Overview

While global calls to action drive much of the news about climate change, direct impacts on people - increases in illness and death - are felt and carried at the local level. In this blog post, we summarize the added value of partnering with local health departments in climate change adaptation efforts. 

Background

Climate change is a complex issue that demands a multifaceted response from all sectors of society and government. Climate change action has naturally stemmed from environmental impacts with expanding attention to the built infrastructure, energy systems, and emergency response. Public health plays a vital role in understanding and addressing the impacts of climate change on human health and quality of life. However, the public health role and contribution is often overlooked when describing the benefits of taking climate action, even though its effects are most acutely experienced at the local level.

Recognizing this gap, the NACCHO Global Climate Change Workgroup explored how to better integrate local public health departments (LHDs) into the development and implementation of climate adaptation strategies.

In partnership with University of Washington researchers, the NACCHO Global Climate Change workgroup set out to assess existing collaborations between LHDs and other agencies to combat climate change and identify areas for improvement. At the 2024 National Adaptation Forum, we facilitated small, round-table discussions with 50+ adaptation professionals across diverse sectors, including transportation, planning, water resources, energy, and emergency management in various levels of government, as well as non-profit and for-profit organizations. The data collected from the discussions was analyzed using the Integrative Framework for Collaborative Governance¹. Notably, this research predated recent shifts in the current political environment that put traditional public health, health equity, and climate action into jeopardy. However, the principles laid out in this work remain applicable to the intersections and opportunities that can be found in cross-sectoral work for climate health.

While public health professionals often collaborate with other sectors on non-climate issues, we found a critical lack of interaction between public health and other sectors on climate change adaptation. This disconnect was rooted in several factors, including siloed structures, political barriers, and funding constraints. For example, one participant said: “Climate adaptation falls on conservation organizations a lot, they recognize the importance of public health outcomes - but understanding of public health is limited.” 

LHDs bring data expertise

Despite these challenges, public health has a significant role to play in climate adaptation in two very actionable areas—data and partnerships. Public health agencies possess valuable data and analytical expertise that make the case for, and inform the development of, effective strategies. These agencies also often have the ability to assess data that relates the effects of climate change on public health. External partners may not have the capacity or expertise to interpret that data and apply it effectively to policy decisions. Public health must go beyond sharing data by actively supporting partners in processing and using it. Describing the burden of climate change on public health—the number of excess deaths due to heat in a city following summer heat events or the increase in emergency department visits associated with a particular wildfire smoke event—provides a substantiated imperative for decision makers to act. Public health facilitated interpretation of these data can motivate resource allocation proactively in preparedness efforts for future heat and wildfire seasons.

LHDs must advertise their partnership benefits

The research also highlighted the need for greater awareness of collaborative efforts that include public health. Some jurisdictions noted that public health may need to proactively seek participation in climate actions. They noted: “All of these sectors should be coming to public health to see what they can provide. They said they are usually chasing the other sectors, rather than being consulted/seeking input.” Once public health is at the table, they are seen as a trusted link and bridge to expanding partnership for future projects. For example, public health data can identify the most impacted communities for each climate-related exposure so that targeted action, which supports prioritizing equity in climate mitigation and adaptation programs, can be taken. By identifying gaps in existing efforts and actively working to bridge them, public health professionals can ensure that their perspective is included from the outset of climate change planning processes. One participant noted, “Public health really brings to the conversation evaluation, how climate adaptations are impacting implementation/seeing if things are having impact. Health assessments, evaluations, etc. collect that data.”

An issue identified during the discussions, however, is that climate-resilience projects were more likely than public health initiatives to be funded quickly. When public health is intentionally included in climate-resilience projects, alternative funding sources may be available that aren’t specifically targeted at climate-resilience. This can allow for improved collaboration efforts and better community outcomes. With the access to data, ability to interpret and report out results, and connection with policy decision-makers, these linkages can improve both public health outcomes and climate-resilience metrics. 

LHDs have expertise engaging community partners with constrained resources

Public health agencies can act as conveners, creating knowledge sharing networks and allowing partners from various sectors to leverage collective resources to develop comprehensive and sustainable solutions to the challenges posed by climate change. This includes addressing the direct and indirect health impacts of climate change, such as heat-related illnesses, air pollution, and waterborne diseases. 

Public health agencies face several internal challenges in taking on climate-focused work, noting staffing and development barriers. They also face serious resource constraints and capacity concerns, limiting the ability to take on the more complex multi-sector issues. On the other hand, much of the climate-related work is already happening. Public health must also work internally to build workforce awareness. One participant said, “State health departments and local agencies often don’t use the same terminology, making collaboration difficult.” Fortunately, there are several resources already available, including workforce development training courses. There are also guides to assist in how to administratively build climate programs at a local health jurisdiction written by the Global Climate Change Workgroup. The guide includes low-resource tips and tools to start demonstrating progress towards climate action in your health department.

In conclusion, incorporating public health into climate adaptation efforts is not only beneficial, but essential. By recognizing the interconnectedness of climate change and public health, and by fostering collaboration across sectors, we can develop more effective and equitable strategies for mitigating the impacts of climate change and protecting the health and well-being of communities. This requires a shift in mindset, a breaking down of silos, and a commitment to working together to address this critical global challenge.

Citations

1. Emerson, Kirk & Nabatchi, Tina & Balogh, Steve. (2012). An Integrated Framework for Collaborative Governance. Journal of Public Administration Research and Theory. 22. 1. 10.1093.

Relevant Resources

• NACCHO’s Maintaining Climate and Health Momentum in Public Health: Communication and Funding Strategies (2025)

Acknowledgments 

This blog was made possible through support from the Centers for Disease Control and Prevention, Cooperative Agreement #6 NU38PW000037-01-01. 

NACCHO would like to thank the Global Climate Change Workgroup co-chaired by Sam Rubens and Katherine Perez, the workgroup members; Bradley Kramer, Carolyn Olson, Adrian Uzanian, Ileana Tiemann, and Kyle Fliflet, and the NACCHO staff members; Aliya Al-Sadi, Angana Roy, Chelsea Gridley-Smith, and Anupama Varma. A special thank you to Andrianna Oelund, who helped summarize the data from the 2024 National Adaptation Forum. NACCHO is grateful for this support. Its contents are solely the views of the authors and do not necessarily represent the official views of the sponsor.