The State of Climate Adaptation in Public Health: An Assessment of 16 U.S. States

Created: 6/27/2019 -


Climate change poses significant threats to the health of individuals and communities, as well as the delivery of healthcare services. Human morbidity and mortality rates are rising due to extreme heat events and changing patterns of water-borne and vector-borne diseases, and healthcare infrastructure is at risk from extreme events. Climate adaptation actions are taken to either avoid or take advantage of climate change impacts either by decreasing vulnerability or increasing resilience.

EcoAdapt was funded by the Natural Resources Defense Council to assess the state of climate adaptation planning and implementation for climate-related threats to public health in 16 U.S. states – Colorado, Florida, Illinois, Iowa, Michigan, Missouri, Nevada, New Jersey, New York, North Carolina, Ohio, Oregon, Pennsylvania, Virginia, Washington, and Wisconsin. These states include a cross-section of areas in which the Natural Resources Defense Council is engaged in climate and clean energy advocacy work, states included in the Strong, Prosperous, and Resilient Communities Challenge program, and a subset of those in which the Building Resilience Against Climate Effects framework is being operationalized.

The project objectives were to:

  1. assess understanding among public health officials of climate change impacts;
  2. document activities – planned and underway – to prepare for and respond to climate-related challenges;
  3. synthesize findings in case studies to inform adaptation planning in other states; and
  4. create a public health topic page on the Climate Adaptation Knowledge Exchange (CAKE) to share relevant resources, tools, and case studies.

EcoAdapt scientists examined if and how climate change is being integrated into activities at state public health departments and other agencies and organizations. The majority of initiatives at the state health departments surveyed are focused on capacity building, primarily environmental health monitoring; vulnerability assessment and adaptation planning efforts; public awareness outreach and communication campaigns related to climate change; and collaborating with local health departments, tribal agencies, and nongovernmental organizations. Eighteen full-length case studies are presented on how various practitioners are integrating climate change into public health.

Published On


Community / Local
State / Provincial
Tribal / First Nation
Sector Addressed
Public Health
Type of Adaptation Action/Strategy
Invest in / Enhance emergency services planning and training
Increase / Improve public awareness, education, and outreach efforts
Conduct / Gather additional research, data, and products
Monitor climate change impacts and adaptation efficacy
Create/enhance resources and tools
Infrastructure retrofitting and improvements
Make infrastructure resistant or resilient to climate change
Community Planning (developing climate-smart communities)
Develop disaster preparedness plans and policies
Create new or enhance existing policies or regulations
Develop / implement adaptation plans
Target Climate Changes and Impacts
Air temperature
Diseases or parasites
Infrastructure damage
Invasive / non-native species, pests
Oxygen concentrations (hypoxia)
Public health risks
Public safety threats
Range shifts
Salinization / Saltwater intrusion
Sea level rise
Storms or extreme weather events
Water quality
Water supply
United States

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