Affiliation: Gillings School of Global Public Health, Department of Health Policy and Management
Over the last decade, there have been growing calls for national and local governments to adapt to a changing climate to protect human health. Due to the shift in U.S. federal climate policy under the Trump Administration, leadership for this climate and health adaptation rests increasingly among state, local and tribal health authorities. These authorities need effective strategies for planning climate and health adaptation in funding-constrained environments. This study proposes an adapted model for planning climate and health adaptation among state and local health departments, based on a review of existing efforts in the U.S., with a particular focus on the U.S. CDC’s Building Resilience Against Climate Effects (BRACE) model employed in the CDC-funded Climate Ready States and Cities Initiative (CRSCI).
Study methods comprised: a literature review of existing adaptation efforts in the U.S.; analysis of 11 CDC interviews with CRSCI grantees; and 11 online, videoconference focus group discussions with 46 city and county health officials. The study characterizes the key inputs and processes involved in BRACE implementation by 9 states and 2 cities, revealing key challenges and enabling factors that influenced successful climate and health adaptation planning. The study also summarizes the input of health authorities on operational requirements to expand climate and health adaptation at state and local levels, and their recommendations for an adapted BRACE model. Lastly, the study proposes an adapted BRACE model for state and local health departments facing resource constraints, and recommendations for how CDC and the broader health community can advance climate and health adaptation nationwide.