Building Public Health Capacity for Climate Action

By Mona Arora, MSPH, PhD, Principal Research Specialist & Course Instructor, Mel and Enid Zuckerman College of Public Health, University of Arizona

The theme for this year’s World Environmental Health Day, celebrated on Sept. 26, calls for unified action among the global environmental health community to tackle climate change. This is not the first call for action of its kind; in fact, Eco-America, Medical Society Consortium on Climate & Health, and American Medical Association have all recently indicated commitment to action among their respective communities.

We need national synergy to increase public health capacity for climate change action, building on the themes identified by the American Public Health Association’s (APHA’s) 2017 Climate Change and Health Needs Assessment. Promoting collaboration and engagement will help us to understand and address the health impacts of a changing climate.

The stark impacts of climate change will be most evident at the local level, where we know that cliché images of polar bears and melting ice caps do not resonate. Portraying climate change as a public health concern is essential to framing this global issue as one of local relevance.

Our public health system is comprised of “a complex and broad range of federal, state, and local health agencies, laboratories and hospitals, as well as nongovernmental public and private agencies, voluntary organizations, and individuals,” according to the Centers for Disease Control and Prevention (CDC). Any action that examines, mitigates, or adapts to climate change necessitates partnerships and collaboration of individuals and agencies that fit within the public health system and influence health and well-being. Local and regional partners described by NACCHO’s Essential Actions for Climate Resilience include government agencies (e.g., land use, urban planning, transportation, utilities), academia, private sector, and non-profit agencies working on issues that influence health.

Collaboration both within public health and across sectors is key to reducing fragmentation of activities and enhancing mutual benefits. In a consistently underfunded environment, partnerships are instrumental to devising cost-effective solutions, leveraging existing resources, and informing tailored actions that address local implications.

However, before public health can reach out and collaborate effectively with agencies and individuals in other sectors, we need a concerted effort to build internal public health capacity to understand the impacts at local and regional levels. Building this internal capacity rests on enhancing climate literacy among health department staff. Due to a lack of dedicated funding, along with competing public health priorities, our current culture of practice acknowledges but does not provide an environment that promotes climate change action, knowledge-sharing and problem-solving among stakeholders.

So, how do we foster a culture of collaboration in other sectors when the public health system, itself, is not on a common platform?

The 2017 APHA Needs Assessment outlines key themes for promoting climate dialogue and action, including building capacity, strengthening leadership, and enhancing collaboration.

APHA and other professional organizations like NACCHO, the National Environmental Health Association (NEHA), and the Association of State and Territorial Health Officials (ASTHO) are at the forefront of this issue and have the opportunity to take on an active role in preparing the public health system to manage and approach climate resilience.

Although there is no silver bullet, the coordinated approach that is described by APHA should be supported by parallel national stakeholders and organizations to build capacity. There is a need to prioritize public health action through education, guidance, and leadership training that elevates the climate-health dialogue to the forefront.

Only 21% of local health department directors surveyed by NACCHO in 2012 indicated climate change as an important priority for their health department. A 2017 report from NACCHO found that even fewer local health departments reported addressing climate change-related issues in 2017 than in 2012.

How can a shift in this prevalent mindset be initiated? A national assessment (to be published) of public health sector professionals conducted by researchers at the University of Arizona highlights several strategies to address this issue. A shift in mindset warrants an exploration and assessment of strategies used by other sectors and regions for public health. This study also underscores the importance of cross-sectoral partnerships at both the policy and community levels. Professional communities, think tanks, and advocacy organizations need to come together to identify strategies aimed at better engaging and enabling the public health workforce.

Participants from this study also highlighted the need for focused efforts to build academic partnerships with universities and institutes of higher learning to leverage expertise and foster common and mutually beneficial interests. This need aligns with findings from a Climate Metrics Survey conducted by NEHA, which found that NEHA members, like many other professional public health communities, have a high degree of trust in scientists, health professionals, and academia.

Finally, public health capacity building requires not only knowledge and awareness but also the identification of concrete, feasible recommendations that can be implemented within the parameters of limited funding and resources. This necessitates innovative approaches that align climate change action to pressing public health issues and existing priorities.

Promoting a public health lens to climate change action requires a knowledgeable and trained workforce that is actively engaged in decision-making to mitigate the health impacts of climate change.

Visit NACCHO’s climate change webpage for resources and more information.

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