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

ABSTRACT

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.