2006 Chair, Scientific Review Panel, AMA-BMA-CMA International Conference on Physician Health, 2006-2008 Master of Ceremonies, Physicians for Social Responsibility fund-raiser, Los Angeles, 2008 Member, all Scientific Review Panels, AMA-BMA-CMA International Conferences on Physician Health, 2009-present

Grant Support: Active support: Mentor, Grand Challenges Canada grant for NextGenU.org, $100,000,2011-2012 Principal Consultant, CrDA grant to NextGenU.org to develop Anti-Sepsis Training in Bangladesh, $45,000 for our component of grant, 2011-2014 Fellow, University Sustainability Initiative, $10,000 in 2010-11, $10,000 in 2011-12 Principal Investigator, Annenberg Physician Training Program research program. $50,000/year since 2009 (total $150,000 to date) Canada Research Chair, $200,000 per year, 2006-present Senior Advisor to Preventive Medicine Residency Program (until 1/1/06, was Program Director), Board for Physician Workforce, State of Georgia, Preventive Medicine Residency, 12%-20% effort, $18,000- $36,000 per year, 7/1/01-present (renewed yearly)

Previous Support: Principal Consultant, CDC study of smoking cessation advice, $5,000, 2011 Principal Consultant, NIH study of primary care physician health, $25,000, 2009-2011 Principal Investigator, Physician Health Fellow Support. Canadian Medical Association Foundation, $50,000, 2008-2009 Principal Investigator, Post-doctoral fellowship for NextGenU.org. Ulrich and Ruth Frank Foundation for International Health, $65,000, 2008 Principal Investigator, Canadian Physician Health Study. Health Canada, $100,000 (via CMA), 2007- 2010 Principal Investigator, Canadian Physician Health Study. Response rate booster for BC: Physician Health Program, $25,900; Healthy Heart Society of British Columbia, $5,000; BC Medical Association, $5,000, 2007-2010 Principal Investigator, Canadian Foundation for Innovation, $100,000 Establishment Grant, 2007-2009; $30,000 renewal, 2010 Principal Investigator, British Columbia Knowledge Development Fund, $100,000 Establishment Grant, 2007-2009 Principal Investigator, Annenberg Physician Training Program, development of Addiction Medicine component ofNextGenU.org, $20,000-$50,000 per year, 2007-2009 Senior Scholar, Michael Smith Foundation for Health Research, salary support for five years at $100,000 per year (till CRC began), plus Establishment Grant ($15,000/year for 5 years), 2006-2011. Principal Investigator, McNeil Pharmaceutical, Residents' Pain-relief Practices, $100,000, 2005-2009 Principal Investigator, GlaxoSmithKline, Residents' Supplement-taking Practices, $100,000,2005-2009

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Principal Investigator, GlaxoSmithKline, Medical Students' Supplement-taking Practices, $46,991, 2001- 2006 Principal Investigator, American Cancer Society, Cancer Prevention Behavior and Attitudes of U.S. Medical Students, 25% effort, $965,000,1/1/01-12/31/05 Principal Investigator, Wyeth-Ayerst, Analysis ofHRT-OC data from the Women Physicians' Health Study, no effort, $84,000, 9/1/00-8/31/04 Principal Investigator, Centers for Disease Control and Prevention, The Healthy Doc - Healthy Patient Project, IPAs from Cancer Control, Nutrition and Physical Activity, STD Communication, Health Care and Aging Studies, and Injury Control, approximately 30% effort yearly, approximately $250,000 total, 711/00-12/31 /05 Principal Investigator, National Institute of Health, National Cancer Institute, The Women Physicians' Health Study - Cancer Prevention, R03, $76,345, 04/01198-03/31/99 Co-Investigator, National Institutes of Health, National Cancer Institute, Dietary Change Through Black Churches, R01, $450,000, 09/01/96-06/30/00 Principal Investigator, American Heart Association, The Women Physicians' Health Study, Clinician Scientist Award, $238,000, 07/01/95 - 06/30/98 and renewal 711/1998-6/30/00 Co-Editor-in-Chief, Preventive Medicine, American Health Foundation, contract, $127,801 (renewed yearly, 1993-1998) Principal Investigator, Merck and Company, The Women Physicians' Health Study - Lipids and Hypertension, $10,000, 1011/97 - 9/30/98 Principal Investigator, Unipath Corporation, Basal Body Temperature Improvement Project, $1,500 instrumentation donation, 6/1998, $3120 instrumentation donation, 3/1999 Co-Principal Investigator, Wyeth-Ayerst Laboratories, Counseling patients about hormone replacement therapy: practices of U.S. women physicians, $63,437, 10% effort, 8/11/98-811 0/2002 Co-Investigator, National Foundation for the Centers for Disease Control, Improving Child and Adolescent Health through Physical Activity and Nutrition, $236,000, 1996 Principal Investigator, American Suicide Foundation, The Women Physicians' Health Study, $5,996, 1996 Principal Investigator, Solvay, The Women Physicians' Health Study, $17,000, 1996 Principal Investigator, Wyeth-Ayerst, The Women Physicians' Health Study, $50,000, 1996 Principal Investigator, Emory Medical Care Foundation, The Women Physicians' Health Study, $23,040 and $24,890, 1995 Principal Investigator, American Medical Association Education and Research Foundation, The Women Physicians' Health Study, $24,890 and $4,800, 1994

Clinical Service Contributions: Built clinical cholesterol management practice and consultancy in two Grady neighborhood health clinics from 1993-2004. Saw patients monthly, and responded to clinician queries and referral in clinics and between clinics. Had Emory Clinic cholesterol management practice (tertiary referral and clinical trials) from arrival at Emory in 1993 until disbanding of dyslipidemia clinic in 1997.

Formal Teaching: Medical Student Teaching: Human Biology Department, Stanford University, "Developing an anti-smoking campaign," and "Community approaches to behavioral change," Invited lecturer, 1990 Problem-based learning (PBL) curriculum, Emory teaching mentor, 1993-2000 "Cholesterol management," 3rd year lectures, Emory, 1995 "Fine tuning your research topic." Emory summer student program, Department of Family and Preventive Medicine, Invited lecturer, Summer 1994, 1995, 1996, 1997 11 11

"The health effects of vegetarianism," Emory medical student nutrition course, 1996-2002

Graduate Program: Senior author, curriculum for Reproductive Health course, Master of Public Health Program, Emory University School of Medicine, 1984 Public Health Campaigns course, with June Flora, Ph.D., Stanford University, Teaching assistant, 1990 "Physicians and tobacco." School of Public Health, Emory University, Invited Lecturer, Spring 1994, 1995 "Meet the Professor", UBC MSc student lecture on Healthy Doc = Healthy Patient and NextGenU.org projects, 2006 Seminars at UBC for graduate students, community medicine residents, and family medicine residents on topics such as: "Rules of authorship", "Health Sciences Online: a tool for global democratization of health sciences knowledge", "Sample Survey design: case studies", "The role of physician health in patient health and climate change", 2006-present.

Other categories: "Effects of plant-based diets" -- Emory undergraduate lecture and seminar series, 4 lectures/year, 1993-1999; graduate program in nutrition, I lecture/year, 2003-2005 "Cholesterol management" -- family medicine residents, 1996, 1997 "Cholesterol management" and "Reading and writing for the medical literature" -- Physicians' Assistant program, 1996, 1997, 1998 "Reading and writing for the medical literature" -- Centers for Disease Control and Prevention/Association of Teachers of Preventive Medicine training program, 1997 "Public Health in the Real World" -- Orientation panelist, Rollins School of Public Health, 1998 "Applying epidemiology in mass media" -- closing workshop, Knight Journalism Fellowship, Centers for Disease Control and Prevention, 2002

Science teacher -- The Atlanta School kindergartenll 5t grade classes, 2002-2004 Mentor - "How does your personal diet affect the environment", Silver medal winner, Life Sciences Category, and winner of the BC Greenhouse Growers' Association Award, Greater Vancouver Regional Science Fair, 2010. Professor and Co-developer - Introduction to Sustainability, undergraduate UBC course, 2010-2012. Course Creator - Climate Change and Health, component of undergraduate UBC course and NextGenU.org course, 2010-2012.

Supervisory Teaching at Emory University: Primary Advisor, thesis Committee (one of two members), Karen Frost, M.P.H. candidate, Division of Behavioral Sciences and Health Education, Rollins School of Public Health, 1993-1995 Director, summer research program, Shamiram Feinglass (MS2), Tricia Frieze (MS3), Juliette Mitchell (MS2), Melissa Schiffman (MS2), employed students full-time, was primary summer research advisor, Summer 1994 Primary Advisor, undergraduate honors thesis, Anisa Nayeem, Emory University, 1994-1996 Primary Advisor, thesis Committee (one of two members), Grant Baldwin, M.P.H. candidate, Division of Behavioral Sciences and Health Education, Rollins School of Public Health, 1994-1996 Director, summer research program, Grant Baldwin (MPH candidate, full-time), Jeanette Durea (MS, full-time), Anisa Nayeem (BS candidate, HIH-Howard Hughes Scholar, full-time), Jaideep Purkasayatha, M.S. (SPH student, part-time), Kavi Rajanna (BA candidate, work study), Yu Gin Win, M.D., M.P.H. (SPH student, part-time), was primary research advisor, Summer 1995 Supervisor, graduate research, Erica Odom, doctoral candidate in nutrition, 1996

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Director, summer research program, Kisha Jones (MSI), Gretchen Koontz (MSI), Kimberly Willey (MS I), was primary summer research advisor, Summer 1996 Primary Advisor, undergraduate honors thesis, Loren Friedman, Emory University, 1996-1998 Member, thesis committee, Karen Tobias, M.P.H. candidate, Division ofInternational Health, Rollins School of Public Health, Member, 1996-1997 Primary Advisor, resident research project (one of two advisors), Kavitha Bhat, M.D., 1997-1998 Director, sophomore elective, and research advisor, Kristen Cone (MS2), 1998 Director, summer research program, Holly Biola (MS2), Kim Pham (Emory Family Planning Program), was primary summer research advisor, Summer 1998 Advisor, graduate research projects, Jason Breyan, doctoral candidate, 1998-2002 Advisor, research project, Maryam Sattari (MS4), 1998 Primary Advisor, thesis committee, Priya Sivanesan, M.P.H. candidate, Division of International Health, Rollins School of Public Health, 1998-2000 Mentor, Holly Biola (MS3-4), Kristen Wood-Reid (MS3-4), 1999-2000 Chair/Primary Advisor, dissertation committee, Elsa Wright, 1999-2004. Supervisor for Dr. Wright's post-doctoral fellowship, 2004-2005 Advisor, research project, Lori Green, Summer 2000 Advisor, research project, Lori Howard, Summer 2000 Director, summer research program, Jamelah D. Tucker (M2), Jen Kearley (M2), and Katherine Brown (M2), Summer 2000 Mentor, Emily Diznoff(MS4), 2000-2001 Mentor, Briana Patterson, Jennifer Nash (MS 1-2), 2000-2001 Mentor, Emory University Passages Program, Jada Bussey-Jones, MD, 2000-2004 Thesis advisor (one of two advisors), Lucia Mclendon, M.P.H. candidate, 2002-2003 Mentor, Emory University Passages Program, Judy Tsui, MD, 2002-2004 Mentor, Emory University Passages Program, Anne Lang Dunlop, MD, MPH, 2002-2005 Supervisor, Jennifer Carrera, MS, 2003-2005 Advisor, public health project, Benjamin Levy, M2, Music Inspires Health Initiative, Summer 2004- 2007 Supervisor, preventive medicine elective, Sallyann Coleman, M3, February-March 2005, January 2006 Supervisor, preventive medicine elective, Surbhi Modi, M4, August 2005

Supervisory Teaching since appointed at University of British Columbia: Secondary Supervisor, Occupational Health rotations at OHSAH, Community Medicine residents, 2006-2007 Supervisor, MPH candidate (at Emory) and Post-doctoral scholar (at UBC) Kate Tairyan, MD, MPH, 2006-2008, Secondary Supervisor, 2008-2010 Supervisor, Jodi Edwards, PhD candidate, 2007-2008 Supervisor (through Emory) for 1 rotation, Secondary Supervisor for residency program, preventive medicine residency, Annen Asatryan, MD, MPH, 2006- 2007; Supervisor (through Emory), preventive medicine practicum, July 2006-June 2007; post-doctoral fellowship, July 2007-2010, Kshamica Nimalasuriya, MD, MPH Supervisor (through Emory) for >=1 rotation, Secondary Supervisor for residency program, Sallyann Coleman, MD, MPH, Shami Feinglass, MD, MPH, Surbhi Modi, MD, MPH, Tisha Titus, MD, MPH, 2007-2008 Co-Supervisor, Sheira Schlair, MD, NYU postdoc, research projects and abstract presentations: "Do physicians preach what they practice? Correlates of resident physicians' obesity counseling".; 13 13

"Medical Students' Dietary Habits and Attitudes Before and After a Novel Nutrition Curriculum", 2007-present Supervisor, Community Medicine Resident Rotation, Yeerle Willaeys, MD, MPH, Winter-Spring 2008 Supervisor, Psychiatry Resident Rotation, Tyler Black, MD, Spring 2008 Supervisor, UBC Medical Student Summer Rotation, Ariella Zbar (IMP), 2008 Supervisor, Medical Student Summer Rotation, Hafiz Assad (St. Andrews), 2008 Supervisor, Carolina Segura, MD, Post-Doctoral Fellow 2008-2009 Supervisor, Andrea Ramirez, (Medical student, Universidad de Los Andes), May-December 2009 Supervisor, UBC Medical Student Summer Rotation, Caroline Walker, 2009 Supervisor, UBC Medical Student Summer Rotation, Brandon Galm, 2009 Secondary Supervisor, UBC Medical Student Summer Rotation, Simon Woo, 2009 Supervisor, Medical Student Summer Rotation, Jessica Woolfson (University of Toronto), 2009 Dissertation Committee Member, Scot Holliday, George Washington University, 2009 Mentor/Panelist, UBC Women in Science and Engineering, UBC, 2009, 2010 Thesis supervisor, Rebecca Barron, Tufts University MD/MPH program, 2009-2011 Supervisor, 6 week Medical Student rotation, Ainsley McCaskill (Flinders University), 2010 Supervisor, Post-baccalaureate Student, Soha Sabeti, 20 I0-20 II Supervisor, UBC Undergraduate Student Directed Study, Anna H. Liu, 2010-2011 Supervisor, UBC Undergraduate Student Directed Study, Aneil Advani (recipient of Rhodes Scholarship, in part for his work with us), 2010-2011 Supervisor, Angela Tonozzi, MD, Preventive Medicine Residency Program, Emory University, Course Developer, "Prevention and Treatment of Hospital and Clinic-Acquired Infectious Disease" for HSO,2010-2011 Supervisor, Abbie Olszewski, PhD candidate, Utah State University, Course Developer, "Speech and Language Pathology" for HSO, 2010-2011 Supervisor, Mike Benusic, UBC Medical Student, Course Developer "Climate Change and Health" for HSO,2010-2011 Supervisor, Kristian Dubrawski, UBC Engineering-Public Health Bridge Program Student, Course Developer "Environmental Health" for HSO, 2010-2011 Thesis Supervisor, Anny Kuang, MSc Student (International Health), Yang Ming University, Taiwan, Course Developer for HSO, 2010-2011 Supervisor, Jennifer Chu, MD, Emergency Medicine Resident, University of Toronto, Course Developer, "Emergency Medicine" for HSO, 20 I0-20 II Thesis Supervisor, Michelle Kunz, UBC MPH Student, Director of Evaluation for HSO, 2010-2012 Supervisor, Florian Stigler, MD, International Federation of Medical Students Associations, Course Developer, "Prevention and Treatment of Tobacco Use" for HSO, 2010-20 II Supervisor, UBC Work Study Program, Afsha Sethna, 2010-2011 Supervisor, I-month International Federation of Medical Students' Associations Student Exchange, Guan Rong Wu (Arnet), 2010 Supervisor, I-month International Federation of Medical Students' Associations Student Exchange, Max Pense I, 2010 Supervisor, I-month International Federation of Medical Students' Associations Student Exchange, Bojan Sekeres, 2010 Supervisor, I-month International Federation of Medical Students' Associations Student Exchange, Tatiana Lerner, 2010 Supervisor, I-month International Federation of Medical Students' Associations Student Exchange, Andressa Sato, 2011

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Faculty Sponsor, Xiao Hua Li, PhD, Visiting Associate Professor on one year Sabbatical from the School of Political Science and Public Administration at Wuhan University, 2010-2011. Supervisor, I-month International Federation of Medical Students' Associations Student Exchange, Veronica Ozaki Gushiken, August 2011 Consultant/Mentor, Lindsay Galway, PhD Candidate, Simon Fraser University, 2011-present Dissertation Supervisor, Anjali Mago, B.D.S., Masters' in Hospital and Health System Management, Birla Institute of Technology (BITS) Pilani, India, 2010-2011; PhD candidate, UBC, 2011-2014 Supervisor, I-month International Federation of Medical Students' Associations Student Exchange, Apisara Dhekariyapak, March 2012 Supervisor, MIT ACS Globalink International Research Internship Program, Drieli Pacheco Rodrigues, June-Sept 2012 Supervisor, MIT ACS Globalink International Research Internship Program, Xining (Linda) Yang, Aug-Oct 2012 External Dissertation Examiner, Tsetsen Tugsmandal, Simon Fraser University, Summer and Fall 2012 Faculty Sponsor, Gerson Schwab, UBC Visiting Scholar, Pontifical Catholic University of Parana, Brazil, PhD candidate, 2012-2013 Supervisor, Rohan Ranayake, Postdoctoral Scholar, 2012-2013 Supervisor, Chelsea Gao, UBC MSc candidate, 2012-2013 MSc Thesis Committee member, Laura Dale, UBC, 2012-2013 Research Supervisor, Audrey Campbell, MD, MPH, Clinical Educator Fellow at the UBC Centre for Health Education Scholarship, 2012-2013 Undergraduate Honours Thesis committee member, Payvand Razaghizad, Faculty of Health Sciences, Simon Fraser University, 2012-2013 Supervisory committee member, Nadia Mithani, MPH Capstone project, Faculty of Health Sciences, Simon Fraser University, 2012-2014 Supervisory committee member, Sarah Topps, MPH Capstone project, Faculty of Health Sciences, Simon Fraser University, 2012-2014 Practicum co-supervisor and MPH Capstone supervisory committee member, Chelsea Hitchen, Faculty of Health Sciences, Simon Fraser University, 2012-present MSc Thesis Committee member, Alaa Al Maiman, Faculty of Health Sciences, Simon Fraser University, 2013-present Dissertation Committee Chair, Noreen Rashda Kamal, PhD candidate, UBC, 2013 Internal Reviewer, Jennie Lynn Moore, PhD candidate, UBC, 2013

Lectureships, Seminar Invitations, Visiting Professorships, and Invitations to National or International Conferences:

The Women Physicians' Health Study (1993-2005): Workshops, AMW A annual meetings, 1993-1996, 1998, 2000; keynote speaker, 1997 Invited speaker, AMA meetings, Women's Caucus, 1993-1998 Invited plenary, AMA International Conf. on Physician Health, 1994 Invited workshop presentation, AMA International Conf. On Physician Health, 1996, 2002, 2004, 2006 Invited speaker, Karolinska Institute, Sweden, 1996 Invited speaker, Southeastern Lipid Conference, 1996 Invited speaker, National Medical Association annual meeting, 1997, 1998 Invited speaker, AAMC annual meeting, 1998 15 15

Inaugural speaker, Marjorie Sirridge Outstanding Women in Medicine lectureship, University of Missouri, Kansas City, 1998 Plenary speaker, National Institutes of Health, "Women Physicians, Women's Politics, and Women's Health: Emerging Narratives" symposium, 2005 Invited speaker, AAMC Physician Workforce Research Conference, 2005

Lipid management: Invited workshop, Prevention '95. "Management ofdyslipidemias." 1995 Invited workshop, Quest for Excellence in Women's Health. "Nutrition and lipids" 1997, 1998

Multiple aspects of "The Healthy Doc - Healthy Patient Project": Plenary speaker, AMA meeting, Section on Medical Schools, 1999 Plenary speaker, Medical Society ofWisc's Regional Summit on Women Physicians, 2000 Invited speaker, Grand Rounds, University of Wisconsin, 2000 Invited speaker, AMW A annual meeting, 2000 Invited speaker, AMA/CMA International Conf. on Physician Health, 2000, 2002, 2004, 2006 Invited speaker, CDC, National Center for Chronic Dis. Prevention & Health Promotion, 2001 Invited speaker, National Medical Association annual student meeting, 2001 Invited speaker, American Cancer Society National Office, 2001 Invited speaker, Grand Rounds, Tulane University, 2002 Invited speaker, Grand Rounds, University of Washington, 2002 Invited speaker, Grand Rounds, University of British Columbia, 2002 Invited speaker, Grand Rounds, Family Planning, Emory University, 2003 Invited speaker, Grand Rounds, Surgery, Emory University, 2004 Plenary speaker, Federation of State Physician Health Programs' Annual Mtg, 2004 Plenary speaker, International Healthy Lifestyles Seminar, Bogota, Colombia, 2004 Keynote speaker, NH Academy of Family Physicians Annual Meeting, 2004 Invited speaker, Grand Rounds, Dartmouth Medical School, 2004 Keynote speaker, Ontario Physician Health Program Annual Meeting, 2004 Plenary speaker, AMA meeting, Section on Medical Schools, 2004 Keynote speaker, Annual Scientific Assembly, Alberta College of Family Physicians, 2005 Invited speaker, Grand Rounds, Advocate Health System, 2005 Invited speaker, CDC, Cancer Control Division, 2005 Invited speaker, AAMC Physician Workforce Research Conference, 2005 Invited speaker, Alabama Physician Health Program, 2005 Invited speaker, Massachusetts Medical Society, 2005 Podium presenter, annual mtg., American College of Preventive Medicine, Reno, NV, 2006 Invited speaker, Grand Rounds, University of British Columbia, 2006 Keynote speaker, Physician Health Program of British Columbia, Vancouver, 2006 Moderator and panelist, Association of American Medical Colleges, Seattle, WA, 2006 Podium presenter, annual mtg., American College of Preventive Medicine, Miami, FL, 2007 Invited speaker, Center for Clinical Epidemiology and Evaluation, Vancouver, 2007 Invited speaker, International Doctors' Health Conference, Sydney, 2007 Keynote speaker, Colombian Collaborative on Medical Student Health, by videocam, Bogota, Colombia, 2007 Invited speaker, CME at Sea, Alaska, 2008 Invited plenary, Canadian Society of Addiction Medicine, 2008 Scientific Chair, Keynote speaker, workshop leader, and concurrent session / poster presenter, AMA/BMA/CMA International Physician Health Congress, London, England, 2008 Invited Speaker (in French), Hotel Dieu, Paris, France, 2008 Invited Speaker, University of Tel Aviv, Israel, 2008

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Invited Plenary, UBC Psychiatry Update, 2009 Invited Plenary, American College of Sports Medicine, 2009 Oral (x2) and Poster (x2) sessions, American Public Health Association, 2009 Keynote speaker, Harvard Active Doctors = Active Patients Conference, 2009 Invited presenter for launch, WHO Health Professional Global Network, 2010 Keynote speaker, Colombian Collaborative on Medical Student Health, by videocam, Bogota, Colombia, 2010 Sole consultant/speaker for Dean's consortium, Hofstra University School of Medicine, 2010 Invited speaker, University of Oslo invitational physician health workshop, 2010 Invited speaker for Ruysch Lectureship, University of Amsterdam, 2010 Invited speaker, Heijermans lectureship on Occupational Health, Univ. of Amsterdam, 2010 Grand Rounds, US Centers for Disease Control and Prevention, 2010 Keynote speaker, University of Lisbon conference on The Health of Doctors and Other Health Professionals, 2011 Presentation to Dean of Academic Affairs and Vice Chancellor, Presbyterian University of East Africa, Kikuyu, Kenya, 2011 Keynote speaker, New Zealand Physician Health Meeting, by videocam, 2011 Plenary, Annual Meeting, American College of Preventive Medicine, 2012 Dinner Speaker, American Association of Colleges of Osteopathic Medicine annual mtg, 2014

NextGenU.org (the world's first portal to free, accredited, higher education): Closing podium speaker, Slice of Life Conference, Philadelphia, PA, 2003 Featured speaker, UN Association-USA (Atlanta Chapter), Atlanta, GA, 2003 Invited speaker, Council of Science Editors, Atlanta, GA, 2005 Invited presenter, The Bill and Melinda Gates Foundation, Seattle, WA, 2006 Podium presenter, annual mtg., American College of Preventive Medicine, Reno, NV, 2006 Invited presenter, World Bank, Washington, DC, 2006 Invited speaker, Pan American Health Org., Washington, DC, for World Health Day, 2006 Poster presentation, AMA/CMA International Conf. on Physician Health, 2006 Podium presenter, annual mtg., American College of Preventive Medicine, Miami, FL, 2007 Invited speaker, Pan American Health Org., Washington, DC, 2007, 2008 Invited speaker, annual mtg., American College of Preventive Medicine, Austin, TX, 2008 Invited speaker, Centers for Disease Control and Prevention, Atlanta, GA, 2008 Invited speaker, University of Dundee, Scotland, 2008 Invited speaker, Tbilisi State Medical University, Georgia, 2008 Invited speaker, Ministry of Health, Yerevan, Armenia, 2008 Invited speaker, E-Learning (Annual Meeting of the Association for the Advancement of Computing in Education), 2009 Poster session, American Public Health Association, 2009 Invited speaker and mentor, Social Entrepreneurship Experience, 2009 Invited panelist, UBC Global Health and Human Security Conference, 2010 Presenter, WHO Health Professional Global Network Videoconference, 2010 Grand Rounds, US Centers for Disease Control and Prevention, 2010 Grand Rounds, Tumu Tumu Hospital, Presbyterian Church of East Africa, Kenya 2011 Grand Rounds, Chogoria Hospital, Presbyterian Church of East Africa, Kenya, 2011 Senior Staff Meeting presentation, Maua Hospital, Kenya Methodist University, Kenya, 2011 Senior Staff Meeting presentation, Outspan Hospital, Kenya, 2011 Presentation to Kihumbu Thairu, Vice-Chancellor of Presbyterian University of East Africa, Kenya, 2011 Senior Staff Meeting presentation, Christian Health Association of Kenya, 2011 17 17

Grand Rounds, Occupational Therapy Specialty Society, Ministry of Health, Kenya, 2011 Presentation to Principal of Health Sciences, and Deans of Medicine, Pharmacy, and Public Health, University of Nairobi, Kenya 2011 Presentation to Prof. Mawuli Kofi-Tsekpo, Chair of Pharmacy, Kenya Methodist University, 2011 Grand Rounds, Kikuyu Hospital, Kenya, 2011 Grand Rounds, Mathere Mental Hospital, Kenya, 2011 Senior Staff Meeting presentation, Kenyan Mental Health Association, Kenya, 2011 Senior Staff Meeting presentation, Kenyan Medical Training College, Kenya, 2011 Separate presentations to Chairs and staff of Departments of Psychiatry, Physiology, Anatomy, and Biochemistry, University of Nairobi, Kenya, 2011 Grand Rounds, Kijabe Nursing School Hospital, Kenya, 2011 Presentation to Dean, Kenya Methodist University, VC-Medical Board, Kenya, 2011 Presentation to Reverend Festus Gitonga, Secretary General, Presbyterian University of East Africa, Kenya, 2011 Presentation to Education Committee Chair, College of Surgeons of East, Central, and Southern Africa, Egypt, 2011 Presentation to Interdisciplinary Studies Leadership, UBC, 2011 Presentation to David Suzuki Foundation Board, Vancouver, 2011 Workshop, Annual Meeting, American College of Preventive Medicine, 2012 Grand Rounds, Yale Preventive Medicine Residency, 2012 Full (l hour) concurrent session speaker at BCNET Conference, 2014 Keynote Speaker, American Association of Colleges of Osteopathic Medicine, Annual Mtg, 2014 Plenary Speaker, Association for Prevention Teaching and Research, Annual Mtg, 2014

"Physicians' Role in Sustainability" Plenary speaker, Physicians for Global Survival National Meeting, 2007 Grand Rounds, White Rock Hospital, BC, 2007 Invited speaker, Centers for Disease Control and Prevention, 2008 Invited speaker, Alternative & Integrative Medical Society, Vancouver, BC, 2008 Grand Rounds, Dell Children's Hospital, Austin, TX, 2008 Grand Rounds, NY University, NY, NY, 2008 Keynote Speaker, Philadelphia College of Physicians, 2008 Invited speaker, Clean Med Conference, 2008 Invited guest speaker, Public Health Agency of Canada, 2008 Invited speaker, Vancouver Global Warming Film Festival, 2008 Invited speaker, Global Health Conference, Simon Fraser Univ., 2008 Invited speaker, CME at Sea, Alaska, 2008 Keynote speaker, Dallas fundraiser for Physicians for Social Responsibility, 2008 Grand Rounds, UT Southwestern, 2008 Family Medicine Resident lecturer, UBC-Vancouver, 2008 Guest Lecturer, Simon Fraser University, 2008 Sir Richard Doll Lecturer, Oxford University, England, 2008 Family Medicine Resident lecturer, UBC-Kelowna, 2009 Workshop leader, Student Physicians for Social Responsibility Conference, 2009 Guest Lecturer, American Medical Student Association Humanistic Health Elective, 2009 Invited speaker, Denver Chapter, Physicians for Social Responsibility, 2009 Alumni weekend featured speaker, Princeton Day School, 2009 Presentation to David Suzuki Foundation Board, Vancouver, 2011 Workshop, Annual Meeting, American College of Preventive Medicine, 2012

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=AMA's 1st_4th International Conferences on Peer Review in Biomedical Publication, Chicago (twice), Prague, and Barcelona, 1989-2001. Various original research on medicaljournalology. =Prevention '94. Invited panelist, Plenary Session. "The Present and Future of Outcomes Research" 1994 =Workshop on conducting physician health research and promoting international collaboration, AMA/CMA International Conf. on Physician Health, Ottawa, 2006; International Doctors' Health Conference, Sydney, 2007 =Master of Ceremonies, Fundraising Gala for Physicians for Social Responsibility - Los Angeles, 2008 = Moderator, UBC National Core for Neuroethics Inauguration, 2008 =Career advice keynote at UBC Leadership Conference, Women in Science Conference, and Pre- Medical Society in 2009, and Women in Science mentor, 2010 =Sole teacher, half-day master class workshop on knowledge translation, University of Amsterdam, 2010 =Workshop on Fukushima: an ongoing case study in bad government risk communication, Changing Environments and Population Health: Annual Symposium on Environmental, Occupational and Public Health, 2014

Research Activities: Principal Investigator: "Smoking status and attitudes toward cigarette smoking: a study of a North Georgia population", a study of 423 ever-and never-smokers in north Georgia, 1986-1988; follow-up study, 1997-2002. Principal Investigator: "The Women Physicians' Health Study", a national study, yielding >50 articles about the personal and clinical practices of U.S. women physicians (n=4,50 1), 1991-2005. Co-principal Investigator, Project director: "Nutrition Intervention for Hong Kong office workers", 1990-1992 Co-investigator, Steering Committee member: "A multi-journal randomized trial of blinded peer review", 1990-1998 Principal Investigator: "Routine editorial requests of peer reviewers: a study of the top 100 scientific and medical journals", 1991-1992 Principal Investigator: "Authorial selection criteria for manuscript submission", a study of parameters authors use to select journals for manuscript submission, 1992-1993 Co-investigator: "A multi-center, placebo-controlled double-blind randomized, 16-week, dose-ranging study to determine the efficacy of once-daily atorvastatin in patients with elevated LDL cholesterol", 1993-1994 Co-investigator: "A double-blind, double-dummy active controlled, parallel study comparing the safety and efficacy of niacin SR versus immediate release niacin in the treatment of hyperlipidemia", 1993-1994 Co-investigator: "A double-blind, placebo-controlled safety and efficacy study of once-a-day, sustained release nicotinyl alcohol tartrate formulation in patients with primary Type II hyperlipoproteinemia", 1993-1994 Principal Investigator: "Physicians modeling healthy behavior", a study of whether physicians who explicitly demonstrate healthy behavior are more convincing preventionists, 1996-2000 Co-investigator: "The PAN Initiative," a program to increase physical activity among overweight African-American adolescent girls, 1996-1999 Co-investigator: "Dietary change through black churches", an intervention to increase fruit and vegetable intake and decrease fat intake through intervention in black churches, 1996-1999 Principal Investigator: "The BBT improvement project", a project to improve the accuracy of basal body temperature as a method of fertility prediction, 1996-1999 19 19

Principal Investigator: "The Healthy Doc - Healthy Patient Project", a study in 17 medical schools of the relationship between medical schools' encouragement of students' healthy personal and clinical prevention practices and their prevention-related practices, 1997-2008. Co-principal Investigator: "Reviewing the editors: articles chosen by the editors of the international editions of the Journal of the American Medical Association", 1998-1989 Principal Investigator: "Bias in medical journals' manuscript selection", George D. Lundberg, M.D., Co-investigator, 1998-2000 Principal Investigator: "Frequency and consistency of reviewers' comments on a methods section", 2000-2001 Co-Principal Investigator: "A more objective approach for journal submission selection", 2000-2001 Senior Advisor, scientific advisory group for survey regarding pathology resident stressors, 2006-2008

Bibliography: Published and accepted research articles in refereed journals (underlining indicates EF's trainees that are coauthors): (1) Frank E, Buckley R. 1988. Falls in the elderly. Georgia Academy of Family Physicians' Journal; 10:2-3. (2) Frank E. 1991. Osler was wrong: you are a preventionist. American Journal of Preventive Medicine (also, a response to a letter to the editor regarding this article); 7: 128. (3) Frank E, Winkleby MW, Altman D, Rockhill B, Fortmann SP. 1991. Predictors of physicians' smoking cessation advice. Journal of the American Medical Association; 266:3139-3144. (4) Winkleby MW, Jatulis D, Frank E, Fortmann SP. 1992. Socioeconomic status and health: comparing contributions of education, income and occupation to cardiovascular disease risk factors. American Journal of Public Health; 82:816-820. (5) Frank E. 1992. Preventive medicine is not a fellowship. American Journal of Preventive Medicine; 8:269. (6) Frank E, Winkleby MW, Fortmann SP, Rockhill B, Farquhar JW. 1992. Improvements in cholesterol- related knowledge, behavior, and plasma cholesterol levels in adults during the 1980's. Journal of the American Medical Association; 268: 1566-1572. (7) Frank E, Winkleby MW, Fortmann SP, Farquhar JW. 1993. Changes in cardiovascular disease risk factor knowledge and behavior during the 1980s. American Journal of Public Health; 83:590-593. (8) Frank E, Winkleby MW, Fortmann SP, Rockhill B, Farquhar JW. 1993. Improvements in cholesterol- related knowledge, behaviors, and plasma cholesterol levels in 12-24 year olds during the 1980s. American Journal of Preventive Medicine; 9: 168-174. (9) White R, Frank E. 1994. The health effects and prevalence of vegetarianism. Western Journal of Medicine; 160:465-471. (Also, a response to a letter to the editor regarding this article, 1994, 161: 529). (10) Frank E. 1994. Authors' journal selection criteria. Journal of the American Medical Association; 272:163-164. (11) Rafferty M, Frank E. 1994. Office-based prevention: how can we make it happen? Western Journal of Medicine; 161:190-191. (12) Tribble D, Frank E. 1994. Dietary antioxidants and the diseases of aging. Western Journal of Medicine; 161:605-612. (13) Frank E. 1995. The Editorial Process: an introduction and a critique. Preventive Medicine; 24: 1-2. (14) Frank E. 1995. The Women Physicians' Health Study: Background, Objectives, and Methods. Journal of the American Medical Women's Association; 50:64-66. (15) Frank E, Kunovich-Frieze T. 1995. Physicians' prevention counseling behaviors: current status and future directions. Preventive Medicine; 24:543-545. (16) Schiffman M, Frank E. 1995. Harassment of women physicians. Journal of the American Medical Women's Association; 50:207-211. (17) Frank E, White R. 1996. An updated basal body temperature method. Contraception; 54:319-321. (18) Frank E. 1996. Print globally, act locally: tertiary prevention for the planet. Preventive Medicine; 25:84.

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(19) Frank E, for the AMA Council on Long Range Planning and Development and the AMA Council on Preventive Medicine. 1996. The future of preventive medicine. Preventive Medicine; 25: 73-81. (20) Frank E. 1996. Editors' requests of reviewers: a study and a proposal. Preventive Medicine; 26: I02-1 04 (21) Frank E, Harvey L. 1996. Prevention advice rates of women and men physicians in primary care and other disciplines. Archives of Family Medicine; 5:215-219. (22) Resnicow K, Robinson T, Frank E. 1996. Advances and future directions for school based health education research: commentary on the CATCH intervention trial. Preventive Medicine; 25:378-383. (23) Frost K, Frank E, Maibach E. 1997. Relative risk in the news media: a quantification of misrepresentation. American Journal of Public Health; 87:842-845. Also, reprinted in The Content Analysis Reader, edited by: Klaus Krippendorff and Mary Bock, Sage Publications, 2007. (24) Frank E, Rothenberg R, Brown V, Maibach H. 1997. Basic demographic and professional characteristics of U.S. women physicians. Western Journal of Medicine; 166:179-184. (25) McNagny S, Wenger N, Frank E. 1997. Personal use of postmenopausal hormone replacement therapy by women physicians in the United States. Annals of Internal Medicine; 127: I093-1 096. (26) Frank E, Brogan D, Mokdad AH, Simoes E, Kahn H, Greenberg RS. 1998. Health-related behaviors of women physicians vs other women in the United States. Archives ofInternal Medicine; 158:342-348. (27) Frank E, Brogan D, Schiffman M. 1998. Prevalence and correlates of harassment among U.S. women physicians. Archives ofInternal Medicine; 158:352-358. (28) Baldwin G, Frank E, Fielding B. 1998. U.S. women physicians' residential radon testing practices. American Journal of Preventive Medicine; 15:49-53. (29) Justice AC, Cho MK, Winker MA, Berlin JA, Rennie D, and the PEER Investigators (Berkwits M, Callaham M, Fontanarosa P, Frank E, Goldman D, Goodman S, Pitkin R, Varma R, and Waeckerle J). 1998. Does masking author identity improve peer review quality? A randomized controlled trial. Journal of the American Medical Association; 280:240-242. (30) Cho MK, Justice AC, Winker MA, Berlin JA, Waeckerle J, Callaham M, Rennie D, and the PEER Investigators (Berkwits M, Fontanarosa P, Frank E, Goldman D, Goodman S, Pitkin R, and Varma R). 1998. Masking author identity in peer review: What factors influence masking success? Journal of the American Medical Association; 280:243-245. (31) Frank E, Brownstein M, Ephgrave L, Neumayer L. 1998. Characteristics of women surgeons in the United States. American Journal of Surgery; 176:244-250. (32) Frank E. 1998. Breastfeeding and maternal employment. Lancet. 352:1083-1084. (Also, a letter to the editor responding to comments on the article, Lancet; 352: 1936) (33) White R, Seymour J, Frank E. 1999. Prevalence and effects of vegetarianism in U.S. women physicians. Journal of the American Dietetic Association; 99:595-597. (34) Frank E. 1999. Political self-characterization of U.S. women physicians. Social Science and Medicine; 48:1475-1481. (35) Frank E, Hudgins P. 1999. Academic vs. nonacademic women physicians: data from the Women Physicians' Health Study. Academic Medicine; 74:553-556. (36) Frank E, Clancy C. 1999. U.S. women physicians' assessment ofthe health care quality they receive. Journal of Women's Health; 8:95-102. (37) Frank E, McMurray J, Linzer M, Elon L, Society of General Medicine Career Satisfaction Study Group. 1999. Career satisfaction of U.S. women physicians: Results from the Women Physicians' Health Study. Archives ofInternal Medicine; 159:1417-1426. (38) Frank E, Lutz L. 1999. Characteristics of women US family physicians. Archives of Family Medicine; 8:313-318. (39) Brogan DJ, Frank E, Elon L, Sivanesan SP, O'Hanlan KA. 1999. Harassment oflesbians as medical students and physicians. MS Journal of the American Medical Association; 282: 1290-1292. Full electronic report http://www.ama-assn.org/sci pubs/m .. ./articles/vol 282/no 13/brogan.htm. (40) Corbie-Smith G, Frank E, Nickens H, Elon L. 1999. Prevalences and correlates of ethnic based harassment in U.S. women physicians." Academic Medicine; 74:695-701. 21 21

(41) Frank E, Feinglass S. 1999. Student loan debt does not predict choosing a primary care specialty for US women physicians. Journal of General Internal Medicine; 14:347-350. (42) Doyle J, Frank E, Saltzman LE, McMahon PM, Fielding BD. 1999. Domestic violence and sexual abuse in women physicians: associated medical, psychiatric, and professional difficulties. Journal of Women's Health; 8:955-965. (43) Frank E, Kellerman A. 1999. Firearm ownership among female physicians in the United States. Southern Medical Journal; 92: 1083- I088. (44) Frank E, Vydareny K. 1999. Characteristics of women radiologists in the United States. American Journal of Roentgenology; 173:531-536. (45) Frank E, Rock J, Sara D. 1999. Characteristics of female obstetrician-gynecologists in the United States. Obstetrics and Gynecology; 94:659-665. (46) Frank E. 1999. Contraceptive use by female physicians in the United States. Obstetrics and Gynecology; 94:666-671. (47) Frank E, Dell ML, Chopp R. 1999. Religious characteristics of U.S. women physicians. Social Science and Medicine; 49:1717-1722. (48) Frank E, Dingle AD. 1999. Self-reported depression and suicide attempts among U.S. women physicians. American Journal of Psychiatry; 156: 1887-1894. (49) Frank E, Breyan J, Elon L. 2000. Physician disclosure of healthy personal behaviors improves credibility and ability to motivate. Archives of Family Medicine; 9:287-290. (50) Frank E, Harvey L. 2000. Family responsibilities and domestic activities of U.S. women physicians. Archives of Family Medicine; 9: 134-140. (51) Frank E, Baldwin G, Langleib A. 2000. Continuing medical education habits ofU,S. women physicians. Journal of the American Medical Women's Association; 55:27-28. (52) Roberts LW, Warner TO, Carter D, Frank E, Ganzini L, Lykestos C, and the Collaborative Research Group on Medical Student Health Care. 2000. Caring for medical students as patients: health concerns, access to services, and care-seeking practices of 1027 students at nine medical schools. Academic Medicine; 75:272-277. (53) Frank E, Rothenberg R, Lewis C, BelodoffB. 2000. Correlates of physicians' prevention-related practices; findings from the Women Physicians' Health Study. Archives of Family Medicine; 9:359-367. (54) Saraiya M, Frank E, Elon L, Baldwin G, McAlpine BE. 2000. Personal and clinical skin cancer prevention practices of U.S. women physicians. Archives of Dermatology; 136:633-642. (55) Baranowski T, Mendlein J, Resnikow K, Frank E, Cullen KW, Baranowski J. 2000. Physical activity and nutrition in children and youth: an overview of obesity prevention. Preventive Medicine; 31 :S1-S 10. (56) Sallis JF, Patrick K, Frank E, Pratt M, Wechsler H, Galuska DA. 2000. Interventions in health care settings to promote healthful eating and physical activity in children and adolescents. Preventive Medicine; 31:S112-S120. (57) Frank E, Cone K. 2000. Characteristics of pregnant vs. nonpregnant women physicians: findings from the Women Physicians' Health Study. International Journal of Gynecology and Obstetrics; 69:37-46. (58) Frank E, Sperling L, Wu K. 2000. Aspirin use among women physicians in the United States. American Journal of Cardiology; 86:465-466. (59) Frank E, Totten V, Andrew L. 2000. Characteristics of women emergency physicians. The Internet Journal of Emergency and Intensive Care Medicine; 4(2). http://www.ispub.com/journals/IJEICM/voI4N2/women.html. (60) Frank E, Biola H, Burnett CA. 2000. Mortality rates and causes among U.S. physicians. American Journal of Preventive Medicine; 19: 155-159. (61) Frank E, Rimer BK, Brogan D, Elon L. 2000. U.S. women physicians' personal and clinical breast cancer screening practices. Journal of Women's Health; 9:791-801. (62) Frank E, Dunlop AL. 2000. What does a patient's outfit weigh? Family Medicine; 32:595-596. (63) Frank E, Bendich A, Denniston M. 2000. Use ofvitamin-mineral supplements by female physicians in the United States, American Journal of Clinical Nutrition; 72:969-975.

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(64) Corbie-Smith G, Frank E, Nickens H. 2000 The intersection of race, gender, and primary care: results from the Women Physicians' Health Study. Journal of the National Medical Association; 92:472-480. (65) Frank E, Meacham L. 2001. Characteristics of U.S. women pediatricians." Clinical Pediatrics; 40: 17-25. (66) Roberts LW, Warner TD, Lykestos C, Frank E, Ganzini L, Carter D, and the Collaborative Research Group on Medical Students Health Care. 2001. Perceptions of academic vulnerability associated with personal illness: A study of 1027 medical students at nine medical schools. Comprehensive Psychiatry; 42: 1- 15. (67) Frank E, Boswell L, Dickstein L, Chapman D. 2001. Characteristics of female psychiatrists. American Journal of Psychiatry; 158:205-215. (68) Brogan D, Frank E, Elon L, O'Hanlan K. 2001. Methodologic concerns in defining lesbian for health research. Epidemiology; 12:109-113. (69) Easton A, Husten C, Malarcher A, Elon L, Caraballo R, Ahluwalia I, Frank E. 2001. Smoking cessation counseling by primary care women physicians: Women Physicians' Health Study. Women & Health; 32(4):77-91. (70) Frank E, Singh S. 2001. Personal and practice-related characteristics ofa subsample of U.S. women dermatologists: data from the Women Physicians' Health Study. International Journal of Dermatology; 40(6):393-400. (71) Dunlop A, Allen A, Frank E. 2001. Involving the male partner for interpreting the basal body temperature graph. Obstetrics & Gynecology; 98(1): 133-138. (72) Saraiya M, Coughlin S, Burke W, Elon L, Frank E. 2001. The Role of Family History in Personal and Clinical Cancer Prevention Practices Among U.S. Women Physicians. Community Genetics; 4: 102-1 08. (73) Easton A, Husten C, Elon L, Frank E. 2001. Non-primary care physicians and smoking cessation counseling: Women Physicians' Health Study. Women & Health; 34(4):15-29. (74) Frank E, Wright E, Serdula M, Elon L, Baldwin G. 2002. Personal and professional nutrition-related practices of US female physicians. American Journal of Clinical Nutrition; 75(2):326-332. (75) Frank E, Kunovich-Frieze T, Corbie-Smith G. 2002. Characteristics of women internists. Medscape General Medicine: 4(1): 11. (76) Frank E, Denniston M, Pederson L. 2002. Decline in smokers' understanding of tobacco's hazards between 1986 and 1998: a report from North Georgia. Southern Medical Journal; 95(7):675-680. (77) Malarcher A, Easton A, Husten C, Frank E. 2002. Smoking cessation counseling: training and practice among women pediatricians. Clinical Pediatrics; 41(5):341-349. (78) Brogan DJ, O'Hanlan KA, Elon L, Frank E. 2003. Health and professional characteristics of lesbian and heterosexual women physicians. Journal of the American Medical Women's Association; 58:10-19. (79) Frank E, Elon L. 2003. Clinical and personal relationships between oral contraceptive and hormone replacement therapy use among U.S. women physicians. Menopause; 10:133-141. (80) Mariotto A, Frank E. 2003. A more objective approach for selecting the journal to which one submits a manuscript. McGill Journal of Medicine; 7(1): 21-25. (81) Frank E, Schelbert KB, Elon L. 2003. Exercise counseling and personal exercise habits of U.S. women physicians. Journal of the American Medical Women's Association; 58(3):178-184. http://www.amwa- doc.org/index.cfin?objectid=6F331 F32-D567-0B25-554 72ED 1093E51 C8 (82) Frank E, Breyan J, Elon L. 2003. Pro bono work and non-medical volunteerism among U.S. women physicians. Journal of Women's Health; 12(6):589-98. (83) Frank E, Elon L, Hogue C. 2003. Transgenerational persistence of education as a health risk: findings from the Women Physicians' Health Study. Journal of Women's Health; 12(5):505-512. (84) Frank E. 2004. Physician health and patient care. Journal ofthe American Medical Association; 291(5):637. (85) Frank E, Galuska DA, Elon L, Wright EH. 2004. Personal and clinical exercise related attitudes and behaviors of freshman U.S. medical students. Research Quarterly in Exercise and Sport; 75(2): 112-121. (86) Frank E, McLendon L, Elon LK, Denniston M, Fitzmaurice D, Hertzberg V. 2005. Medical students' self-reported typical counseling practices are similar to those assessed using Standardized Patients. Medscape General Medicine. http://www.medscape.com/viewarticle/497041. 23 23

(87) Frank E, Hedgecock J, Elon LK. 2005. Personal health promotion at US medical schools: a quantitative study and qualitative description of deans' and students' perceptions. BioMed Central Medical Education. http://www.medscape.com/medline/abstract/15 581424 (88) Dunlop AL, Schultz R, Frank E. 2005. Interpretation of the BBT Chart Using the "Gap" Technique Compared to the Coverline Technique. Contraception; 71: 188-192. (89) Spencer EH, Elon LK, Hertzberg VS, Stein AD, Frank E. 2005. Validation of a brief diet survey instrument among medical students. Journal of the American Dietetic Association; 105(5): 802-806. (90) Spencer EH, Frank E, McIntosh NF. 2005. The effect of 100 billion hamburgers sold by McDonald's. American Journal of Preventive Medicine; 28(4):379-381. (91) Frank E, Smith D, Fitzmaurice D. 2005. A description and qualitative assessment of a 4 year intervention to improve medical student health. Medscape General Medicine. http://www.medscape.com/viewartic1e/50 1770. (92) Frank E. 2005. Funding the public health response to terrorism. British Medical Journal (and BMJ USA); 331 :526-527. (93) Frank E, Carrera JS, Prystowsky J, Kellerman A. 2006. Firearm-related personal and clinical characteristics of U.S. medical students. Southern Medical Journal; 99(3):216-25. (94) Frank E, Carrera JS, Stratton T, Bickel J, Nora LM. 2006. Belittlement and harassment experiences and their correlates among U.S. medical students. British Medical Journal; 333: 682. http://www.bmj.com/cgi/content/fu 11/333/7570/682 ?maxtoshow=&H1TS= 1O&hits= 1O&RESUL TFO RMA T=&author I=frank&fu Iltext=bel ittlement&andorexactfulltext=and&search id (95) Frank E, Carrera JS, Elon L, Hertzberg VS. 2006. Basic demographics, health practices, and health status of U.S. medical students. American Journal of Preventive Medicine; 31(6):499-505. http://dx.doLorg/l 0.1016/j.amepre.2006.08.009 (96) Frank E, Elon L, Saltzman LE, Houry D, McMahon PM, Doyle J. 2006. Clinical and Personal and intimate partner violence training experiences of U.S. medical students. Journal of Women's Health; 15(9):1071-1079. (97) Spencer EH, Frank E, Elon LK, Hertzberg VS, Galuska DA, Serdula MK. 2006. Predictors of nutrition counseling behaviors and attitudes among U.S. medical students. American Journal of Clinical Nutrition; 84:655-662. (98) Spencer EH, Bendich A, Frank E. 2006. Vitamin/mineral supplement use among U.S. medical students: a longitudinal study. Journal of American Dietetic Association; 106(12):1975-1983. (99) Spencer EH, Elon LK, Frank E. 2007. Personal and professional correlates of vegetarianism among U.S. medical students. Journal of American Dietetic Association; 107(1):72-78. (100) Frank E, Elon E, Carrera JS, Hertzberg VS. 2007. Predictors of US medical students' prevention counseling practices. Preventive Medicine; 44(1 ):76-81. (101) Frank E, Carrera JS, Dharamsi S. 2007. Political self-characterization of U. S. medical students. Journal of General Internal Medicine; 22(4):514-517. (102) Dunlop A, Isakov A, Compton M, White M, Nassery H, Frank E, Glanz K. 2007. Medical outreach following a remote disaster: lessons learned from Hurricane Katrina. American Journal of Disaster Medicine; 2(3):121-133. (103) Henderson S, Frank E, Elon L. 2007. Self-report of health care quality in medical students. Medical Education; 41(7):632-637. (104) Frank E, Elon L, Hertzberg V. 2007. Quantitative assessment ofa 4-year intervention that improved patient counseling through improving medical student health. Medscape General Medicine; 9(2):58. http://www.medscape.com/viewartic Ie/557088 (105) Frank E, Tong E, Lobelo F, Carrera J, Duperly J. 2008. Physical Activity Levels and Counseling Practices of US Medical Students. Medicine & Science in Sports & Exercise; 40(3):413-421. (106) Werny OM, Saraiya M, Carrera JS, Coughlin S, Frank E. 2008. Learning amid controversy: prostate cancer knowledge and screening practices among US medical students. Journal of Cancer Education; 23(2): 108-113. http://www.informaworld.com/smpp/content~content=a793653576~db=all~order=page

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(107) Compton M, Frank E, Elon L, Carrera JS. 2008. Changes in U.S. Medical Students' Specialty Interests over the Course of Medical School. Journal of General Internal Medicine; 23(7): 1095-11 00. (108) Frank E, Modi S, Elon L, Coughlin S. 2008. U.S. medical students' attitudes about patients' access to care. Preventive Medicine; 47(1): 140-145. http://dx.doi.org/l 0.1016/Lypmed.2007 .12.015 (109) Frank E, Coughlin SS, Elon L. 2008. Sex-related knowledge, attitudes, and behaviors of US medical students. Obstetrics and Gynecology; 112:311-319. (110) Frank E, Carrera JS, Rao J, Anderson L. 2008. Satisfaction with career choice among US medical students. Archives ofInternal Medicine; 168(15): 1712-1716. http://archinte.ama-assn.org/cgi/content/short/168/15/1712 (111) Compton M, Carrera JS, Frank E. 2008. Stress and depressive symptoms/dysphoria among U.S. medical students: Results from a large, nationally-representative survey. The Journal of Nervous and Mental Disease; 196:891-897. (112) Frank E, Elon L, Naimi T, Brewer R. 2008. Alcohol consumption and alcohol counseling behaviors among a cohort of U.S. medical students. British Medical Journal; 337:2155. http://www.bmj.com/cgi/content/full/33 7/nov07 I/a2155?maxtoshow=&HITS=1 O&hits=1 O&RESUL TFORM AT=&fulltext= Naim i&searchid= 1&FIRSTIND EX=O&resourcetype= HW CIT (113) Lobelo F, Duperly J, Frank E. 2008. Physical activity habits of physicians and medical students influence their counseling practices. British Journal of Sports Medicine. http://bjsm. bmj .com/cgi/rapidpdf/bjsm.2008.055426v 1?maxtoshow=&HITS= 1O&hits= 1O&RESUL TFORMA T=&author 1=Frank&andorexactfu Iltext=and&searchid= 1&FIRSTIND EX =O&sortspec=relevance&resourcety pe=HWCIT (114) Frank E. 2008. Health Sciences Online: 8+ revolutions and 10+ brief analyses. Open Medical Education Journal; I: 1-4. http://www.bentham.org/open/tomededui!openaccess2.htm (lIS) Akhtar AZ, Greger M, Ferdowsian H, Frank E. 2009. Health Professionals' Roles in Animal Agriculture, Climate Change, and Human Health. American Journal of Preventive Medicine; 36:182-187. (116) Lovell BL, Lee RT, Frank E. 2009. May I long experience the joy of healing: professional and personal wellbeing among physicians from a Canadian province. BMC Family Practice; 10:18. http://www.biomedcentral.com/1471-2296/1 0/18 (117) Duperly J, Lobelo RL, Segura C, Sarmiento F, Herrera D, Sarmiento 0, Frank E. 2009. The association between Colombian medical students' healthy personal habits and a positive attitude toward preventive counseling: cross-sectional analyses. BMC Public Health; 9:218. (118) Frank E, Elon L, Spencer E. 2009. Personal and clinical tobacco-related practices and attitudes of U.S. medical students. Preventive Medicine; 49(2):233-239. http://dx.doi.org/10.1 016li.ypmed.2009.06.020 (119) Frank E, Segura C. 2009. Health Practices of Canadian Physicians. Canadian Family Physician; 55(8):810-811. http://www.cfp.ca/cgi/reprint/55/8/810 (120) Frank E, Nimalasuriya K, Tairyan K, Grajales Fl, Segura C, Wruck M. 2009. A Transformation in Health Sciences Education: A Description of Health Sciences Online. Medical Informatics in a United and Healthy Europe. http://www .ncbi.nIm.nih.gov/pu bmed/l 9745462 ?ordinalpos= 1&itoo 1=EntrezSystem2. PEntrez. Pubmed. Pubme d ResultsPanel.Pubmed DefaultReportPanel.Pubmed RVDocSum (121) Frank E. 2009. Physician, humble thyself. British Medical Journal; 339:b4218 http://www.bmLcom/cgi/content/fuIl/bmj.b4218 (122) Oberg E, Frank E. 2009. Physicians' Personal Health Practices Efficiently and Effectively Influence Patient Health Practices. Journal of the Royal College of Physicians of Edinburgh; 39:290-291. http://www.rcpe.ac.uk/journal/issue/journal 39 4/editorial.pdf (123) Leiter M, Frank E, Matheson T. 2009. Demands, Values, and Burnout: their Relevance for Physicians. Canadian Family Physician; 55(12): 1224. http://www.cfp.ca/cgi/reprint/55/12/1224 (124) Dresner Y, Frank E, Baevsky T, Rotman E, Vinker S. 2010. Screening practices ofIsraeli doctors and their patients. Preventive Medicine; 50: 300-303. http://www.sciencedirect.com/science? ob=ArticleURL& udi=B6WPG-4YDC3H7- 1& user=1 022551 & coverDate=06/30/2010& rdoc=1 & fmt=high& orig=search& sort=d& docanchor=&v 25 25 iew=c& acct=C000050484& version=1 & ur!Version=O& userid=1 02255 l&md5=c81c78914d8ed9fedeccf5 565fe66c89 (125) Voltmer E, Schwappach DLB, Frank E, Wirsching M, Spahn C. 2010. Work-related Experience and Behavior Patterns and Predictors of Mental Health in German Physicians in Medical Practice. Family Medicine; 42:433-439. (126) Frank E, Ratanawongsa N, Carrera J. 2010. American medical students' beliefs in the effectiveness of alternative medicine. International Journal of Collaborative Research on Internal Medicine & Public Health; 2(9) :292- 305. http://iomcworld.com/ijcrimph/ijcrimph-v02-n09-0 1.htm (127) Frank E. 2011. Another reason to care about physician health: its role in climate change. Climatic Change; 105:619-623. http://www.springerlink.com/content/2266uOn5765g2w3h/ (128) SC King, Frank E. 2010. The Unwillingness of Future U.S. Physicians to Limit Adolescent Prevention Counseling to Abstinence-Only Messages. Journal of Pediatric and Adolescent Gynecology; 23(4):237-241. (129) Frank E, Segura C, Shen H, Oberg E. 2010. Predictors of Canadian physicians' prevention counseling practices. Canadian Journal of Public Health; 101(5):390-395. (130) Frank-White NE, Frank E. 2010. Diet vs. Sugar-Sweetened Soda Preferences and Attitudes in a Sample of Adolescents. Open Pediatric Medical Journal; 4:23-25. http://www.benthamscience.com/open/toped j/ artic lesN004/23 TOPE OJ .pdf (131) Frank E, Oberg E, Segura C, Clarke A, Shen H. 2010. Physical and Mental Health Status of Physicians in British Columbia. BC Medical Journal; 52(7):349-355. (132) Zbar A, Frank E. 2011. Significance of authorship order: an open-ended international assessment. American Journal of the Medical Sciences; 341 (2): 106-109. (133) Compton M, Frank E. 2011. Mental health concerns among Canadian physicians: results from the 2007-2008 Canadian Physician Health Study. Comprehensive Psychiatry; 52:542-547. (134) Frank-White NE, Burns-Kirkness R, Frank E. 2011. The Effect of Dietary and Transportation Choices on Climate Change. Food and Nutrition Sciences; 2(5):482-485. http://www.scirp.org/journallPaper Information .aspx?Paper 10=5 799&J ournalID=208 (135) Smith AW, Borowski L, Benmei L, Galuska DA, Signore C, Klabunde C, Terry T-K T, Krebs-Smith S, Frank E, Pronk N, Ballard-Barbash R. 2011. US Primary Care Physicians' Provision of Diet, Physical Activity and Weight-related Care to Adult Patients. American Journal of Preventive Medicine; 41(1): 33-42. (136) Rose A, Frank E, Carrera J. 2011. Factors affecting weight counseling attitudes and behaviors among US medical students. Academic Medicine; 86(11): 1463-1472. (137) Barron R, Frank E, Git10w S. 2012. Evaluation of an Experiential Curriculum for Addiction Education Among Medical Students. Journal of Addiction Medicine; 6: 131-136. (138) Kay M, Mitchell GGK, Clavarino A, Frank E. 2012. Developing a Framework for Understanding Doctors' Health Access: a qualitative study of Australian GPs. Australian Journal of Primary Health; 18(2): 158-65. (139) Schlair S, Hanley K, Gillespie C, Disney L, Kalet A, Darby P, Frank E, Spencer E, Harris J, Jay M. 2012. How medical students' behaviors and attitudes affect the impact of a brief curriculum on nutrition counseling. Journal of Nutrition Education and Behavior. http://www.jneb.org/artic1e/S 1499-4046(11)00529- X/abstract http://her.oxford journals.org/cgilreprint/cys073?i jkey=zzX gLoXggkb IjMI&keytype=ref (140) Kruger J, Shaw L, Kahende J, Frank E. 2012. Health Care Providers' Advice to Quit Smoking- National Health Interview Survey, 2000, 2005, and 2010. CDC Preventing Chronic Disease; 9: 110340. http://dx.doLorg/l0.5888/pcd9.11 0340 (141) Holtz KA, Kokotilo K, Fitzgerald B, Frank E. 2013. Exercise behaviors and attitudes of fourth year medical students at UBC. Canadian Family Physician. 59(1):e26-32. (142) Frank E, Oberg E. 2013. Physicians' health practices are better than patients'; others' less certain. JAMA Internal Medicine. 173(12): 1155-1156. (143) Frank E, Dresner Y, Shani M, Vinker S. 2013. The association between physicians' and patients' preventive health practices. Canadian Medical Association Journal. 185(8):649-653.

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(144) Frank E, Schlair S, Elon L, Saraiya M. Do US medical students report more training on evidence-based prevention topics? 2013. Health Education Research. 28(2):265. doi: 10.1 093/her/cys073 http://her. oxfordjournals.org/content/28/2/265. full. pdf+html (145) Voltmer E, FrankE, Spahn C. 2013. Personal health practices and patient counseling of German physicians in private practices. ISRN Epidemiology. 2013(176020). (146) Schwab GL, Moyses ST, Franca BHS, Werneck RI, Frank E, Moyses SJ. 2013. Chronic conditions policies: oral health, a felt absence. International Dental Journal. doi: 10.1 1ll/idj.12066. http://authorservices.wiley.com/bauthor/onlineLibraryTPS.asp?DOI=10.l1ll/idj.12066&ArticleID=1194902 (147) Tyssen R, Palmer KS, Solberg IB, Voltmer E, Frank E. 2013. Physicians' perceptions of quality of care, professional autonomy, and job satisfaction in Canada, Norway, and the United States. BMC Health Services Research. 13:516. doi: 10.1186/1472-6963-13-516. http://www.biomedcentral.com/1472-6963/13/5l6 (148) Schwab GL, Moyses ST, Werneck RI, Frank E, Moyses SJ. 2014. Healthy Cities and Cittaslow Helping Chronic Conditions: A Comparative Study. Social Science & Medicine. In Review.

Review articles: (1) Frank E. 1993. "Benefits of smoking cessation: a review." Western Journal of Medicine, Vol. 159, pgs. 83-87. (2) Frank E, Taylor B. 1993. "Coronary heart disease in women: influences on diagnosis and treatment." Annals of Behavioral Medicine, Vol. 15, pgs. 156-161. (3) Frank E, Fortmann SP. 1993. "The effects of smoking cessation on cardiovascular disease risk." Cardiovascular Risk Factors, Vol. 3, pgs. 253-259 (4) Frank E, Causey D, Fortmann SP. 1994. "The effects of smoking cessation on cardiovascular disease." Modern Medicine, Vol. 62, pgs. 3-10. (5) Tribble D, Frank E. 1994. "Dietary antioxidants and the diseases of aging." Western Journal of Medicine, Vol. 161, pgs. 605-612.

Book chapters: (1) Frank E. 1990. "Lifestyles and Lipids". In: Women and Lipids, Geoffrey P. Redmond, Ed. New York: Springer-Verlag, pgs. 229-237. (2) Frank E, Taylor CB. 1993. "Psychosocial Influences on Diagnosis and Treatment Plans of Women with Coronary Heart Disease." In: Cardiovascular Health and Disease in Women, Nanette K. Wenger, Leon Speroff, Barbara Packard, Eds. Greenwich: Le Jacq Communications, pgs. 231-2317. (3) Frank E, White R. 1998. "An updated basal body temperature method." In: Year Book of Family Practice, Chapter 15, M.A. Bowman, Ed., St. Louis: Mosby-Year Book, pgs. 296-298. (4) Frank E. 2000. "Self-Care, Prevention, and Health Promotion." In: The AMA's Guide to Physician Health, Larry Goldman, Michael Myers, Leah Dickstein, Eds. Chicago: American Medical Association. (5) Frank E, contributor. 2001. Definition of "Preventionist." In: A Dictionary of Epidemiology, John M. Last, Ed. New York: Oxford University Press. (6) Frank E. 2001. "Women in Medicine." In: The Oxford Illustrated Companion to Medicine, Stephen Lock, Ed. New York: Oxford University Press. (7) Frank E. 2005. "Preface". In: Emerging Infectious Diseases and Public Health and Occupational Health Un-Readiness. William Charney, Ed. Boca Raton: CRC Press. (8) Frank E, Fee E, Parry M, More E. 2009. "Conclusion: Opportunities and Obstacles for Women Physicians in the Twenty-First Century". In: Women Physicians and the Cultures of Medicine, Ellen S. More, Elizabeth Fee, and Manon Parry, Eds. Baltimore: Johns Hopkins University Press. (9) Tairyan K, Frank E. 2011. "Learning about Neuroethics through Health Sciences Online: a model for global dissemination". In: Oxford Handbook ofNeuroethics, Judy Illes, Barbara J. Sahakian, Eds. Oxford: Oxford University Press.

Books edited and written: 27 27

(1) Frank E, Moriarty D. 1984. CDC. Teen Health Risk Appraisal User Manual. (Also masters thesis on this topic), Atlanta: CDC. (2) Hatcher R, Guest F, Stewart G, Trussell J, Frank E. 1984. Contraceptive Technology, 1984-1985 edition (contributor: 1982-1983 edition). New York: Irvington Publishers, Inc. (3) Bowman M, Frank E, Allen D. 2002. Women in Medicine: Career and Life Management, 3rd edition. New York: Springer. Also Italian version (2003) and Japanese version (2005). (4) Frank E, with The Atlanta School kindergarten-I sl grade class. 2004. Springvale Park Field Guide.

Other selected non-peer reviewed scientific publications: (I) Frank E, Frank UA. 1982-1989. Patent disclosures. "A device for hypothermic anesthesia", #192539; "Simultaneous printing of electronic piano compositions", # 172729; "A new urostomy application", # 161416; "Control of deer overpopulation problems through contraception; also, a new human intrauterine device"; #151673. (2) Frank E. 1982. "A History of the Contraceptive Sponge". Commissioned article for Vorhauer Labs. (3) Frank E. 1985. Project Officer, "Closing the Gap: Report ofthe Carter Center Health Policy Consultation." JAM A, Vol. 254, 9/13/1985 (4) Frank E. 1989. Editorial, student component of JAMA. "On burning." Vol. 261,4/7/1989. (5) Frank E. 1989. Editorial, Resident Forum, JAMA. "Not everything causes cancer". Vol. 262,9/15/1989 (6) Frank E. 1990. Student component of JAMA. "An interview with Senator Kennedy." Vol. 263, 5/2/1990 (7) Frank E. 1997. Book Review. "John Snow, a biography," DAE Shephard. American Journal of Preventive Medicine, Vol. 13, pg. 404 (8) Frank E. 1999. Book Review. "Preventive Nutrition," A Bendich, RD Deckelbaum, Ed. American Journal of Preventive Medicine, Vol. 16, pg. 159 (9) Frank E, et al. 2000. Abstract. "Mortality rates and causes among U,S. physicians." Journal of the American Medical Association. Vol. 284, pg. 2853 (10) FrankE. 2001. Letter to the Editor. JAMA, Vol. 285; 8: 1016 (11) Nimalasuriya K, Frank E. 2006. Perspectives in Prevention From the American College of Preventive Medicine. A New Key to Improving the Health of Patients and of the Whole Population: Physicians Preach What We Practice. http://www.medscape.com/viewarticle/522907?sssdmh=dm 1.204967 &src=top I0 (12) Co-Creator, e-module on the role of physicians' physical health habits on their patient care, with Drs. Carolina Segura and Derek Puddester, for the Canadian Medical Association, 2009.

Computer-based education: (1) Founder and Executive Director, Health Sciences Online and NextGenU.org. NextGenU currently includes health sciences education (and research on that education) from the community health level worker level through medical school, residencies (in preventive medicine and family medicine), core and elective courses for the Master's degree in Public Health, and Continuing Medical Education, 2001-present. (2) Education and Training Coordinator, WHO Health Internetwork, 2002-2005 (3) Primary content developer, CDC electronic STD case studies, 2003 (4) Consultant, CDC electronic STD self-study modules, 2003 (5) Consultant, CDC Hemochromatosis website, 2003 (6) Consultant, American Medical Student Association health promotion website, 2003 (7) Consultant, Southern Alliance for Clean Energy website, 2003 (8) Internet2 Health Science Education Special Interest Group member, 2006-present (9) Founding Member, External Advisory Board, International Telehealth Video Resource Center, 2008-2011. (10) Co-Creator, e-module on the role of physicians' physical health habits on their patient care, with the University of Ottawa, for the Canadian Medical Association, 2009. (11) Founding Member, Cancer Commons Editorial Advisory Board, 20lO-present.

Lay Education and Mass Media:

3611311843095 _IIALA TIMER 17/07/2014 28 28

(1) Medical News Department, Cable News Network, Intern, 1983-1984 (2) Georgia Radio Reading Service, Medical News Reporter, 1983 (3) U.S. Public Health Service, "Teen Health Risk Appraisal." Performed all research, scripting, production, on-camera talent and editing; videotape and slide-tape presentation, Centers for Disease Control. Ensign, Summer 1984 (4) Cable Atlanta, Co-Producer, On Camera Talent, Co-Editor, seven part health education series, 1984 (5) ABC affiliate, central Georgia, health reporter/producer/editor. Independently created twice-weekly health report, 1985-1987 (6) Dr. Art Ulene (NBC-TV), Dr. Tim Johnson (ABC-TV), intern, spring 1988 (7) Vogue magazine, author, "Diet in a pill," April 1989; "Tough choices: decisions about birth control have grown more complicated," August 1989; "Women and smoking," October 1989 (8) Lifetime Medical Television, full-time Associate Medical Editor, 1989-1990 (9) Medical News Network, reporter for physician-education video network, 1993-1994 (10) Medscape Webcast Video Editorial: "We Physicians Preach what we Practice, and that Matters", 2007. http://www.medscape.com/viewartic le/566991 (11) Multiple international television and radio appearances, editorials, and quotes in print as expert on various prevention-related topics with Agence France Presse, Associated Press, BBC, CBC, CNN, Later Today Show, National Press Club, New York Times, Reuters, USA Today, etc. (12) Vancouver Observer, occasional public health/environmental reporter/editorialist, 2009-present, including http://www.vancouverobserver.com/b logs/ earthmattersl2009/ 12/13/out-co Id-c1imate-change- ubc- professor- organizes-vigil-and-hopes-real http://www.vancouverobserver.com/blogs/earthmatters/20 10/0 1/04/my-week- hydrocarbon-dieting-vancouver# msocom 2 http://www.vancouverobserver.com/world/ asia/20 II /03/24/increased- thyroid-cancer- rad iation- upsurge- not- expected-herefor-now http://www.vancouverobserver.com/b logs/earthmatters/20 II /1 0/25/fisker-karma-car-designed-get -you-hot- not-planet 29

4 '

'C '" ¥ , FARRIS ""

25th Floor VanCtHlv(,.'r .• Be Tel (iO.', (;R4 915.1 700 \V C;,~orgi[l Sl C" ""d" V7Y 11\3 hlX 604661 9349

Our File No.: 36 1 1 3 - 0 0 0 1 - 0 000

Reply Attention of: Joseph J. Arvay, Q.c. Direct Dial Number: (604) 661-9338 July 17,2014 Facsimile: (604) 661.9349 This is Exhibit B referred to in the Affidavit of Email Address: [email protected] Erica Frank sworn (aftirme ) before me this 28th day of July, 2014. VIA EMAIL

Dr. Erica Frank 6260 Logan Lane Vancouver Be V6T 2K9

Dear Dr. Frank:

Re: Trans Mountain Expansion Project Hearing Order OH-001-2014 File No. OF-Fac-Oil-T260-2013-03 02

As you know we represent Professor Danny Harvey in an application to have the NEB reconsider its July 29, 2013 decision which set out the List ofIssues that the National Energy Board ("NEB") would consider during the hearing into the Trans Mountain Expansion Project, and also the related matter of who would be granted standing to make submissions at the hearing. As you know the List of Issues explicitly excluded the environmental and socio-economic effects associated with upstream activities, oil sands development, or downstream use of the oil.

We write to confirm your discussions with Alison Latimer regarding your willingness to provide us with an expert opinion in this matter. Specifically we ask you to answer the following questions:

1. Is climate change a threat to human health?

2. If so, please categorize and describe the types of diseases that would be consequent to climate change.

If you are relying on any facts or assumptions you should make them clear in your opinion.

We ask you to include a copy of your current curriculum vitae as an attachment to your expert opinion and to include a narrative description of how your expertise relates to the issues posed by this request for a report in particular in the body of your opinion.

Thank you for your willingness to work on this important matter and for assisting us in preparing these materials as soon as possible. The hearing of this case has yet to be set down. It is possible that you will be asked to submit to a cross-examination prior to or at the hearing. If that occurs we will endeavour to find a time and place that is convenient to you.

r:/\HHTS, Vr\UCI-TAN. \\1.11.1.$ L,. :\JURPHY LLl'

tt-uristcrs • Solidrol's 361 1311843082_IIJARVAY 30

- 2 - FARRIS

Finally, there is the matter of compensating you for your time and effort in preparing this opinion. Due to our clients' financial constraints, expert witnesses in this action will not be paid at this time. I hope that this arrangement is acceptable to you.

Please note that pursuant to the British Columbia Supreme Court Civil Rules, your report must be signed and must include a certification in the following terms:

I certify that:

(a) I am aware that, in giving an opinion to the court, I have a duty to assist the court and not to be an advocate for any party;

(b) this report has been made in conformity with that duty; and

(c) I will, if called on to give oral or written testimony, give that testimony in conformity with that duty.

Thank you for your willingness to work on this important matter and for assisting us in preparing these materials as soon as possible.

Finally, this matter is confidential and privileged at this time. Please do not discuss this matter with anyone other than our legal team.

Yours truly,

FARRIS, VAUGHAN, WILLS & MURPHY LLP

Per:

Joseph J. Arvay, Q.C.

JJNsy

361 1311843082_IIJARVA Y 31

PSR Summaries

This is Exhibit C referred to in the Affidavit of Eriea Frank sworn (affirmed) before me this 28th day ofJuly, 2014.

taking Affidavits for British PSR~ Climate Change: 32 PHYSICIANS FOR SOCIAL RESPONSIBILITY

'1:", Impacts i .~ .. '-j".-,.. f'.'.' ..i.,: .' ": .\"" :('" ;~ The Health r .. :,', i.';\,:' www.psr.org

umangenerated greenhouse gas emissions to heat-related illness. In 2010 a Russian heat are warming the earth's climate. The threats wave killed an estimated 56,000. 201B Hto health posed by climate change are brought severe and record-breaking heat multiple, and increasingly severe. waves and drought to many U.S. regions ,Uld around the world. \Varming generates more frequent and intense heat waves, extreme weather events, shoreline loss, II- Increasing heat levels and humidity are flooding and drought, air ,Uldwater pollution, and making outdoor work, play, and sporL~riskier agricultural losses. These in turn have health to healtll. consequences: heat-related illness and deadl; storm- driven mortality and iqjuries; allergies, asthma, and EXTREME WEATHER EVENTS AND RISING SEA other conditions exacerbated by pollution; insect and LEVELS water borne diseases; poorer nutrition and lessened food security, and greater mental and emotional stress. As the climate heats up, storms ,Uldfloods are becoming more frequent, widespread, and intense.

It> Severe storm surges on coastal areas can be devastating. Hurricane Katrina displaced over 1 million people and caused over 1,800 deadls. Hurricane Sandy inundated parts of New York City, flooding subways and cutting ofTpower. Over fifty healdl care f;lcilities evacuated their patients during Sandy.

II- Thermal expansion and melting polar ice raise sea level, endangering people, animals, and crops in coastal areas worldwide. The city of Miami now has rq,'Ular sewer backups with high tide and a full moon.

It> 2012 and 201B together saw 21 U.S. weadler nesearchers have found that climate change may lead to more asthma- and climate disaster events that cost more related health problems in children, and more emergency room (ER) than $1 billion. The 201(3Moore, visits in the next decade. Oklahoma, tornado measured among the strongest tornadoes ever. I-IEAT\VAVES

It> Extreme weadler disasters not only cause In most years, heat waves are the leading killer among event-related deadl and iltiUry,but due to loss extreme weather events in the U.S. Extreme heat of homes, infrastructure and jobs, markedly events are rising in li-cquency, duration, and worsen social determinants of heald1. For magnitude. example, poverty levels rose significandy after Hurricane Katrina and have not returned to It> Effects of extreme heat range from cramps to baseline eight years later. These elTecL~are exhaustion and stroke. Heat stroke can result much worse on dlOse who are poorer at the in delirium, convulsions, coma, ;Uldeven time of the event. death.

It> In the 200::3European heat wave, an estimated 45,000 to 70,000 people died due

A FACTSHEET FROM PHYSICIANS FOR SOCIAL RESPONSIBLLlTY ______33

AIR POLLUTION malnourished. Climate change is expected to worsen this. Higher temperatures.increase ground-level ozone, a dangerous air pollutant. Almost half of Americans VECTOR c BORNE DISEASES live in urban areas that already f~lilto meet the health standards for ozone. Rising temperatures and c:hanges in precipitation expand the habitable areas for disease-carrying iii- Ozone exposure can reduce lung function, animals, including birds, rodents, snails, and insects. permanently damage lung tissue, provoke This can increase the spread of such diseases as new cases or asthma, and aggravate other yellow fever, Schistosomiasis, Lyme disease, tick. chronic lung diseases. Ozone also alfects the borne encephalitis, and hantavirus pulmonary cardiovascular system-and can increase tlle risk of dangerous heart arrhythmias. Further, ozone exposure increases the number of low birth-weight babies, currently the leading cause of inbnt mortality. Exposure to ozone in the first and third trimesters of pregmmcy call cause 20% intrauterine growth retardation. iii- Climate change is increasing tlle extent,intensity, and frequency of wildfires. The smoke contains particulates and toxic gases which aggravate health problems, including heart and lung diseases, infections, and emergency department visits.

II> The allergy Season will grow longer as OnLy lorty-six jJerwlt of peoj)Le in Africa luwe safe drinking water. ragweed and other pollens spread. Orban heat islands, pollutants, and allergens will syndrome. combine to aggravate asthma. II> Mosquitoes carry malaria, dengue lever, West Nile Virus, and other diseases. Higher temperatures boost their reproductive and WATERBORNE DISEASES biting rates, lengthen tlleir breeding season, ,md accelerate the maturation rate of the Increases in heavy rainfall, especially when malarial pathogen. Dengueor bone-break interspersed with periods of drought, can contribute fever is now present in Texas and Florida, as to flooding and contaminate water supplies. mosquitoes capable of carrying Ule disease D,lngerous waterboi"1lediseases include hepatitis, move north. giardiasis, cryptosporidiosis, and Naegleria fowleri - ••. According to the W orid Health the brain-eating amoeba. Organization, in 2010, 219 million people around Ule worid were infected and 660,000 II> Flooding can cause sewer over/lows, with died from malaria. As global warming potential increases in infectious diseases. continues, as many as 90 to 200 million Flooding can also cause injuries ,md deatlls, additional people may be at risk of malaria mold, psychological effects, ,Uld an increase by the latter half of this century. in the populations of rats, mosquitoes and other disease-bearing hosts.1n 2013, a thous,Uld-year flood in Colorado caused $2 AGRICULTURAL LOSSES billion in damage. Climate change threatens food supply through severe

II> Infectious diarrhea is one of the most storms, flooding, heat, drought, water evaporation, prevalent waterborne diseases globally. decreased pollination, and sea level rise. Severe diarrhea may be life-threatening, particularly in young children and Ule II>- Every I.8°}?increase in global average surl~lce temperature yields an estimated IQ% decline -- 34

in the world's me~jorgrain crops. II'wc continue buming lossilluels at our current In the short term we can adapt to climate change, rate, global temperatures may rise as much as applying tedmologies like barriers on coastlines and 5.4° to 9°F by the cnd of the century, with pumps to avoid sewer backup. But as thc climate 30% to 50% declines in crop production. heaL~up, the consequcnces will becomc catastrophic. The latest IPCC climate report wams that adaptation ••. W cather and rising temperatures can damage alone is not possible." livestock and fisheries as well as crops. Rapid To slow climate change, we must address tlle largcst warming will rorce farmers to keep changing what they grow as agricultural zones migrate sources of greenhouse gases. Small steps can help, and rapidly. some - such as bicycling and eating less meat and palm Higher food prices resulting /i'om diminished oil - also contribute to a healthier IilCstyle.But to have I()od security will rcduce the capacity or eUlimpact on a scale adequate to resolvc the problem, peoplc, especially the poor, to consume we must slash lossilluel combustion. This means nutritious diets. transitioning quickly to clean, sale renewable energies. All cnergy system based on wind, sun and water power ••. Nearly one-third of the world's land surface will allow us to reduce greenhouse gases and slow and may be at risk or extrcme drought by 2100. eventually stop c1imatc change. The use of rcnewable cnergies also reduces air and water pollution, contributing yet again to healthier conditions lor human lilC.

FOR FURTHER READING

All overview: McMichaell\J. 2013. Globalization, Climatc CheUlge,and HumeUl Health. Nl

• •• ••••••••••• •••••••• • •••••••••••••••••••••••••••••••••••••••• 1111 •••••• If you share tlle goal of reversing climate change, please join today.

Visit us at www.psr.org PHYSICIANS FOR SOCIAL REPONSIBILITY Like us. rT'weet us.

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May, 2011. 35 PSR" Climate Change and Health: PHYSICIANS FOR SOCIAL RESPONSIBILITY' Insect-borne Disease

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Climate change is acknowledged by scientists Climate Change Aids Mosquitoes around the world to be a reality and to be caused primarily by human activity, especially the burning As the climate changes, new temperature and rain of fossil fuels. As the earth warms, the delicate patterns will affect where mosquitoes live as well as balance of climate, weather events, and life is their breeding and feeding patterns. disrupted. Consequences emerge that threaten human health and, ultimately, survival. What is Higher temperatures: truly needed for health is restoration of a cool and • Expand the range of mosquitoes pole-ward stable climate. and to higher elevations, putting previously unexposed populations at risk. Climate Change Increases the • Boost reproduction rate, lengthen breeding Threat of Disease from Insects season, make mosquitoes bite more, and speed the development of the disease- Insects can carry and transmit numerous diseases to causing agents they carry (bacteria, viruses, humans. One concern about climate change is that it etc.) to an infectious state. increases the spread of these insects and the Rainfall: diseases they carry. • Standing water left by more intense and • Changing temperature and precipitation frequent rainfall, storms and hurricanes in shifts the geographic range in which insects many regions creates sites for mosquitoes live, resulting in expansion pole-ward and to breed. into higher elevations. • Individual diseases that are sensitive to heat Mosquitoes and Their Threat to Health and precipitation will have a larger range and longer lifespan. The insects that carry Mosquitoes are transmitters of several viruses that them may experience an increase in their can cause severe illness or death in humans, reproduction rate. including West Nile Virus, dengue fever, encephalitis, and malaria.

West Nile Virus • Between 1999 and 2012, about 37,000 cases of West Nile Virus were reported in the U.S., causing approximately 1,500 deaths annually. • There are no medications to treat or vaccines to prevent WNV infections • Approximately 80% of people who contract West Nile Virus do not show any symptoms.

PHYSICIANS FOR SOCIAL RESPONSIBILITY 36

Mosquito-borne Diseases, continued ...

Dengue Fever • Dengue fever can be transmitted by the Asian tiger mosquito, which is found in 36 countries. • The disease is now established in many countries of the Americas, including popular tourist areas. Cases have been found in Florida. Signs like the one above can alert you to tick-prone • The most serious form of dengue, known as areas and caution you about the diseases they can dengue hemorrhagic fever (DHF), can be carry. fatal. It kills about 5% of its victims, mostly children and young adults. How to Protect Yourself • Wear protective clothing and insect repellent Malaria to prevent insect bites. • In 2012 there were 207 million cases of • Check yourself and pets for ticks after being in malaria worldwide, causing some 627,000 wooded or grassy areas deaths, mainly in sub-Saharan Africa. • Take extra precautions from dusk to dawn, • Each year in the U.S. there is an average of when mosquitoes are most likely to bite. 1,500 reported cases of malaria, usually • Capture and remove or store water runoff that brought in by people who contracted the provides a breeding ground for mosquitoes. disease in a foreign country. • Repair damaged screens to prevent insects from coming inside your home. Climate Change and Ticks • Listen to warning systems and signs to be Ticks serve as "bridges," carrying diseases between aware of hazardous areas and outbreaks. affected animals and humans. Take action to reduce climate change! Lyme Disease To protect our world from the health effects of climate • Typical symptoms of this tick-borne disease change, we must take steps that restore the include fever, headache, fatigue, and a climate. This includes switching from fossil fuels to characteristic skin rash. If left untreated, safe clean renewable energy sources like sun, water infection can spread to joints, the heart, and and wind. Planting trees and protecting forests. the nervous system. Planning growth to assure efficient, convenient mass • Modeling indicates the tick that carries transit. Where conditions permit, walking and Lyme disease will reach north into Canada, bicycling more. We'll all live better on a cool, green, affecting previously unexposed populations. healthy planet!

Rocky Mountain Spotted Fever To learn more about what you can do, visit PSR's • Rocky Mountain Spotted Fever (RMSF) is a website: tick-borne disease that is potentially fatal. www.psr.org/environment-and-health/climate-change/ Typical symptoms include fever, headache, abdominal pain, vomiting, and muscle pain. • Untreated, RMSF can cause serious damage to internal organs, particularly the kidneys. • Despite its name, over half of U.S. cases occur in the South Atlantic states (Delaware PHYSICIANS FOR SOCIAL REPONS!IBILITY through Florida).

• Research suggests that, with warming 111114" 51. NW, Su'je 100 • Washington, bC ::10.005 trends, incidence of RMSF will increase in Telephone: (202) 661-4:160 • Fax: (202) 667-4201 • 'hW.".psr,o'll northern latitudes. 37

PI•. Climate Change and Health: PHYSICIANS FOR SOCIAL RESPONSIBILITY'

r:..'i. 11Jliti4lt" f'j k1;';ualtll"flll'hY'l<.!'Il", /

Climate change is real and is caused primarily by Heat and Health human activity, especially burning fossil fuels. As ocean and air temperatures rise, the delicate Extreme heat can cause a range of ailments: balance of climate, weather events and life is disrupted. Human health suffers as a result. What • Milder effects: rashes, cramps, heat exhaustion. is truly needed for health is a cool, stable climate.

• Severe effects: Heat stroke. This is a severe Climate Change and Heat Waves illness. Body temperature rises to 105°F or more and can be accompanied by delirium, A heat wave is an extreme convulsions, coma and even weather event when the death. temperature for a given region The risk of death from heat is unusually warmer than waves is higher for people with average, for a period lasting pre-existing heart conditions from a few day to months. and respiratory illnesses.

It is difficult to directly Hospitalizations for stroke and attribute a specific heat wave to cardiovascular disease also climate change. However, increase as temperature rises. scientists see a strong correlation. How serious is the threat? • For the 21st century, the Serious! 750 people died as a Intergovernmental Panel on result of heat-related illnesses in the 1995 Climate Change (IPCC) projects with 80% Chicago heat wave. confidence that extreme heat events will During the European heat wave in 2003, an intensify in magnitude and duration over estimated 70,000 people died from stroke, portions of the U.S. where they already occur. heart attack, lung disease, and other causes exacerbated by heat. • The IPCC is also "virtually certain" there will be a decrease in the frequency and magnitude Heat and Mental Health of cold days/night and increase in frequency and magnitude of unusually warm days/nights • Long-lasting bouts of heat exacerbate stress on a global scale. and symptoms of mental illness.

• Scientists estimate that human influence on • Heat waves have been shown to increase climate change more than doubled the violent behavior, suicide, and homicide. probability of the European heat wave of 2003.

PHYSICIANS FOR SOCIAL RESPONSIBILITY 38

How to Protect Yourself Take action to reduce climate change ~'. '<':':'''~'.'''''''''''''''''''-'"<-' ---=.:""""':'~~-<':':<':_":':<':'''~*'''':>-''''''''''''''''''''<'''''- ..,'''''_:<_.,.-.,'''''''-,,,,',~... ~."',,:,~.,, <',",,:=-

• Stay inside air conditioned homes or To protect our world from the health effects of shelters during heat waves climate change, we must take steps that restore the . climate. This includes switching from fossil fuels • Avoid physical exertion outdoors on hot to safe clean renewable energy sources like sun, days, especially if you have asthma water and wind. Planning future growth to ensure efficient, convenient mass transit. Where • Stay hydrated conditions pennit, walking and bicycling more. We'll all live better on a cool, green, healthy • Know the symptoms of heat exhaustion and . planet! heat stroke and seek medical attention: . Heat Exhaustion: To learn more about what you can do, see PSR's o Headache website: www.psr.org/environment-and-health o Dizziness o Dark colored urine o Rapid heartbeat o Profuse sweating o Confusion o Muscle cramps o Nausea o Fainting Heat Stroke (most of the above plus): o Lack of sweat o Red, hot, dry skin o Fainting and unconsciousness

Who is most vulnerable?

• The elderly, who have diminished ability to regulate body temperature and are more likely to suffer from poor health Get involved! • Babies and young children Anyone can become a member of • Pregnant and nursing mothers Physicians for Social Responsibility. If you • Those chronically ill with pre-existing share our goal of protecting our health cardiovascular, respiratory, neurologic, and from the threat of toxic chemicals, please psychiatric conditions, or obesity. join today! Visit us at www.PSR.org • Outdoor workers • Athletes, and children who are' active outdoors. • People who abuse drugs and alcohol • People without access to air conditioning including the poor and those in areas previously not warm enough to warrant air conditioning. • Urban populations. City environments PHYSICIANS FOR SOCIAL ,REPONSIBltlTY hold more heat and routinely experience

temperatures 2-10 degrees Fahrenheit 111114'" St, N'N, Suite lOa • Washinglon, bC 20005 wanner than surrounding areas. Telephone: (20.2) 667-'\:1;)0 • Fax; (202) 6G7.42(JI • YMw.psr.org 39 PSR' Climate Change and Health: PHYSICIANS FOR SOCIAL RESPONSIBILITY t', lNiPt~(o>Jf,>,. Wildfires www.psr.org

Climate change is real and is caused primarily by populations living in areas with higher fine human activity, especially burning fossil fuels. As particulate air pollution. ocean and air temperatures rise, the delicate balance of climate, weather events and life is disrupted. • Bums and death. Those who do not evacuate Human health suffers as a result. What is truly safely and firefighters are at risk of being burned needed for health is a cool, stable climate. or killed by wildfires. The 2013 wildfire in Arizona killed 19 firefighters.

• Damage to homes affects people's physical and mental health. It also impacts access to medical care.

How to Protect Yourself & Others

• If a wildfire occurs in your area, avoid outdoor activities. People with respiratory problems and chronic heart problems should consult with their doctor about taking extra precautions.

• If you must go outdoors in a smoky area, breathe Wildfires and Your Health through a damp cloth. While driving in smoky areas, keep windows and vents closed. Widespread fires have a major impact on human health and life. • Know evacuation routes. Listen to evacuation • Air pollution particles in smoke and ash can and safety advice if a wildfire occurs. cause coughing, irritated throat and sinuses, shortness of breath, chest pain, headaches, and • Be responsible with fire: stinging eyes. o Be cautious disposing cigarettes. o Only build fires in designated areas and • Smoke worsens respiratory conditions such as during permitted times. Do not leave allergies, asthma, or chronic obstructive campfires unattended. Extinguish them pulmonary disease. thoroughly. o Use spark arrestors on off-road vehicles. • Inhalation of carbon monoxide can aggravate angma. • Make sure trees and woody vegetation are a safe distance from your home. Stick to drought- • Chronic health effects include increases in resistant plants in your yard. cardiovascular disease and mortality in

PHYSICIANS FOR SOCIAL RESPONSBILITY 40

Climate Change Spurs Wildfires making them more prone to drought, and ultimately, wildfires. Wildfires are uncontrollable and unpredictable fires in natural landscapes. The frequency of large wildfires In addition, areas in the Western United States that and the area they bum has been increasing, especially already naturally experience fires, are experiencing in the western United States. Climate change is major decreased precipitation. In recent years, this region contributor to this increase, for a number of reasons. has been experiencing drought conditions, drying out vegetation -- and dry plant matter bums at higher temperatures. Combined with large quantities of fuel, Warmer Temperatures this can lead to catastrophic fires. Average global temperatures have increased by 1.2°C over the past century, primarily because of increasing heat-trapping greenhouse gases, including carbon Take action to reduce climate change dioxide. To protect our world from the health effects of As global temperatures rise, fire seasons become climate change, we must take steps that restore the longer as wanner temperatures begin earlier and climate. This includes switching from fossil fuels to extend into the fall. safe clean renewable energy sources like sun, water and wind. Plmming future growth to ensure efficient, convenient mass transit. Where conditions pennit, walking and bicycling more. We'll all live better on a cool, green, healthy planet!

To learn more about what you can do, see PSR's website: www.psr.org/environment-and-health

Get involved! Anyone can become a member of Physicians for Social Responsibility. If you share our goal of protecting our health from climate Insects change, please join today! Visit us at Higher temperatures allow for a longer lifecycle for www.PSR.org beetles and other insects that eat trees. Dry conditions also weaken trees and make it easier for theses insects to damage them further, resulting in dead and highly combustible plants. ~ M 985' 1m!. Drier Conditions " PEACE Snow packs are now melting up to four weeks '<:: J>RIZ~ PSR" " earlier than they did 50 years ago, due to wanner temperatures. The water these snow packs supply PHYSICIANS FOR SOCIAL REPONSIBILITY u.s. nffi',are of InrmlUlIOnal Ph}'!!c',oJUforrh" Pfiwr.rion

PHYSICIANS FOR SOCIAL RESPONSBILITY 41 PSI[ Climate Change and Health: PHYSICIANS FOR SOCIAL RESPONSIBILITY Climate Change l;,,~ {;jfi/Wll" fit tYlj,"t(;/ijipM1 j'h)'tfMIUJVf Ihl' J~n'hl(l(m (<) ,V'Mlu" V,iIY, Tfn/I! •.••II.>/ l!;f !!<,{~X,..hll'il~f"i"> j-'{'ija www.psr.org Contaminates Your Water

Climate change is real and is caused primarily by Some regions, like the Midwest, have experienced human activity, especially burning fossil fuels. As alternating patterns of flooding and drought. Drought ocean and air temperatures rise, the delicate balance reduces the earth's ability to absorb the water. When of climate, weather events and life is disrupted. precipitation falls as more intense storms or as Human health suffers as a result. What is truly hurricanes that can cause flooding and jeopardize needed for health is a cool, stable climate. water quality. • In rural areas, water runoff picks up animal Climate Change and Waterborne wastes, pesticides, and fertilizers. Diseases • In cities, runoff both Climate change is making carries pollutants and heavy intense downpours, overwhelms sewage droughts and rising water systems, causing temperatures more common. untreated sewage to This can alter the quality of our flow into drinking and drinking and recreational recreational water water. Bacteria and viruses sources. thrive in these new conditions and when they come into Drought Disrupts contact with humans, can cause Water, Food, and numerous illnesses. Lack of Health water can also impact human health, especially in drought conditions. Some regions, such as the Southwest U.S. and at times the Midwest, will experience decreased Flooding and Runoff Contaminate Water precipitation and longer, more frequent droughts. Contamination of drinking water by bacteria, viruses, These conditions can also impact waterborne disease. and protozoa can trigger outbreaks of illnesses such • As water sources decline, the concentration of as the diarrheal diseases legionella, campylobacter, contaminants increases, making them more and cholera. likely to affect human health. • From 2009-2010,33 water-associated disease outbreaks were reported in the U.S. They • Lack of clean water prevents adequate caused 1,040 cases of illness, 85 hospitaliza- hydration and disrupts good hygiene. tions, and nine deaths. • Periods of drought impact crops and livestock Many regions of the world, including the Northeast production and increase the price of food. and Southern Great Plains of the United States, have experienced an increase in precipitation. This is • Severe drought can also create dust-storm expected to continue as climate change persists. conditions, which can increase the risk of respiratory infections and exacerbate asthma.

PHYSICIANS FOR SOCIAL RESPONSIBILITY 42

The Dying Oceans • Listen to warnings about pollution and outbreaks of illnesses related to water. The vast oceans are not immune to climate change. Rising carbon dioxide emissions increase ocean o Avoid pollution-prone beaches and temperatures and acidity. lakes when notified, especially after rainfall. • The combination of higher surface water and increased nutrient loading from agricultural • Take government or medically advised runoff contribute to harmful algae blooms precautions when contamination is detected in that produce biotoxins. drinking water, such as boiling the water before use. • Consumption of fish or shellfish contaminated with toxins can cause neurological damage, respiratory harm, skin irritations and diarrhea. Take action to reduce climate change

• Increases in ocean acidity threaten coral reefs To protect our world from the health effects of and the future of shellfish like oysters, clams, climate change, we must take steps that restore the and mussels. Where people depend heavily climate. This includes switching from fossil fuels to on seafood for food and income, incomes and safe clean renewable energy sources like sun, water nutrition are both likely to suffer. and wind. Planning future growth to ensure efficient, convenient mass transit. Where conditions pennit, walking and bicycling more. We'll all live better on a cool, green, healthy planet!

To learn more about what you can do, see PSR's website: www.psr.org/environment-and-health

Get involved! Anyone can become a member of Physicians for Social Responsibility. If you share our goal of protecting our health from How to protect yourself and your planet climate change, please join today! Visit us at www.PSR.org • Decrease your household water use, especially during periods of drought. • Listen to federal, state, and local fish consumption advisories for fish that are unsafe to eat. o Limit consumption of fish that "I,'., .. ~:...: "'~'... ;a.:.-.'":.'..i".'""",g, typically have higher levels of ~)~\;~ mercury. These include tuna, ~'j~ swordfish, mackerel, sea bass, and PHYSICIANS FOR SOCIAL REPONSIBILITY grouper. 111114';'Sl.NW,Suile70D • Washlng!oo,DC2D005 o If pregnant, avoid completely fish Telephon", (202) 6674250 • Fox: (20'2) 607-4201 • www,psr.org with the highest amount of mercury. 43

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limate change is already threatening the ~ Heavy rains and storms flooding fields, eroding soils

! Earth's ability to produce food. These effects and washing away crops are expected to worsen as climate change C ~ Melting glaciers and changing river flows reducing worsens. Estimates vary, but for every I.SeF increase water availability for irrigation in global average surface temperature, we can expect about a 10% decline in yields of the world's major ~ Rising sea levels and storm surges flooding crops grain crops- corn, soybean, rice and wheat',2 Climate and salting soils experts predict that global temperature may rise as ~ Higher ozone levels damaging plants and reducing much as 5.4eF to geF if we continue burning fossil crop yields fuels at our current rate.3 This could lead to 30% to 50% declines in crop production.! Already, one in seven people, including many living in the U.S., is hungry every day.4 Most models only consider the effect of rising rtISIC\'!G v~r~10'[s!lAiUt'las:The effects of warmer temperatures and carbon dioxide (C0 ) levels on 2 temperatures on crop production will vary by region crop growth, and thus represent relatively conservative and crop, but almost all estimates indicate eventual scenarios. Climate change will disrupt food production reduced overall crop yields.I,5 Higher temperatures and distribution in other waysthat are hard to quantifY decrease rates of photosynthesis, reduce soil moisture, and include in prediction models, such as: increase water demand and lead to increased survival ~ More droughts causing large-scale crop loss of plant pests, diseases and weeds-all of which combine to reduce final yields. 1,5,G,7 ~ Increasing frequent, severe, and longer-lasting heat waves killing crops INCrtt:ASIMG CO2: In certain plants, like wheat,

~ Thriving plant pests and diseases destroying crops soybeans and rice, higher CO2 levels actually increase

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Thirty percent oj Russia's wheat crop was lost tofire 2010. Climate change will disrupt food production and distribution.

L , .__ _ • , A ~~ ~ __ • ,,~._= A FACTSHEET FROM PHYSICIANS FOR SOCIAL RESPONSIBiliTY 44

growth by the "C02 fertilization effect". 1,2.6Higher variations in yields.5.IOEighty percent of agriculture CO2 levels increase photosynthesis and reduce plant is rain-fed and especially susceptible to drought,5 but water loss, 1,5.6However most experts agree that the even irrigated agriculture is threatened by drought CO2-related benefits on some crops will be outweighed as stored water supplies are depleted.loThe area of by other negative effects of climate change as global land producing major crops (corn, rice, soy, wheat, temperatures continue to rise.2.8,9 sorghum and barley) affected by drought has risen from 5-10% in the 1960s to 15-25% today.12 INCREASING TEMPERATURE EXTREMES: An increase in the number of days of extreme heat leads HEAVY RAINS, FLOODS AND TROPICAL STORMS: to large declines in crop yields, especially when they Extreme rainfall events and intensity of tropical occur during key stages of plant development such as storms is increasing.5 Rainfall intensity could increase flowering and grain-filling.1.5.19Extreme heat damages by 25% in many agricultural areas.5 Heavy rainfalls photosynthetic and reproductive cells, causing reduce crop productivity by a number of mechanisms. decreased growth and sterility, and can decrease Flooding wipes out vast areas of crops and damages grain quality.5.6.IO,11 others. In Bangladesh in 2007, cyclone Sidr damaged 1.6 million acres of cropland and over 25% of the rice INCREASING DROUGHT: Climate change will cause crop.13 Heavy rains also cause significant soil erosion more frequent, severe and long-lasting droughts. Many reducing long-term productivity. Waterlogged soils of the largest crop losses in history can be attributed reduce plant growth and increase fungal diseases.5.6 to drought and it is the main cause of year-to-year Farming operations are often delayed when soils

u.s. Drought Monitor hllp:/ / droughlmonilor,unl.edu/ archive .hlml

~ Drought Impact Types' DO Abnormally Dry o r-' Delineates dominant impacts o 01 Drought - Moderate S' Short-Term, typically <6 months D 02 Drought - Severe (e.g. agrlcutture, grasslands) C 03 Drought. Extreme L' Long-Term, typically >6 monlhs • 04 Drought - Exceptional (e.g. hydrology, ecology)

The Drought Monitor focuses on broad-scale conditions. Local conditions may vary. See accompanying text summary Released Thursday, August 30,2012 for forecast statements. Author: Brian Fuchs, National Drought Mitigation Center

Fifty percent of cropland had significant drought in 2012. 45

are too wet for heavy machinery and flooding can destroy farming supplies, machinery and other infrastructure.5 Finally, coastal storm surges contribute to soil salinization making widespread areas unfit for planting.5

MELTING GLACIERS AND CHANGING RIVER FLOWS: Glaciers are a critical water supply for drinking and irrigation but the majority of the world's glaciers are shrinking.14Glacier runoff provides water through the year where rainfall is limited, allowing I irrigation during dry seasons.5 Receding glaciers threaten large rivers, such as the Ganges, Indus and Brahmaputra in India, on which over 500 million J people depend, to become seasonal-devastating Corn crop under water regional agriculture if adaptations are not made.5.15

SEA LEVEL RISE: As sea levels rise, low-lying coastal Conclusion agriculture in major river deltas and small island nations is especially vulnerable.5 Rising seas and Farmers are resilient and frequently adapt to changes storm surges will inundate agricultural lands, and in weather. However, climate change will create salinization of soils and aquifers will threaten conditions outside of human experience, challenging agriculture.5 farmers' ability to adapt.5While farmers with more wealth and resources are more likely to be able to PESTS AND DISEASES: Many crop pests, such adapt to a changing climate through investments as aphids and weevils, grow better and live in a in new technologies, seed varieties and cropping wider range of areas in warmer temperatures patterns, poorer subsistence farmers will be less likely 5 to adapt and are thus more vulnerable. .2•G Regardless and higher C02levels. Changes in climate also ' shift the geographic range and frequency of crop of wealth, complete adaptation is not possible. diseases, altering the predictability of outbreaks.2,5.'7 Increasing extreme weather events has the potential Environmental stresses may cause mutations in crop to devastate infrastructure of the entire food system.IO diseases that increase their destructiveness. Heat Storms and flooding can destroy food processing, and water stress reduce crop resistance to pests and packaging and storage facilities and disrupt diseases.5 transportation infrastructure such as roads, bridges, railways, airports and shipping routes preventing WEEDS: Certain invasive weeds, such as privet and available food from getting to where it is needed.,o.17 kudzu in the United States, benefit from increasing Though this fact sheet focuses on agricultural temperatures and CO2 levels more than crops.17There crops, they are only one part of the food supply. The is evidence that herbicides may lose effectiveness changing climate also affects animal production. 17 at elevated CO2 levels. As increasing amounts of Decreasing supply and increasing prices of feed herbicide are required to maintain productivity, grains will increase the price of meat. 1.9Temperature significant economic, environmental and healt.h costs extremes will increase animal deaths and the cost of will resultP cooling animal facilities.1.9Rising temperatures and changing rainfall patterns will alter the distribution INCREASING OZONE: Ground-level ozone is a of animal diseases such as anthrax and blackleg, major air pollutant that results from burning fossil potentially reducing production.9 The overall impact fuels.9 Ozone inhibits photosynthesis and stunts on fisheries is uncertain, however a 40% catch decline plant growth.5.G•9Current ozone levels are already is expected in the tropics as commercial species move suppressing yields of many crops (alfalfa, beans, north out of warming waters. I peanut, potato, rice, soy and wheat) and these effects Food prices will rise as climate change reduces will worsen as ozone levels continue to rise.9 the amount of food available. And people get angry, even violent, when food becomes more expensive. 46

In 2008, world wheat, rice, corn and soybean prices 7. Ziska LH, Blumenthal DM, Runion GB, Hunt ER, Diaz-Soltero H. Invasive Is species and climate change: An agronomic perspective. Clim Change. tripled. Food riots erupted across Egypt, Yemen, 2011;105:13-42. Morocco, Cameroon, Senegal, Ethiopia, Haiti, 8. Long SP, Ainsworth EA, Leakey AD, Morgan PB. Global food insecurity. Indonesia, MexiCo,and the Philippines. IS Social order treatment of major food crops with elevated carbon dioxide or ozone unraveled as armed Thai villagers guarded their rice under large-scale fully open-air conditions suggests recent models may have overestimated future yields. Phi/os Trans R Soc Lond 8 Bioi Sci. fields against rice rustlers; grain trucks were hijacked 2005;360( 1463):2011-2020. in Sudanese refugee camps; Pakistani troops had to 9. United States Department of Agriculture (USDA). Climate chonge ond ogriculture in the United Stotes: Effects and odoptation. 2013;USDA guard grain elevators and wheat trucks. IS There is Technicol Bulletin 1935:1-186. concern about increased conflict and violence as food 10. Handmer J, Honda Y, Kundzewicz ZW, et 01. Changes in impacts of climate supplies constrict. extremes: Human systems and ecosystems. In: Managing the risks of Already one billion people in the world go hungry extreme events and disasters to advance climate change adaptation. A special report of working groups I and II of the intergovernmental panel on every day-that's one in every seven people. IS Every climate change (IPCe). 2012: year one third of child deaths are caused in part by 231-290. 11. Teixeira EI, Fischer G, van Velthuizen H, Walter C, Ewert F. Global hot- under-nutrition. 19 World population continues to spots of heat stress on agricultural crops due to climate change. Agric For 20 grow and is expected to reach 9 billion by 2050. To Meteorol.2013;170(15):206-215. feed this many people and their rising demand for 12. Li YP, Ye W, Wang M, Yon XD. Climate change and drought: A risk animal products, overall food production must rise assessment of crop yield impacts. Clim Res. 2009;39:31-46. by 70% from 2005-07 levels.20 But a 5°F to gOFrise in 13. United Nations. Cyclone Sidr United Nations rapid initial assessment report. 2007. http://ochaonline.un.org/News/Natural Disasters/Bangladesh/ global average temperature could reduce grain yields tabid/2707/Default.aspx by 30% to 50%, and global food supplies even more. 14. Zemp M, et.al. Global glacier changes: Facts and figures. UNEP world The combination of decreasing food production glacier monitoring service. 2008. 15. Kehrwald NM, Thompson LG, Yao TD, et 01. Mass loss on Himalayan glacier in the face of increasing food demand would likely endangers water resources. Geophys Res Lett. 2008;35(L22503). lead to widespread social unrest and hunger-even 16. Gregory PJ,Johnson SN, Newton AC, Ingram JS. Integrating pests and catastrophic global famine. pathogens into the climate change/food security debate. J Exp Bot. 2009; This is the future that awaits us if we fail to act. But 60:2827 -2838. 17. Hatfield J, Takle G, Grot john R, et 01. Chapter 6: Agriculture. we can rewrite the future from this grim view IF we In Draft of National climate assessment development. 2013; 11 Jan:227- work to create many solutions, from efficiencies to new 261. http://ncadac.globalchange.gov / download/NCAJan 11-2013. renewable energy, to reduce greenhouse gas emissions p ubl icrevi ewd raft-cha p6-a g ricu Itureopdf 18. Brown L. World on the edge: How to prevent environmental and economic by 80% by 2050. To find out how you can get involved collapse. First ed. New York, NY: W.W. Norton & Company, Inc.; in making a better future, visitWww.PSR.ORG to 2011:240. discover actions going on in your area. 19. United Nations Inter-Agency Group for Child Mortality Estimation. Levels and trends in child mortality. Report 2011. 2011: 1- 19. 20. Food and Agricultural Organization (FAO), Office of the Director, Agricultural Development Economics Division Economic and Social Development Department. High level expert forum-How to feed the world 2050.2009. Endnotes

1. Committee on Stobilizotion Torgets for Atmospheric Greenhouse Gas Concentrations, Board of Atmospheric Sciences and Climate, Division of Earth and Life Studies, National Research Council. Climate stabilization targets: Emissions, concentrations, and impacts over decades to millennia. National Academies of Sciences. 2011. 2. Henson R. Warming world: Impacts by a degree. National Academies of Sciences. 2011. 3. National Research Council (NRC). Advancing the science of climate change. National Academies of Sciences. 2010. 4. Food and Agriculture Organization of the United Nations. The State of Food Insecurity in the World. 2012. PSR PHYSICIANS FOR SOCIAL RESPONSIBILITY' 5. Gornall J, Betts R, Burke E, et 01. Implications of climate change for U,S, al/Illalr of blltftlill"",al/'Il"s;(I(III"jor Iht /'UlJrtllifJIl "I .vurltm" WfII, rrrtJ)/fli/ oj tilt 19lJ5 ,\'llb,1J',iu fm' Pracr agricultural productivity in the early twenty-first century. Philos Trans R Soc Lond 8 8iol Sci. 2010;365(1554):2973-2989. 1111 14th St, NW, Suite 700 • Washington, DC 20005 6. Lobell DB, Gourdii SM. The influence of climate change on global crop Telephone: (202) 667-4260 • Fax: (202) 667-4201 • Web: www.psr.org productivity. Plant Physio/. 2012;160(4):1686-1697.