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.

 

 

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