PDF Integration of Public Health with Adaptation to Climate Change: Lessons Learned and New Directions

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Physical Injuries Extreme storms, flooding and other hazard events often lead to grievous falls, collisions, and infrastructure damage, and increase cases of physical injuries, ranging from minor to severe. Wet, icy, or flooded roads are hazardous for pedestrians, bicycles and cars, often leading to grievous falls and collisions. Extreme storms can bring dangerously high winds, heavy rain and snow, or sewer overflows that damage transportation and energy infrastructure, knock down trees, and increase danger of blunt trauma, cuts, scrapes, breaks, sprains, electrocution, and infection.

Medical Service Disruption Storms, flooding, extreme temperatures, or other climate-related hazard events can damage essential electrical, communication, and transportation infrastructure, disrupting the provision of critical medical services. Overloaded electrical systems can lead to power outages, and extreme weather events can damage critical electrical, communications, and transportation infrastructure.

As a hub for medical services, the Boston areas is home to 25 hospitals and community health centers, providing critical services to thousands on a daily basis. Mental Health Climate related events can be stressful, shocking, and traumatic, with impacts that can take a serious toll on mental health, leading to stress-related disorders such as anxiety and depression. In addition to illness and injury discussed above, extreme weather events such storms and flooding can lead to property damage, evacuation, displacement, food stress, and economic losses.

Project: Assessing the Impacts of Climate Change on Social and Political Stresses

Income Loss Loss of income due to climate-related environmental changes and hazard events will further exacerbate health inequities and lead to negative health outcomes, even for health conditions unrelated to climate change. Environmental changes and hazard events can lead to illness and injury, property damage, loss of employment or income, and even displacement, all of which have significant associated economic costs. As income is a known determinant of health across the board and for every income level, loss of income due to climate-related environmental changes and hazard events will further exacerbate health inequalities and.

The vulnerability of a person, population, or system to climate change is a function of the physical exposure to weather or climate-related hazards, the sensitivity to such climatic changes and events, and the capacity to adapt or cope with the ultimate impacts.

Adaptive capacity is based around resources available such as financial and social capital and systems capable of utilizing such resources effectively and efficiently. For example in the case of extreme heat: a person living in city will have greater exposure due to the urban heat island affect,14,17,78 someone who is very young, elderly, or has an existing cardiovascular or respiratory illness would have increased sensitivity to the heat,2,9 and those who are poor, uneducated, socially isolated, or speak limited English might have.

1. Introduction

Economic factors, include community-scale things like neighborhood poverty rates, employment, community investments, and individual-scale such as personal income, educational attainment, and access to health services. Environmental factors include the built infrastructure and conditions such as air quality, availability of healthy food, proximity to transportation, and neighborhood safety.


Social factors include the ways relationships, family structure, and cultural dynamics influence health-related behaviors and prevalence of positive engagement and social bonds between individuals and groups in a community. While these indicators are not encompassing of all that makes people vulnerable, they identifying geographic areas for heightened concern and concentrated attention. From a health perspective, the addition of community-scale. Nine key findings are grouped into three major themes, highlighting different aspects of a successful climate-health planning: foundational development, integrated framing, and targeted action.

General lessons are presented in coordination with case precedents that illustrate how such concepts have been put to action by other US cities, and strategic recommendations outlining how lessons can be applied to the specific context of Boston. This overview of the field is intended to situate Boston amongst its larger network of peers, with case examples to spur conversation and inspire innovation.

Formal studies surveying health agencies have found numerous conceptual and institutional constraints to greater climate-health action within city agencies. Conceptual barriers include a general lack of knowledge about how climate and health are connected, uncertainty of the role a specific department might play in addressing such issues, apprehension around discussing the highly charged and complex topic of climate change, and belief that climate change is less urgent than other pressing issues. These challenges are further compounded by the need for longterm interdisciplinary prevention and planning to address the social determinants of health necessary to effectively tackle climate-health concerns.

Need for long-term interdisciplinary prevention and planning to address the social determinants of health and vulnerability. Consideration of climate change impacts on existing work is a relatively new ask for most public agencies, and capacity to adapt to these changing demands varies widely between professional fields, specific institutions, and individual actors.

Additionally, every public agency has distinct strengths and weaknesses depending on bureaucratic structure and investment, past experience with hazard mitigation, and priorities established by previous leadership. While most cities have perceived these challenges anecdotally, a few have conducted rigorous internal. When conducted, findings from internal assessments have given those cities a better sense of their personal shortcomings and existing operational capacity, leading to more tailored plans for internal capacity development. In , they conducted an extreme heat response gap analysis comprised of a review of relevant plans along with a series of key informant interviews with city employees who play significant roles in public health planning and emergency response activities.

Key informants also discussed their perceptions of the strengths and challenges.

Regional organisations supporting health sector responses to climate change in Southeast Asia

Findings from this study were included in a report with specific recommendations for further action that could be taken by SFDPH. They also reported that, while many members of the department had significant experience, capacity, and networks relating to emergency response, that knowledge should be better recorded and formalized in order to better address new challenges that will occur with climate change.

San Francisco continued this process of selfassessment in subsequent years.

  • Permanent Identifier?
  • Improving Public Health Responses to Extreme Weather Events!
  • Ergodic Theory and Harmonic Analysis: Proceedings of the 1993 Alexandria Conference.
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They hired. Findings from this survey influenced the development of resources to help departmental leadership better appreciate relevant climate-health risks, understand causal pathways, and overall prepare for the impacts of climate change. The two metrics, sensitivity and adaptive capacity, were combined in a Vulnerability Scoring Matrix, used to identify planning areas for internal prioritization. Implications for Boston The City of Boston has a fairly educated and progressive workforce, and the importance of climate change, health, and equity are generally agreed upon values.

However, experiences from other cities suggest that, while most Bostonians know about the physical hazards related to climate change, such as sea level rise, it is likely that the majority of City of Boston agencies are not aware of how specifically climate change will impact their own programs or the health of their target populations.

Without such knowledge, department leadership will be less likely to value climate-related work, let alone allocate resources or incorporate climate-health considerations into regular planning and decisionmaking processes. As the climate change field brings with it new challenges, most departments will need support to understand why to care as well as how to act, in order to achieve city-wide incorporation of climate-health priorities. Furthermore, many departments have specific services, resources or. Internal-facing processes of inquiry and evaluation can help the City to better understand specific knowledge shortcomings, procedural bottlenecks, and available resources related to climate-health, and therefore better direct efforts.

This interview process presents an opportunity. The research reported herein has supported this effort by influencing the design of the interview guidelines, inspired by the above examples. This selfassessment process is a foundational step toward. Such internal assessment processes should be repeated moving forward, utilizing an array of inquiry methods to gather different types of information. Findings should be formalized in reports to inform decision-making processes.

Causes and Effects of Climate Change - National Geographic

Recommended Actions Work with relevant departments to regularly assess and report on existing knowledge of, interest in, and capacity to address health-related impacts of climate change. Interview agencies participating in the extreme temperature planning process to assess current climate-health related knowledge, programs, and resources.

Formally record and map relevant agency assets, actions, partnerships, and communication pathways. Conduct follow-up interviews with participants at the end of the extreme temperature planning process, and in subsequent years to assess how perspectives and approaches change over time. Reach out to departmental leadership through an online survey to quantitatively gauge selfreported vulnerability, preparedness, and adaptability in relation to climate change and health. Produce an annual report from findings highlighting areas for internal concern and prioritization. Explore potential for health-based climate change vulnerability assessment and report coming out of the Public Health Commission.

Assess vulnerability of health and critical response facilities and services to climate-related hazards. Adapting to and sufficiently preparing for the health impacts of climate change will require long-term, coordinated actions.

Heatwaves past and future impacts on health

However, in interviews, city officials identified siloed working practices, restricting budgetary and timeline constraints, and frequent changes in personnel. The sporadic nature of interventions impacted momentum, which, once garnered, was hard to sustain. In order to counteract such trends, numerous interviewees emphasized their. Incorporation of climate-health perspectives and practices into formal reports and plans helps to clarify messaging and values, while also further engaging potential allies.

Additionally, incorporating climate-health-oriented priorities and initiatives into the tangentially-related plans of other departments provides a point of reference to hold people accountable over time, and build on momentum that might otherwise be temporary. Furthermore, cities have often found that when it comes to emergency management or interdepartmental coordination processes, there is much more that is known and practiced, than actually formally codified. In order to facilitate such work, respondents reported the necessity of key people or agencies taking on leadership roles and responsibilities.

Within cities reviewed for this study, that leadership came from a wide variety of places—from sustainability offices, to public health preparedness, to mayoral offices, to specific climate and health programs within public health agencies. Respondents emphasized that, while public health departments are often situated to be natural leaders in the realm, the source of such leadership is less important than the scope of its reach. However, Denver does not have the capacity to. They have found the explicit inclusion of climate change adaptation in non-climate-specific plans a key step to sustained interdepartmental buy-in and resource allocation.

For each issue identified, they had departments set goals with metrics for evaluation, and each year Environmental Health compiles results from across the city for an annual progress update. The framework presents strategies to reduce the health burden of climate change, advance health equity, and promote a culture of.

Presented along with each recommended action are proposed quantitative indicators for measuring and tracking climatehealth risks and progress.

Not only will the framework serve to guide actions taken across. The five priorities of the plan are: 1. Promote local planning, land use, transportation, water, and energy policies that reduce carbon emissions and support the design of healthy and sustainable communities. Provide guidance on climate preparedness to local government and community partners to reduce health risks and create more resilient communities. Build the capacity of Departmental staff and programs to monitor health impacts, integrate climate preparedness, and improve climate response. Adopt best management practices to reduce carbon emissions associated with Departmental facilities and internal operations.

Inform and engage the general public about the nature of climate change and the health co-benefits associated with taking action to reduce carbon emissions. Implications for Boston Climate change adaptation is a long-term iterative process, requiring commitment to be sustained over time. While champions are important, the people behind projects change and so it will be key for Boston to formalize knowledge commitments and strategies in as many places as possible to ensure the endurance of current efforts.

As other cities have noted, knowledge learned but not recorded is vulnerable to loss, and with so much knowledge being generated around climate-health in Boston right now, it would be a shame if it was not passed down to the next generation of leaders and doers. Boston has recently undergone many new planning efforts, setting priorities and laying out frameworks to guide work for decades to come.

As one of those plans, Climate Ready Boston engaged partners in the development process, identified relevant partners for each proposed initiative, and has begun tracking progress on all initiatives both inside and outside of the jurisdiction of the Environment Department. This approach should be continued and strengthened in further planning process, particularly calling out health-specific components, delegating responsibilities, and designating metrics for success.

1st Edition

Furthermore, Climate Ready Boston should strive. The BPHC would also benefit from formalizing agency-wide commitment to addressing immediate and long-term impacts of climate change, and designating specific departmental responsibilities. Specific commitments from offices—such as environmental health, infectious disease, and health equity—that formally acknowledge the climate-related components to their work and set goals for addressing such challenges would be a great step in sustaining and integrating climate-health perspectives.