Climate Change Adaptation Activities and Needs in US State and Territorial Health Agencies.

OBJECTIVE: To characterize US State and Territorial Health Agencies' (S/THA) climate change adaptation activities and priorities to facilitate appropriate investments, skills development, and support that will strengthen health sector capacity in response to a changing climate. DESIGN: In 2021, we conducted an online survey of S/THA staff requesting information on current activities related to climate change and health, the state of climate and health programming, and anticipated needs and priorities for assistance. We analyzed survey results using descriptive statistics. SETTING: US State and Territorial Health Agencies. PARTICIPANTS: We received responses from 41 of 59 S/THAs (69.5%). MAIN OUTCOME MEASURES: Implementation of S/THA climate and health programs (CHPs); engagement in climate and health activities; maintenance of hazard early warning systems and action plans; employment of climate and health communications strategies; capability to assess risks and adaptation needs related to various climate-sensitive conditions; priorities and plans for climate change adaptation in relation to climate-sensitive health risks; climate change adaptation-related partnerships and collaborations; requests of the Association of State and Territorial Health Officials (ASTHO) for advancing climate change adaptation activities; and the impacts of the COVID-19 pandemic on climate change work. RESULTS: Nineteen S/THAs reported having CHPs, the majority of which are federally funded. On average, S/THAs without CHPs reported engagement in fewer climate and health activities and more early warning activities. The S/THAs reported the highest levels of concerns regarding non-vector-borne infectious disease (66%), vector-borne infectious diseases (61%), and extreme heat (61%) hazards. CONCLUSIONS: As S/THAs with CHPs report substantially greater climate and health capacity than those without, additional federal and state investments (eg, Building Resilience Against Climate Effects [BRACE]) are urgently needed to catalyze climate and health capacity.

Adapting by Their Bootstraps: State and Territorial Public Health Agencies Struggle to Meet the Mounting Challenge of Climate Change

PREPAREDNESS GAPS IN THE PUBLIC HEALTH SYSTEM Concomitantly, the health effects of climate change and the need for public health system engagement are increasingly apparent. The primary federal effort to build state and local climate and health capacity has been the Centers for Disease Control and Prevention (CDC) Climate-Ready States and Cities Initiative, which has funded a handful of jurisdictions to implement its Building Resilience Against Climate Effects framework.8 Through its preparedness mandate, the CDC established this framework to provide guidance for state, territorial, and local health agencies in developing and implementing climate change adaptation activities. A lack of sufficient and sustained investments has forced STHAs to master the art of doing more with less;we can only begin to imagine what these agencies could do to prepare for and respond to the health effects of climate change with investments proportional to the magnitude of the threat. CONCLUSION Climate change is stressing our public health system, which is already on the precipice, by exacerbating health disparities, damaging health care facilities and resources, and stretching personnel and capabilities to their limits.

Epidemiological versus meteorological forecasts: Best practice for linking models to policymaking

Weather forecasts, climate change projections, and epidemiological predictions all represent domains that are using forecast data to take early action for risk management. However, the methods and applications of the modeling efforts in each of these three fields have been developed and applied with little cross-fertilization. This perspective identifies best practices in each domain that can be adopted by the others, which can be used to inform each field separately as well as to facilitate a more effective combined use for the management of compound and evolving risks. In light of increased attention to predictive modeling during the COVID-19 pandemic, we identify three major areas that all three of these modeling fields should prioritize for future investment and improvement: (1) decision support, (2) conveying uncertainty, and (3) capturing vulnerability.

Guidelines for Modeling and Reporting Health Effects of Climate Change Mitigation Actions.

BACKGROUND: Modeling suggests that climate change mitigation actions can have substantial human health benefits that accrue quickly and locally. Documenting the benefits can help drive more ambitious and health-protective climate change mitigation actions; however, documenting the adverse health effects can help to avoid them. Estimating the health effects of mitigation (HEM) actions can help policy makers prioritize investments based not only on mitigation potential but also on expected health benefits. To date, however, the wide range of incompatible approaches taken to developing and reporting HEM estimates has limited their comparability and usefulness to policymakers. OBJECTIVE: The objective of this effort was to generate guidance for modeling studies on scoping, estimating, and reporting population health effects from climate change mitigation actions. METHODS: An expert panel of HEM researchers was recruited to participate in developing guidance for conducting HEM studies. The primary literature and a synthesis of HEM studies were provided to the panel. Panel members then participated in a modified Delphi exercise to identify areas of consensus regarding HEM estimation. Finally, the panel met to review and discuss consensus findings, resolve remaining differences, and generate guidance regarding conducting HEM studies. RESULTS: The panel generated a checklist of recommendations regarding stakeholder engagement: HEM modeling, including model structure, scope and scale, demographics, time horizons, counterfactuals, health response functions, and metrics; parameterization and reporting; approaches to uncertainty and sensitivity analysis; accounting for policy uptake; and discounting. DISCUSSION: This checklist provides guidance for conducting and reporting HEM estimates to make them more comparable and useful for policymakers. Harmonization of HEM estimates has the potential to lead to advances in and improved synthesis of policy-relevant research that can inform evidence-based decision making and practice. https://doi.org/10.1289/EHP6745.

Health Risks Due To Climate Change: Inequity In Causes And Consequences

Climate change has altered global to local weather patterns and increased sea levels, and it will continue to do so. Average temperatures, precipitation amounts, and other variables such as humidity levels are all rising. In addition, weather variability is increasing, causing, for example, a greater number of heat waves, many of which are more intense and last longer, and more floods and droughts. These changes are collectively increasing the number of injuries, illnesses, and deaths from a wide range of climate-sensitive health outcomes. Future health risks will be determined not just by the hazards created by a changing climate but also by the sensitivity of individuals and communities exposed to these hazards and the capacity of health systems to prepare for and effectively manage the attendant risks. These risks include deaths and injuries from extreme events (for example, heat waves, storms, and floods), infectious diseases (including food-, water-, and vectorborne illnesses), and food and water insecurity. These risks are unevenly distributed and both create new inequities and exacerbate those that already exist. Most of these risks are projected to increase with each additional unit of warming. Using an equity lens to move beyond incremental to transformational resilience would reduce vulnerability and improve sustainability for all, but substantial additional funding is required for proactive and effective actions by the health system.