Project Summary

Efforts to address climate-related public health risks by the New Jersey Department of Health include environmental public health data monitoring, tracking of medical assets and extreme events, education and technical assistance, and targeted research to evaluate programmatic vulnerabilities. Complementary activities include efforts to advance climate mitigation and adaptation goals through the New Jersey Climate Change Alliance, U.S. Climate Alliance, and state and regional initiatives to reduce greenhouse gas emissions.

Background

New Jersey’s temperatures have increased by about 3˚F over the last century. Additional climatic changes and impacts of concern in the state include sea level rise, saltwater intrusion, extreme storms and flooding, extreme heat events, vector-borne diseases, and a more severe allergy season.

In 2009, Meeting New Jersey’s 2020 Greenhouse Gas Limit: New Jersey’s Global Warming Response Act Recommendations Report identified the challenges associated with greenhouse gas emissions. The primary focus of the report is on emissions reductions but does include limited discussion of how climate change can affect public health via degraded air quality and reduced quality of life. While a full statewide adaptation plan was recommended as part of the 2009 report, no formal plan has been released. The New Jersey Department of Health (DOH) also does not have a formal climate or adaptation plan, but does have several programs and activities relevant to climate change and public health and safety.

Implementation

DOH conducts monitoring and surveillance of climate-related health factors, provides education and technical assistance to local health departments and communities during emergencies, and funds research to evaluate how its operations fare during extreme events.

Monitoring and surveillance

While the department’s Environmental Public Health Tracking Program is not directly linked to climate change, it does include monitoring of air and water quality, heat stress, Lyme disease, and disaster response through the State Health Assessment Data (SHAD) system. SHAD provides access to public health data indicators (e.g., air and water quality, cardiovascular disease, infectious disease), details on tracking mechanisms and sources, and links to other relevant datasets and publications to support decision-making. DOH also uses the Hippocrates online system to capture and share critical health information and support day-to-day operations and rapid response and recovery for emergency situations. The system integrates data from DOH’s Medical Coordination Centers, local health departments, clinics, and other healthcare facilities. Hippocrates combines real-time feeds of weather events (e.g., fires, floods), incidents, and medical assets (e.g., hospitals, command centers, blood banks) with basic GIS map layers on a closed system only accessible by public health practitioners.

Education and technical assistance

DOH and the Department of Environmental Protection (DEP) partnered to launch the Clean Air NJ campaign in 2015 to raise public awareness about the negative effects of ground-level ozone and measures that can reduce the likelihood of smog. The Clean Air NJ website provides details about the health and environmental effects of smog, access to daily air quality data via the Air Quality Index, and tips on how the public can reduce ozone formation and avoid exposure.

DOH’s Division of Public Health Infrastructure, Laboratories, and Emergency Preparedness (PHILEP) oversees the Office of Disaster Resilience, Office of Emergency Medical Services, and the Public Health and Environmental Laboratories. Superstorm Sandy tested PHILEP’s preparedness, response, and recovery initiatives. For example, the Office of Emergency Medical Services collaborated with public health agencies and practitioners to provide transportation for residents from vulnerable areas to shelters, and provided technical assistance to local departments overwhelmed by the storm’s impacts. 

Targeted research

DOH also funded the Sandy Child and Family Health Study (S-CAFH), an initiative to examine the health needs of families affected by Superstorm Sandy and inform the modification of departmental programs to better serve the state in the face of future extreme events. S-CAFH was modeled after the post-Hurricane Katrina Gulf Coast Child and Family Health Study, and is a partnership between the Rutgers University School of Social Work, New York University’s Global Institute of Public Health, Columbia University’s National Center for Disaster Preparedness, and Colorado State University’s Center for Disaster Risk and Analysis. The project team conducted interviews with over 1,000 adults from the most affected counties in the state to identify household decision-making processes (e.g., evacuation vs. shelter-in-place), post-storm health and well-being, and health services sought after and received. For example, 24% of the residents (~240,000 people) were under a mandatory evacuation order but only one-third of them compiled, and over 90% of residents that suffered major infrastructure damage reported being directly in contact with floodwaters, debris, and/or mold. Mold exposure was directly linked to asthma and mental distress diagnoses as a result of the storm, and children in these counties were found to be at very high risk for psychological and emotional health problems. Two reports have been released to date on the study’s findings: Hurricane Sandy PLACE Report: Evacuation Decisions, Housing Issues, and Sense of Community, and Hurricane Sandy PERSON Report: Disaster Exposure, Health Impacts, Economic Burden, and Social Well-Being. Both reports include key findings as well as implications for improved preparedness, response, and recovery programs. For example, some suggested improvements include:

• Advanced physical and mental health screening and psychological first aid programs for residents with greatest exposure to the disaster(s);
• More targeted risk communication to garner attention and compliance for evacuation orders, although many residents that remained at home did not have a place to go; and
• Financial counseling to assist residents, particularly those in the poorest communities. One key finding from the study was that the poorest residents tended to have the greatest housing needs but were much less likely to apply for assistance from resources such as the Sandy Homeowner and Renter Assistance Program and therefore suffered an additional “poverty penalty.”

Outcomes and Conclusions

Although New Jersey is not a formal participant in Centers for Disease Control and Prevention’s (CDC) Climate-Ready States and Cities Initiative, the New Jersey Climate Change Alliance (formerly the Climate Adaptation Alliance) used the initial steps of the Building Resilience Against Climate Effects (BRACE) framework to create a Climate and Health Profile Report. The report covers observed and projected climate change impacts in the state with a detailed emphasis on the most vulnerable populations. The report recommends several action steps for the New Jersey Climate Adaptation Alliance’s Climate Change and Public Health Working Group to advocate for advancement, including:

• Creation of a coordinated statewide pharmacy plan to support prescription distribution during emergency events;
• Creation of a web-based registration system to track individuals in emergency shelters;
• Provision of crisis counseling to emergency shelter staff and residents;
• Development of a  statewide emergency stockpile plan for food, water, medication, fuel, and other supplies; and
• Assessment of the state’s capacity to adequately address the climate-related health needs of vulnerable populations and communities.

In January 2018, the DEP’s Air Quality, Energy, & Sustainability program was directed to re-commit to participation in the Regional Greenhouse Gas Initiative (RGGI), an effort to reduce regional emissions between other New England and Mid-Atlantic states. Governor Phil Murphy’s Executive Order links participation in RGGI to efforts to improve air quality and public health, increase energy efficiency, and grow the state’s green economy. In February 2018, New Jersey also joined the U.S. Climate Alliance, a collaboration between states seeking to take on-the-ground action towards climate adaptation and mitigation, particularly by meeting the goals of the Paris Agreement to reduce greenhouse gas emissions by 26­­-28% below 2005 levels by 2025. This commitment is in addition to the state’s objective to reduce emissions by 80% of 2006 levels by 2050.

Citation

Gregg RM. 2019. Assessing links between climate change and public health and safety in New Jersey [Case study on a project of the New Jersey Department of Health, New Jersey Department of Environmental Protection, and New Jersey Climate Change Alliance]. Product of EcoAdapt's State of Adaptation Program. Retrieved from CAKE: https://www.cakex.org/case-studies/assessing-links-between-climate-change-and-public-health-and-safety-new-jersey (Last updated June 2019)