Project Summary

The Climate and Health Program of the Washington State Department of Health aims to reduce the negative effects of climate change on public health by working with local health departments, communities, and other state, tribal, and local agencies. The department seeks to address climate change by strengthening monitoring of and response to climate-sensitive health risks, characterizing the specific threats climate change poses to people’s health in Washington, and working with partners to carry out evidence-based strategies that protect and improve community health in an era of climate change.

Background

Climatic changes such as warming temperatures, declining snowpack, drought, wildfire, sea level rise, flooding, and ocean acidification are projected to have various consequences on human health in Washington State. For example, drier and warmer conditions are expected to increase wildfires, in turn posing increased health risks for people exposed to unhealthy levels of smoke.  Climate change is also expected to increase illness, injuries and deaths from extreme weather events like high heat days, storms and flooding, increase some vector-, water-, and food-borne diseases, disrupt critical infrastructure and services, and negatively impact mental health.

The Washington State Department of Health participated in the development of the state’s Integrated Climate Response Strategy. The Strategy explicitly notes that climate change will negatively affect public health, particularly the state’s most vulnerable populations, as well as mental health and quality of life. The Strategy recommends five overall strategies:

1. Protect the most vulnerable communities by providing financial and technical support to local health departments and communities, improving community planning efforts to support healthy communities (i.e. expand open space, prevent development in vulnerable zones), and develop and improve access to emergency shelters and evacuation routes.
2. Enhance surveillance, reporting, and response systems by improving surveillance systems to better detect climate-related disease outbreaks, expanding public health datasets and tracking, and developing harmful algal bloom warning systems.
3. Incorporate climate adaptation into DOH’s programmatic efforts by incorporating mitigation and adaptation strategies into health planning and regulations, and enabling local health and emergency departments to better prepare for and respond to events.
4. Engage and motivate the public to create resilient communities by improving climate change awareness and knowledge among the medical community, public water resources managers, and the public.
5. Build capacity to effectively protect human health by improving training on climate-related health risks, developing response strategies, and securing reliable funding sources to enable climate-informed action.

DOH is an active participant in the Washington Interagency Climate Adaptation Network (ICAN), a partnership of state agencies that aims to implement the Strategy, advance climate resilience, share knowledge, and leverage partnerships. While DOH does not have a formal departmental climate adaptation plan, programs across the agency are taking steps to address climate change impacts on public health, such as:

• Integrating climate change into the Department’s Strategic Plan;
• Examining how climate change magnifies the hazards that DOH Office of Emergency Preparedness and Response addresses in its everyday work;
• Coordinating a strengthened public health response to wildfire smoke events;
• Publishing indicators for climate-sensitive health outcomes on the publicly accessible Washington Tracking Network;
• Strengthening syndromic surveillance for climate-sensitive conditions, using data from patient visits to emergency rooms, hospitals, and clinics to detect emerging health risks and inform public health response;
• Using early warning systems to detect the presence of dangerous marine biotoxins in water and shellfish to prevent human exposures;
• Partnering with researchers to understand how climate conditions in Washington influence risk of zoonotic and mycotic diseases, such as West Nile Virus, Lyme disease and other tick-borne diseases, hantavirus, leptospirosis, Valley Fever from Coccidioides, and infection with Cryptococcus gattii;
• Funding projects to advance understanding of climate and ocean acidification risks to shellfish safety and explore adaptation options;
• Providing low interest grants and loans for protecting drinking water resources and  building more resilient drinking water infrastructure; and
• Raising awareness of the links between climate change and public health within the department, with other state agencies, and with the public.

Implementation

DOH Strategic Plan

The department incorporated climate change impacts and resilience into its two most recent strategic plans––2014-2016 and 2016-2019. Climate change is recognized as a major external factor that influences the success of the DOH mission from negative effects on air and water quality to threats to public safety from sea level rise and storms. Strategic goals for the department include creating effective prevention, surveillance, and response systems; maintaining operational readiness within DOH; raising awareness of the effects of climate change on public health; and providing quality data to support local health department and community decision-making.

Office of Emergency Preparedness and Response

As part of routine work to plan and build capacity for rapid public health response to emergencies, DOH’s Office of Emergency Preparedness and Response considers how changing climate conditions are magnifying hazards such as floods, wildfires, and heatwaves and increasing weather-driven disruptions to critical services such as power and drinking water. In addition to training for and responding to events, they provide Emergency Fact Sheets on a range of threats and preparedness topics.

Washington Tracking Network (WTN)

WTN, supported by the Centers for Disease Control and Prevention as part of the National Environmental Public Health Tracking Network, helps users identify and analyze environmental health data. Established in 2002, WTN includes data on air and water quality, drought, flooding, snowpack, heat events, weather extremes, wildfire, and disease. WTN also includes an Environmental Health Disparities Map that provides a way to compare broader environmental health risks between communities depending on exposure and social determinants of health. For example, users can compare particulate matter concentrations, toxic releases from industrial facilities, percentage of disabled population, and cancer deaths between an urban area such as Seattle and Moclips on the remote outer coast. DOH continues to pull together climate-related data for WTN and uses the site to synthesize information for local health departments and communities to track health challenges over time.

Syndromic surveillance system

DOH also houses the Rapid Health Information NetwOrk (RHINO) Program, which collects, analyzes, and disseminates near real-time data on symptoms, diagnoses, and demographic data from patient visits to emergency rooms, hospitals, and outpatient clinics. Syndromic surveillance is an approach to timely population-based health surveillance used for rapid detection of outbreaks, changing trends, and emergent disease occurrence, providing early alerts to prompt public health response. The RHINO program collects and validates data from clinics and hospitals before sharing with the Centers for Disease Control and Prevention’s National Syndromic Surveillance Program and other health surveillance partners throughout Washington state. Public health practitioners and officials have access to these records to compare trends across communities, regions, and the country. DOH is investigating how weather and climate data could support informed surveillance that may improve overall preparedness, and currently uses weather and air quality data to enhance its surveillance of heat and cold-related illnesses and the health effects of wildfire smoke.

Monitoring impacts on shellfish

Changes in ocean temperatures and chemistry along with increased land-based pollutant runoff are increasing the risk of harmful algal blooms (HABs) and diseases. Shellfish are of natural, cultural, and economic importance to the state. Increased HAB occurrence, ocean acidification, and hypoxic conditions all contribute to declines in shellfish growth and production. HABs produce marine biotoxins such as domoic acid and okadaic acid that can bioaccumulate throughout the food web. These biotoxins are of particular concern to DOH as people consuming contaminated shellfish may contract amnesic, diarrheic, and/or paralytic shellfish poisoning. DOH’s Biotoxin and Illness Prevention Program closely monitors toxin levels, temporarily closing shellfish harvest areas when conditions are unsafe.

Outreach and communication efforts

DOH also works extensively to effectively communicate public health risks to local health departments and communities. For example, wildfires have become a more pervasive threat in the state over the last few summers and department epidemiologists have prioritized public messaging on wildfire smoke and preparedness. This includes work with partners to deliver critical health protection messages, and development of the “Smoke From Wildfires Toolkit,” which provides information in multiple languages about air quality advisories, health effects and evidence-based protective measures (i.e. masks, air filters).

Outcomes and Conclusions

Future goals include increasing collaboration with other state agencies, tribal governments, and local partners to advance climate adaptation and mitigation initiatives, and improving internal departmental efforts to incorporate climate change into programmatic work. As part of ICAN, DOH has an opportunity to engage with other members of the network but identifying other potential venues for collaboration with state agencies is an important next step. Additional efforts DOH aims to take on include:

• Conducting a more honed health-specific assessment by compiling information on relevant climate and health risks in the state;
• Integrating climate change projections into public health programs and planning, particularly by identifying opportunities for early warning and response systems;
• Providing climate-informed health information relevant to policy makers about energy, land use and the built environment; and
• Showcasing how proven public health strategies like supporting physically active transportation choices can reduce greenhouse gas emissions while improving community health.

Citation

Gregg RM. 2019. Addressing climate change impacts on public health in Washington State [Case study on a project of the Washington Department of Health]. Product of EcoAdapt's State of Adaptation Program. Retrieved from CAKE: https://www.cakex.org/case-studies/addressing-climate-change-impacts-public-health-washington-state (Last updated June 2019)