Communities across the United States can – and want – to take action now to reduce the impact of climate change on health, but they need clearer, more flexible guidance and better resources at the state and local levels, according to a new study from the University of Washington School of Public Health.

Published online Jan. 8 in the American Journal of Public Health, the study outlines a set of indicators, set within a standard public health framework, to help state and local health agencies plan and track climate change adaptation efforts.

“The indicators are a guide to aid agencies, departments and tribes in considering what steps they need to take and what areas they need to invest to become more climate-prepared organizations,” the researchers wrote. 

Said lead author Annie Doubleday: "We hope they can use it to help guide their efforts, as a starting point for adaptation work.” Doubleday conducted the research while a graduate student at the UW School of Public Health’s Department of Environmental & Occupational Health Sciences.

Researchers used climate change adaptation indicators – identified through a narrative literature review – and mapped them alongside public health activities grouped by the U.S. Centers for Disease Control and Prevention’s Ten Essential Services (TES) of Public Health. The TES is a guideline for state, tribal, territorial, and local public health agencies in the U.S. that outlines their basic responsibilities.

The result was a preliminary set of indicators that was then discussed with practitioners in Washington state and Oregon. Researchers conducted key informant interviews with 17 tribal, state, and local public health officials working on climate and health. Results from the interviews were used to refine the indicators.

The research illuminated a need for guidelines that can be easily and effectively modified to reflect a state, tribal or local agency’s unique organizational structure, climate hazards, resource limitations and public health approaches. Other themes that emerged were the:

• Importance of integrating adaptation efforts into existing programs and data streams;
• Need for clarity regarding the role of public health in climate change adaptation, and
• Desire to strengthen communications, partnerships and response capacity to increase resilience.

Findings showed that “practitioners perceive a large gap” between needs and available resources, even in settings highly aware of the health risks of climate change and urgency for adaptation, such as the Pacific Northwest. This gap, according to informants, “hinders a comprehensive approach to health adaptation, connection with stakeholders and coordination with other sectors.”

What’s more, the lack of clarity regarding the role of population health in climate change has led to inadequate resource and capacity allocation. Washington and Oregon rank No. 22 and No. 30, respectively, for per capita public health spending, indicating that these practitioners’ resource concerns may reflect those of their counterparts in other public health agencies.

By integrating the new indicators into the TES framework, researchers proposed ways that activities and resources could build and track additional capacity for climate adaptation efforts. But they caution, “given the climate-related health impacts that communities are likely to face in the coming years, additional resources will ultimately be necessary to meet the demands placed on public health.”

The study's corresponding author is Jeremy Hess, associate professor of emergency medicine, environmental and occupational health sciences and global health at the UW. Co-authors are Nicole Errett, lecturer, and Kristie Ebi, professor, in the Department of Environmental & Occupational Health Sciences at the UW School of Public Health. Ebi is also a professor in the Department of Global Health (jointly housed in the UW Schools of Public Health and Medicine).