Addressing climate-related public health risks in Colorado

Jessi Kershner Kathryn Braddock
Posted on: 6/25/2019 - Updated on: 12/18/2020

Posted by

Rachel Gregg

Project Summary

Colorado is implementing climate change adaptation and action initiatives across agencies and scales throughout the state. However, the integration of climate change into public health is limited and planning, implementation, and evaluation efforts are variable across state-, county-, and city-level endeavors. The Colorado Department of Public Health and Environment collaborated with the Department of Natural Resources, Colorado Energy Office, and other agencies in the development of the state Climate Action Plan; however, plans to implement these strategies and direct actions taken to address climate impacts on health at the state-level are largely unknown. Notable successes in the state include the City of Denver’s strategic climate and health planning initiative as well as the dedication of the Colorado Resiliency Office in providing support during natural disasters that could threaten the health and safety of communities and individuals.


Primary climate-related impacts of concern for Colorado include extreme weather events, wildfires, drought, flooding, degraded air quality, and diminished water availability caused by reduced snowmelt and runoff, each of which has consequences for public health. For instance, population displacements and insecurities in healthcare services, heat-related illnesses, reduced water supply and quality, water-borne diseases, and exacerbation of asthma and chronic disease are common concerns. In general, Colorado acknowledges climate change effects on human health at state and local levels, however, evidence of actions taken to address impacts is inconsistent.


City and County Level Climate and Health Adaptation Efforts

At the local level, Denver is taking the lead on actions to address climate change effects on human health. The City and County of Denver 2014 Climate Adaptation Plan identifies extreme temperatures, urban heat islands, changes in disease patterns, air pollution, and water quality as priority concerns. The plan aims to (1) safeguard the health of citizens in light of climate change; (2) preserve the ability of medical and healthcare providers to sustain services during extreme heat events; (3) conduct vector monitoring and control; and (4) provide sufficient emergency response measures during extreme heat events. Specific strategies and actions include:

  • Reducing health-related impacts of extreme weather events (e.g., increase number of shelters for at-risk populations, designate public cooling shelters, adopt a severe weather ordinance);
  • Reducing health-related vulnerabilities from vector-borne diseases (e.g., develop a vector-borne and zoonotic disease surveillance system to improve epidemic predictions);
  • Developing energy and communications systems that are resilient to power outages (e.g., install off-grid alternative systems, obtain reliable backup generation capacity); and
  • Advising medical providers on whether critical infrastructure is at risk and identifying risk mitigation solutions.

To date, the city has assessed extreme heat events, created a city-wide vector control plan, and drafted an extreme heat annex for the city’s Emergency Operations Plan. In progress activities include creating and executing an extreme events public education campaign and identifying how Denver Environmental Health will cooperate with other agencies (e.g., Office of Emergency Management and Homeland Security) during extreme heat events. In 2018, Denver released the 80 x 50 Climate Action Plan, which identifies the need for increased access to transportation choices that help decrease air pollution, safer and more reliable energy sources that would reduce greenhouse gas emissions and improve air quality, and equitable health outcomes to preserve quality of life in light of climate change.

Other noteworthy local planning efforts in Colorado that incorporate health concerns include Pitkin and Boulder Counties. Boulder County’s Climate Change Preparedness Plan directly identifies public health threats associated with climate change, outlining potential impacts, opportunities, policy recommendations, and suggestions for future study and action. While the report details ideas, it does not provide information on any actions underway. Pitkin County’s Climate Action Plan focuses on greenhouse gas emissions reductions, and information provided by the County Public Health Department regarding potential adaptation strategies. These goals include building local resilience by identifying vulnerable populations; improving public health preparedness, response, and communication; and improving disease education, surveillance, and response to food-borne and zoonotic diseases.

State Level Climate and Health Adaptation Efforts

Colorado's 2015 Climate Action Plan describes projected climate impacts (e.g., air quality, vector-borne disease, and extreme weather events) and potential health response strategies (e.g., monitoring, assessment, education, and outreach), however implementation details and direct actions taken to address climate impacts on health are lacking.

The Department of Public Health and Environment’s website includes information on air quality issues and greenhouse gas emissions reporting, and a local environmental health reporting tool. The Colorado Public Health Tracking Portal serves as a data source for improved public health decision-making on factors related to air quality, drinking water quality, toxins, and harmful algal blooms. The portal is part of the National Environmental Public Health Tracking Program, funded by the Centers for Disease Control and Prevention. Additional resources on the department’s website that do not explicitly include climate change but may support climate-informed decision-making include:

  • The Engage-Calm-Distract resource kit, which provides strategies to help health providers rapidly respond to the psychological and emotional needs of children and parents in times of crisis;
  • Disaster recovery guides for local public health departments and the public, both of which detail human health concerns that arise from emergencies and disasters such as issues related to sanitation, disease, pollution, and shelter;
  • The multiagency Colorado Crisis Education and Response Network for behavioral health disaster response; and
  • Training related to field emergency response and psychological first aid.

The department also funds Supplemental Environmental Projects that benefit the environment or public health funded by monetary settlements of violations of environmental regulations. As of 2019, there have been two funded projects: one that promotes public health through green retrofits and another that focuses on solar energy.

The Colorado Resiliency Office (CRO) aims to empower Colorado to build stronger, safer, and more resilient communities in the face of natural disasters. The main climate impacts of concern for CRO include wildfires, drought, flooding, and subsequent impacts on air and water quality. While there is not a mandate for climate action work, CRO has recognized the need to address climate adaptation. In local-level initiatives, CRO encourages community resilience planning to incorporate climate change considerations (e.g.,  integration into comprehensive, hazard mitigation, land use, and economic development plans). CRO is working with the Colorado Department of Natural Resources’ Water Conservation Board and Colorado’s Division of Homeland Security and Emergency Management to develop a scenario-based risk assessment for the state to better understand the impacts of climate change on drought, wildfire, and flooding. The project’s goals are to identify at both local and regional levels the impacts of climate change, the costs of inaction versus immediate action, tools for local-level decision-makers to better understand climate impacts, and needs for guidance on types of actions, best practices, and case studies. CRO and its partners recently secured funding for this project and aim to conduct outreach and education initiatives via its website; workshop series, such as the resilient Colorado communities workshop series; and technical assistance on planning. CRO’s Working Group investigates how to build resilience into state investments and operations (e.g., building resilience into competitive and discretionary grants, not building a school in a flood zone); how to take broad criteria and apply them to a range of agencies (i.e. public health or transportation); and how to add weighting criteria to guidelines and metrics.

The Colorado Communities Symposium, which kicked off in January of 2018, brought together a consortium of city and county agencies, including CRO, throughout the state that agreed to meet the guidelines of the Paris Agreement. The Symposium focused on transportation, energy, resilience, and aimed to identify goals for the state and communities. The Association of Climate Change Officers is leading the follow up to this symposium, and is interested in developing peer-to-peer exchanges and a resilience forum.

Outcomes and Conclusions

CRO has used the guidance and resources of the Water Conservation Board and climate change specialists in its efforts to address climate adaptation needs. A challenge in CRO’s work is proper framing during communication with communities, particularly making sure conversations are relevant at local levels and addressing impacts that communities are already experiencing firsthand (e.g., long-term drought). Factors that facilitate climate action within CRO include the support of the state climate plan (e.g., implementing and meeting goals in a top-down direction), community openness and willingness to work on adaptation issues, and research institutions (e.g., National Center for Atmospheric Research, National Renewable Energy Laboratory, and University of Colorado) that provide technical resources and guidance.

While CRO is pushing climate action forward in Colorado by participating in adaptation initiatives and projects, there is little focus on public health impacts in plans. CRO’s new project is still in developmental stages and there is no detail on project implementation or evaluation to date. This is a similar finding with other state, city, and county adaptation plans: public health seemingly is not a true focal point of action planning, and many proposed strategies and goals regarding health, while well outlined, are not supported by results in implementation.


Kershner J & Braddock KN. 2019. Addressing climate-related public health risks in Colorado [Case study on a project of the Colorado Department of Public Health and Environment and Colorado Resiliency Office]. Product of EcoAdapt’s State of Adaptation Program. Retrieved from CAKE: (Last updated December 2020).

Project Contact

Rob Pressly
[email protected]

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