Almost 700 people died from heat-related stress during the catastrophic 1995 heat wave in Chicago, Illinois.1 The three-day weather event saw 24-hour mean average temperatures of 87.2°F; the heat reached triple digits on two days, and there was little relief at night.2 Many people succumbed to heart attack and dehydration, while others collapsed during severe episodes of existing respiratory conditions.3 The death toll in the summer of 1995 gave Chicagoans a clear picture of how a surge in hot weather can affect human health. A decade later, Mayor Richard Daley launched an extensive program that brought together city agencies, academics, and scientists to develop a Climate Change Action Plan to help reduce the city’s contribution to climate change.4 Much of the plan focuses on sustainable mitigation actions such as planting trees and training workers to install renewable energy technologies. Within that plan, however, is a climate change adaptation strategy with a goal of preparing the city and its residents for future unusual weather events associated with climate change.5 Chicago is one of several large cities with climate action plans in place—others include New York City, San Francisco, Sydney, and Mexico City.6 Like Chicago’s, these plans promote mitigation and sustainability. Much of the adaptation portion of these initiatives is aimed at the built environment—buildings, highways, and facilities. But officials in these cities are beginning to talk about the public health cobenefits from their action plans, and public health advocates are speaking up and pushing for programs designed to prepare for or prevent climate-sensitive disease and illness.

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