Evaluating an equity-focused approach to assess climate resilience and disaster priorities through a community survey.

As the Duwamish Valley community in Seattle, Washington, U.S.A. and other environmental justice communities nationally contend with growing risks from climate change, there have been calls for a more community-centered approach to understanding impacts and priorities to inform resilience planning. To engage community members and identify climate justice and resilience priorities, a partnership of community leaders, government-based practitioners, and academics co-produced a survey instrument and collected data from the community using the Seattle Assessment for Public Health Emergency Response (SASPER), an approach adapted from the Centers for Disease Control and Prevention's Community Assessment for Public Health Emergency Response (CASPER). In addition, we conducted a process and outcome project evaluation using quantitative survey data collected from volunteers and qualitative semi-structured interviews with project team members. In October and November 2022, teams of volunteers from partner organizations collected 162 surveys from households in the Duwamish Valley. Poor air quality, extreme heat, and wildfires were among the highest reported hazards of concern. Most Duwamish Valley households agreed or strongly agreed that their neighborhood has a strong sense of community (64%) and that they have people nearby to call when they need help (69%). Forty-seven percent of households indicated willingness to get involved with resilience planning, and 62% of households said that they would use a Resilience Hub during an emergency. Survey volunteers evaluated their participation positively, with over 85% agreeing or strongly agreeing that they learned new skills, were prepared for the survey, and would participate in future assessments. The evaluation interviews underscored that while the SASPER may have demonstrated feasibility in a pre-disaster phase, CASPER may not meet all community/partner needs in the immediate disaster response phase because of its lack of focus on equity and logistical requirements. Future research should focus on identifying less resource intensive data collection approaches that maintain the rigor and reputation of CASPER while enabling a focus on equity.

After the fire: A qualitative study of the role of long-term recovery organizations in addressing rural communities' post-wildfire needs.

U.S. wildfire activity has increased over the past several decades, disrupting the systems and infrastructure that support community health and resilience. As the cumulative burden of wildfire damage is projected to increase, understanding an effective community recovery process is critically important. Through qualitative interviews with leaders of long-term recovery organizations (LTROs), a key component of wildfire recovery, we explored barriers and facilitators to LTROs' ability to support post-wildfire needs among rural communities. Between February-May 2022, we conducted surveys and semi-structured interviews with 18 leaders from six LTROs serving rural communities in Washington, Oregon, and California impacted by wildfires between 2015-2020. The Robert Wood Johnson Foundation's Culture of Health Framework informed the semi-structured interview guide and a priori codebook, to examine LTROs' ability to address post-wildfire community needs from a health equity perspective. Additional codes were added through an inductive approach, and emerging themes were identified. Our findings indicate that LTROs face many barriers in addressing community needs post-wildfire, including the policies governing access to and the slow arrival of recovery resources, the intertwined nature of community economic health and built environment restoration, and the challenge of forming a functional LTRO structure. However, participants also identified facilitators of LTROs' work, including the ability of LTROs and their government partners to adapt policies and procedures, and close collaboration with other community organizations. Factors both internal and external to the community and LTROs' organizational characteristics influence their ability to address community needs, essential to health, post-wildfire. This study's findings suggest the need for policy improvements to promote more equitable recovery resource access, that economic recovery should be a core LTRO function, and that recovery planning should be incorporated into community disaster preparedness activities. Future research should focus on LTROs' role in other contexts and in response to other disasters.

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.

Barriers and facilitators to state public health agency climate and health action: a qualitative assessment.

BACKGROUND: As the health implications of climate change become more apparent, agencies and institutions across the United States are developing recommendations for state and territorial health agencies (S/THAs) to implement evidence-informed climate and health adaptation strategies. The CDC established the Building Resilience Against Climate Effects (BRACE) framework in 2010 to encourage local and state public health engagement in climate change adaptation. However, even after a decade of the BRACE initiative, the elements that affect the adoption and implementation of climate and health programming by S/THAs are not well understood. METHODS: Using an implementation science framework, this study sought to further understand and define the barriers and facilitators that determine the breadth and success of climate change and health activities undertaken by state health agencies (SHAs). We conducted focus groups with representatives from SHAs with and without climate and health programs, and analyzed data using the framework method for qualitative research. RESULTS: This study identified funding, state and agency-level prioritization, staff capability and capacity, and political will and polarization as factors that influence the readiness for implementation and implementation climate for climate and health activities. CONCLUSIONS: As the impacts of climate change intensify, S/THAs will need to expand resources and capacity, and seek advocacy and assistance from external organizations in order to support the level of engagement required to strengthen climate resilience. Findings from this study have implications for public health policy and highlight potential pathways to expand support for climate and health activities in S/THAs in the U.S.

From pity to fear: security as a mechanism for (re)production of vulnerability.

Vulnerability is not only a shared basic condition, but also a condition of potential. In the context of disasters and crises, the concept of vulnerability is frequently used to portray individuals and groups as 'weak', 'threatened', and 'in need of help'. Occasionally, though, a shift occurs and the 'threatened'-and therefore usually the pitied-become those who are feared and hated, that is, they become a 'threat'. This paper explores how apparently incompatible discursive regimes of 'threatened' and 'threat' intertwine, merge, and feed upon each other, and how vulnerability can be and is consequently securitised. It demonstrates that too often the freedoms and opportunities prescribed by the neoliberal state are impossible to actualise when 'normality' and hence 'otherness' are also defined by the state, where people are first and foremost subjects of a global market. These considerations are critical if we are truly to reduce vulnerabilisation by focusing on justice.

Do actions reduce perceived risk? A longitudinal analysis of the relationship between risk perception and actions in response to forest disturbance in Colorado.

As residents living in hazard-prone areas face on-going environmental threats, the actions they take to mitigate such risks are likely motivated by various factors. Whereas risk perception has been considered a key determinant of related behavioral responses, little is known about how risk mitigation actions influence subsequent perceived risk. In other words, do actions to prevent or mitigate risk reduce risk perception? This longitudinal study considers the dynamic relationships between risk perception and risk-mitigating behavior in the context of forest disturbance in north-central Colorado. Based on panel survey data collected in 2007 and 2018, the results provide a first look at changes in perceived forest risks as they relate to individual and community actions in response to an extensive mountain pine beetle outbreak. Analysis revealed that the perception of direct forest risks (forest fire and falling trees) increased, whereas indirect forest risk perception (concern on broader threats to local community) decreased across the two study phases. Higher individual or community activeness (level of actions) was associated with subsequent reductions in perceived forest fire risk, smaller increases in direct risk perception, and larger decreases in indirect risk perception. These findings contribute insights into the complex risk reappraisal process in forest hazard contexts, with direct implications for risk communication and management strategies.

A Review of Public Health Emergency Preparedness and Response (PHEPR) Curricula in US CEPH-Accredited Schools and Programs of Public Health.

OBJECTIVE: To assess the current state of graduate-level disaster-related curricula (i.e., Masters and Doctoral programs, degree concentrations, and graduate certificates) offered by the Council on Education for Public Health (CEPH)-accredited public health schools and programs in the US. METHODS: This research reviewed, evaluated, and summarized the content of websites of all US-based CEPH-accredited schools and programs to identify disaster-related degree programs, degree concentrations and graduate certificates from April - June 2021. RESULTS: Of 191 schools and programs reviewed, 29 (15%) offered disaster-related curricula, totaling 44 degrees and programs. Programs included Masters-level degrees and Masters/ Doctoral degree concentrations, with the majority taking the form of graduate certificates (64%). Schools that offered disaster-related curricula were clustered in eastern and Gulf states. CONCLUSION: Most US CEPH-accredited schools and programs do not offer graduate-level disaster-focused curricula. Of the programs offered, far fewer opportunities exist for in-depth graduate-degree level training compared to certificate-level training. Additionally, programs are constrained to certain areas of the country. Our findings suggest a need for disaster and public health emergency-related curricula development within schools and programs of public health to meet the growing needs of communities affected by disasters and emergencies.

Challenges to evidence-informed decision-making in the context of pandemics: qualitative study of COVID-19 policy advisor perspectives.

INTRODUCTION: The exceptional production of research evidence during the COVID-19 pandemic required deployment of scientists to act in advisory roles to aid policy-makers in making evidence-informed decisions. The unprecedented breadth, scale and duration of the pandemic provides an opportunity to understand how science advisors experience and mitigate challenges associated with insufficient, evolving and/or conflicting evidence to inform public health decision-making. OBJECTIVES: To explore critically the challenges for advising evidence-informed decision-making (EIDM) in pandemic contexts, particularly around non-pharmaceutical control measures, from the perspective of experts advising policy-makers during COVID-19 globally. METHODS: We conducted in-depth qualitative interviews with 27 scientific experts and advisors who are/were engaged in COVID-19 EIDM representing four WHO regions and 11 countries (Australia, Canada, Colombia, Denmark, Ghana, Hong Kong, Nigeria, Sweden, Uganda, UK, USA) from December 2020 to May 2021. Participants informed decision-making at various and multiple levels of governance, including local/city (n=3), state/provincial (n=8), federal or national (n=20), regional or international (n=3) and university-level advising (n=3). Following each interview, we conducted member checks with participants and thematically analysed interview data using NVivo for Mac software. RESULTS: Findings from this study indicate multiple overarching challenges to pandemic EIDM specific to interpretation and translation of evidence, including the speed and influx of new, evolving, and conflicting evidence; concerns about scientific integrity and misinterpretation of evidence; the limited capacity to assess and produce evidence, and adapting evidence from other contexts; multiple forms of evidence and perspectives needed for EIDM; the need to make decisions quickly and under conditions of uncertainty; and a lack of transparency in how decisions are made and applied. CONCLUSIONS: Findings suggest the urgent need for global EIDM guidance that countries can adapt for in-country decisions as well as coordinated global response to future pandemics.

Native Americans: Where in Environmental Justice Research?

While the last two decades have seen important theoretical, empirical, and policy advancements in environmental justice generally, much remains to be done regarding Native Americans. Unique political and cultural dynamics shape the study and pursuit of environmental justice (EJ) in Native American communities. This review summarizes Native American EJ issues based on a cross-disciplinary search of over 60 publications. In so doing, we discuss the unique nature of Native American EJ in terms of conducting research and working toward reducing the continuation of historical trauma associated with environmental ills, the types of strategies used in Native American EJ research, and issues of Native American climate justice. We conclude with discussion of remaining knowledge gaps and future research needs.