Integrating Climate Change into Public Health
California faces considerable risks from climate change to human health. This is especially true for a number of vulnerable groups. In addition to direct hazards like rising sea levels and extreme heat, climate change can impact service provision by government, business, and community organizations.
Public health actions – particularly by local health departments with strong connections to surrounding communities – can protect people from some of the impacts of climate change. Preparing for a changing climate will require a combination of:
- Cross-sector collaboration to address root causes of inequity which are exacerbated by climate change (e.g., planning climate-resilient transportation systems, and installing cooling trees and green infrastructure)
- New and modified public health practices and systems
- Increased capacity to respond to, and prepare for, both slow-moving environmental changes and extreme events
- Engagement of impacted and vulnerable communities; giving them decision-making power over resource allocation
Early actions for public health prevention provide the greatest benefits. Planning can begin with leveraging community knowledge and population data that is already available. Local health departments can convene and work with stakeholders to prioritize populations with specific vulnerabilities that are unique to their jurisdiction.
Outreach and Engagement
The CalBRACE Climate Change and Health Vulnerability Assessment Indicators and Reports can be used to identify the people and places most at risk to the health impacts of climate change. Once these communities are identified, it is important to engage agencies, community groups, and organizations that are inclusive of, represent, and serve these populations and that are interested in reducing health risks. An integrated and cross-sector approach may involve coordination between emergency management, community and neighborhood groups and organizations, businesses, community clinics, health care providers, and other partners. Public health departments should also integrate information on community resilience into training and educational programs related to climate change preparedness and response.
Many local jurisdictions are already engaged in Climate Action Planning and Sustainable Communities Strategies Planning.
Senate Bill 375 (SB 375) (Steinberg, Chapter 728, Statutes of 2008),also known as "The Sustainable Communities and Climate Protection Act of 2008", affects regional Metropolitan Planning Organizations (MPO) in California. Each MPO has developed a Sustainable Communities Strategy (SCS) Plan to achieve mandated targets for greenhouse gas emissions reductions to comply with SB 375 and share members and partnerships with local climate change collaboratives.
Under Senate Bill 1000, (SB1000) (Leva, Chapter 587, Statutes of 2018)also known as “The Planning for Healthy Communities Act”, cities and counties are required to adopt an Environmental Justice element, or integrate EJ-related policies, objectives, and goals throughout other elements of their General Plan. The bill also includes a process for communities to become meaningfully involved in the decision-making processes that govern land use planning in their neighborhoods.
Other partners may include local water, public works, transportation, utility, fire, and planning departments, as well as neighborhood groups, housing and environmental advocacy groups, community coalitions, social service providers, family resource centers, senior centers, United Way, faith communities, health care providers, and farmworker groups. New partners, including tribal, and conservation and working lands stewards are also key to successful outcomes across the state.
Finally, opportunities to integrate climate adaptation planning and activities into existing public health programs may exist. For example efforts to reduce environmental exposure to air pollution or reduce respiratory disease burden will benefit from incorporating the impacts of heat and wildfire into their work.
Public Health Emergency Preparedness Programs
Emergency Preparedness, Hazard Mitigation, and Response plans are important for adaptation planning.7 Public Health Emergency Preparedness (PHEP) programs are already responding to climate-related natural disasters, and are often the first traditional public health programs to incorporate climate change considerations into their daily work. PHEP programs and expertise need to be included in local government climate adaptation and resiliency plans as well as General Plan Safety elements and Local Hazard Mitigation Plans.
Chronic Disease Prevention and Health Promotion
Public health professionals in chronic disease prevention and health promotion are important messengers for integrating climate change into healthy eating and active lifestyles. Those with existing chronic diseases are more vulnerable to the effects of climate change. Many of the same activities that prevent chronic diseases, such as safe and active communities and nutrition and food security, also increase community resilience to climate change.
Promoting healthy lifestyles through new policies and strategies can increase resilience to climate change. Policies, such as land use and transportation guidance to promote mixed use development, active transportation and public green space improve health and slow climate change by reducing vehicles miles traveled, urban warming, and related greenhouse gas emissions.
Active and Accessible Transportation
Partnerships with metropolitan planning organizations, transit agencies, air districts, non-profits, transportation departments, and others support active transportation resulting in active lifestyles. Active lifestyles (regular walking, bicycling, or other physical exercise) reduce chronic diseases, such as stroke, diabetes, heart diseases, and respiratory diseases. A healthier population is more resilient at the personal and community levels. For example, populations with lower rates of Type 2 diabetes and other treatable chronic diseases will be better able to cope with service disruption in pharmaceutical supplies that may result from extreme weather and/or evacuations.
Nutrition and Food Policy
Fruit and vegetable consumption is good for health and can reduce greenhouse gas emissions.10,11 Encouraging evidence-based public health strategies for healthy eating, that prevent obesity and diabetes and promote cardiovascular health, can increase resilience to heat waves and other extreme weather conditions. Such strategies include supporting programs that provide access to healthy food choices for mothers, children, and those without adequate financial resources, or support for home and community gardens to reduce food insecurity and maintain healthy food supplies for families. Other useful strategies include:
- Promote zoning and land use policies that allow agricultural production in urban and suburban areas.
- Create and support local farmer’s markets, farm stands, community gardens, orchards, and garden programs, and ensure accessibility to residents with limited financial resources.
- Develop education materials about the value of selected vegetables, legumes, and nut protein sources.
- Consider education materials about climate change and healthy eating, such as the curriculum developed and piloted by San Luis Obispo (SLO) Public Health Department’s OutsideIn SLO campaign.
Family Services & Nursing
Maternal, Child, and Adolescent Health (MCAH) programs can provide families, children’s health advocates, and medical providers information about the unique hazards that extreme heat and wildfire smoke pose for pregnant women, infants and young children.3 Public health nurses (PHN) and promotoras (i.e., Hispanic/Latino community members who received health education training) reach families that can benefit from education about home- and school-based interventions to protect against heat, drought, wildfires, air pollution, and floods. PHNs are excellent messengers for integrating education about climate change curriculum and systems change into their professional collaboratives and coalitions for family health.
Mental Health Promotion and Treatment
People with mental illness are at higher risk of death and illness in extreme weather events. Some medications that treat mental illness interfere with self-regulation of body temperature, and can thus increase vulnerability to heat.14 Trauma from wildfire, floods, drought, or other disasters can aggravate mental health problems and increase stress for individuals and communities.15 Mental health practitioners can prepare for climate change related traumas and mental health impacts, and work with health prevention programs to create conditions for community resilience and prevention.
Environmental Health and Vector-Borne Diseases
Food borne illnesses, caused by contaminated meats or vegetables, drinking water, wastewater or recreational water, are monitored and regulated by environmental health departments or divisions. Practitioners in this field are increasingly addressing climate change as an environmental health issue. Hazardous environmental conditions during and after extreme weather events, such as heat waves, algal blooms, and unsafe air or water quality, are more frequently linked to climate change. Environmental health practitioners plan and mobilize surveillance and monitoring systems, and they provide warnings to prevent or reduce exposure to new and more intense hazards including vector-borne diseases.