Abstract
Current public health strategies, policies, and measures are being modified to enhance current health protection to climate-sensitive health outcomes. These modifications are critical to decrease vulnerability to climate variability, but do not necessarily increase resilience to future (and different) weather patterns. Communities resilient to the health risks of climate change anticipate risks; reduce vulnerability to those risks; prepare for and respond quickly and effectively to threats; and recover faster, with increased capacity to prepare for and respond to the next threat. Increasing resilience includes top-down (e.g., strengthening and maintaining disaster risk management programs) and bottom-up (e.g., increasing social capital) measures, and focuses not only on the risks presented by climate change but also on the underlying socioeconomic, geographic, and other vulnerabilities that affect the extent and magnitude of impacts. Three examples are discussed of public health programs designed for other purposes that provide opportunities for increasing the capacity of communities to avoid, prepare for, and effectively respond to the health risks of extreme weather and climate events. Incorporating elements of adaptive management into public health practice, including a strong and explicit focus on iteratively managing risks, will increase effective management of climate change risks.
Highlights
Public health has an impressive history of identifying and reducing health threats, as evidenced by the dramatic increase in life expectancy in the past 100 years
Initial policies and measures to adapt to the health impacts of climate change emphasized enhancing current health protection to climate sensitive health outcomes, such as implementing heatwave early warning systems [1]
Further modifications are needed to increase the resilience of public health and health care policies and measures in a changing climate, where resilience is defined as the ability to timely and effectively anticipate, prepare for, respond to, and recover from climate change and other risks; definitions of resilience vary across disciplines, with all incorporating elements of effectively responding to, limiting impacts from, and recovering after a perturbation
Summary
Public health has an impressive history of identifying and reducing health threats, as evidenced by the dramatic increase in life expectancy in the past 100 years. Initial policies and measures to adapt to the health impacts of climate change emphasized enhancing current health protection to climate sensitive health outcomes, such as implementing heatwave early warning systems [1]. Such actions are vital, they will not necessarily reduce risks in a future climate; changing baselines mean that current efforts could be neutral or, in a worst case, maladaptive under new weather patterns. Public health in the U.S has historically focused on top-down measures aimed at reducing individual exposures and behaviors that increase disease risk This approach is a consequence of public health tending to view the world through a medical model, with individuals and communities more as units for intervention than as partners in action. The impacts experienced in a particular location will vary, depending on the effectiveness of the public health and health care systems, and on the vulnerabilities specific to that location
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