Equitable Adaptation Legal & Policy Toolkit

 

Public Health Tools

Public health agencies and community-based organizations working on climate change are preparing for and responding to climate impacts to public health while ensuring their communities’ most frontline residents and neighborhoods are fully protected. Public health agencies’ powers in non-emergency situations traditionally focus on roles such as investigating health hazards, educating the public, mobilizing community partnerships, developing policies and plans to support individual and health efforts, and enforcing health laws and regulations.See footnote 1 Several of these public health roles easily translate to the climate change context, simply used in new ways and thinking prospectively instead of looking at past conditions.See footnote 2 The following public health tools have already been adapted to confront climate impacts.

Mobilizing community partnerships

A medical professional wears a medical mask, face shield, and protective scrubs while taking a blood sample from a young woman with her arm extended, seated, also wearing a medical mask.
COVID-19 anti-body testing in New York City
(Source: NYC Health + Hospitals)

Public health departments have broad authority to carry out their responsibilities. They have important pre-existing priorities, however, such as gun violence or managing opioid addiction, and new and quick-developing crises such as COVID-19. They also tend to have extremely limited funding, which makes taking on a complex issue like climate change challenging.See footnote 3 They work best in many cases in partnership with community-based organizations such as churches and other faith-based organizations, local organizations on aging, and others, who may add more capacity for on-the-ground work and who may have deep knowledge of people in the neighborhood that city governments may lack. Without this deep knowledge, equitable adaptation is unlikely to be as successful at the individual or family level. Community-based organizations in many cases may already be undertaking efforts that local agencies should be careful to take into account and build upon when designing new interventions.

Disease surveillance and public education

Disease surveillance and public education are at the heart of public health. Intended to track changes in disease burdens in order to contain and, ideally, prevent disease, surveillance can assist local agencies in deciding which other powers are necessary to invoke (e.g., vector control, public education, enforcing public health laws, etc.). As climate change transforms the diseases our system has to handle as well as the incidence of those diseases, surveillance is a key step in identifying problems while they are small.See footnote 4 Public education, similarly, of both the general public in the literal sense but also healthcare professionals who may not be familiar with new diseases, or with the particular populations who may be most susceptible to those diseases, can make our healthcare system more resilient and prepared for climate effects and to respond equitably to those effects.See footnote 5 

Building community capacity

In a similar vein to engaging with community partners, public health agencies have a vested interest in building community capacity to respond by increasing resilience and training local leaders to help manage climate impacts.See footnote 6 Community-based organizations are filling this role in some places; public health departments would be smart to coordinate and cooperate. Engaging local communities and building that capacity, in turn, helps local departments understand community problems and strengths in a deeper way, informing policy decisions and programs put in place by the department and helping to keep equity at the forefront of those programs.

Considerations of Public Health Tools

Economic

  • Public health funding tends to be extremely limited and often earmarked for particular purposes (e.g. disease-specific programs for hypertension or heart disease).See footnote 7 

Environmental

  • Some public health tools can have environmental co-benefits as well. For example, controlling disease vectors like mosquitos can also protect wildlife that might be prone to diseases carried by those vectors.See footnote 8 

Social/Equity

  • Public health practice is always to focus on specific vulnerabilities, meaning that public health tools will almost always focus more attention on populations that are at higher risk. Incorporating climate risks to look prospectively at how risks are anticipated to change in the future may change the specifics of who is on the front line of the phenomenon.

Administrative

  • Public health agencies often have competing priorities depending on national trends and local conditions. As responders to public health crises of all kinds, public health departments may have top priorities already including gun violence, opioid addiction, or infectious disease control that may make climate change seem like competition for staff time and funding.
  • Public health workers may also not be well trained in environmental health, much less climate change; additional training and continuing education may be necessary for staff to have the necessary skills and knowledge to respond constructively.

Legal

  • Public health agencies in most locations have broad authority to use their essential public health tools in the ways that they see fit.

Lessons Learned

  • The most successful projects are those done by government and community-based organizations together. The collaborations bring a terrific combination of resources, knowledge, and reach into communities.
  • Many projects are multi-faceted, combining direct services with leadership training, or emergency response measures and built-environment measures together. These projects recognize both short-and long-term needs and increase resilience over the longer term.

 

Related Resources

 
New York City COVID-19 Heat Wave Plan

In May of 2020, New York City (NYC)’s Mayor Bill de Blasio announced a COVID-19 Heat Wave Plan to keep vulnerable New Yorkers cool at home, create safer summer cooling options, and anticipate and reduce power outages. The plan addresses the higher risk for indoor summer heat exposure that vulnerable residents face while simultaneously trying to maintain social distancing in the context of a global pandemic. The $55 million plan directs the City to install 74,000 air conditioning units in the homes of residents who are 60 years of age or older, retrofit new spaces for emergency cooling centers, and better prepare for power outages. The plan lessens risk for vulnerable NYC residents of heat-related illnesses and death, as well as COVID exposure or infection. NYC recognizes the intrinsic connection with climate change, social equity, and COVID-19 recovery, and is committed to protecting the most vulnerable from climate impacts like extreme heat.   

New Orleans, Louisiana Zika virus response

In 2016, when the risk of Zika virus in the United States became higher, the mayor of New Orleans brought together public and private partners to proactively manage those risks and protect the city’s most vulnerable residents. By activating the local public health department, the board of mosquito control, local physicians, environmental experts, and community members, the government was able to create a comprehensive Zika response plan to protect the public, especially pregnant women. In the first phase, partners educated the public on risks and mitigation strategies, especially healthcare providers and facilities. The city also stepped up vector control to reduce the risk and surveillance of mosquito populations to ensure effectiveness. This combination of efforts was intended to ensure that Phases 2 and 3 of the Plan (activated in the case of reported cases of Zika) would be delayed or unnecessary due to preventive measures. By focusing education efforts for the public and healthcare entities on the risk to the most vulnerable subgroup of residents, the partners could ensure that pregnant women would be well protected. The efforts were funded by general public health funding streams.

Resilient Baton Rouge, Louisiana

Resilient Baton Rouge is a program designed to increase local community capacity in the Baton Rouge area to manage mental and behavioral health in flood-prone parts of the region. By engaging local leaders, healthcare providers, the program has been able to focus on not only delivering mental health services to residents displaced by floodwaters but also to engage community members in a longer-term process to strengthen both the local communities themselves but also the plans to increase resilience in the region. By deeply engaging affected residents and stakeholders, the plans for resilience broadly are more responsive and targeted to those most affected by the floods. The Robert Wood Johnson Foundation funds the program with fiscal sponsorship from the Baton Rouge Area Foundation. 

Philadelphia, Pennsylvania Community Heat Relief Plan

The City of Philadelphia’s effort to tackle heat disparities in the city via its Beat the Heat Hunting Park Community Heat Relief Plan (the Plan) provides a roadmap of how to conduct an inclusive climate planning process through a community-based approach to combat urban heat emergencies. The Plan was released in July 2019 by the city’s Office of Sustainability (OOS), in response to increased heat being identified as one of the main climate change threats in the City of Philadelphia. OOS found that communities in which low-income residents and residents of color reside are also most vulnerable to the heat. To cope with the heat disparities, in the summer of 2018, OOS initiated the Beat the Heat pilot project in Hunting Park, which was identified as the most heat vulnerable neighborhood. The purpose of the project is to learn the causes of heat disparities and utilize a community-driven decisionmaking process to generate possible solutions for staying cool in the future. The Plan is a collaborative work effort of city agencies, Hunting park organizations, residents, and community groups. Through the community engagement process, three priority areas were identified: 1. Staying cool and safe at home; 2. Staying cool and safe in public spaces; and 3. Greening and tree planting. Corresponding recommendations and the next steps are further being discussed and presented. The Plan also provides a step-by-step toolkit for communities facing similar situations to reduce inequities and build resiliency. 

Harlem Heat Project, New York City

The Harlem Heat Project is a community-based initiative that began in New York City in the summer of 2016. It combines crowdsourcing, data reporting, and narrative journalism to tell the story or urban heat islands in New York City. Nonprofit journalism and community-based organizations came together to provide low-cost heat sensors to homeowners in "heat-vulnerable" areas of Harlem in New York City. The data was used to tell the story of disproportionate risks to extreme heat for lower-income and communities of color as a result of increasing temperatures from climate change.

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