Synopsis: Public Health – Seattle & King County (PHSKC) grew from a climate and health committee to a full program over seven years (2015-2022). Much of King County’s government climate action is driven by their Strategic Climate Action Plan (SCAP), which is updated every five years. In the 2015-2020 SCAP, King County formed a committee and asked PHSKC to review the actions and plan potential future actions. To support this work, PHSKC formed a Climate Health Action Team, which began meeting monthly in 2015. In partnership with and funded by the Public Health Institute, PHSKC produced the Blueprint for Addressing Climate Change and Health (or “Blueprint”) in 2018. The details below describe the steps taken to move forward from Blueprint to inception of PHSKC’s Climate & Health Equity Initiative.

Challenge: King County’s 2020-2025 SCAP consists of three chapters: 1) Greenhouse Gas Reduction, 2) Sustainable Resilient Frontline Communities, and 3) Preparedness. The second chapter, written by community members, identifies their needs in order to prepare and adapt to the effects of climate change. As much as the field of public health practice sees health in all policies, the community sees health in all climate action. PHSKC was written into the 2020-2025 SCAP and assigned to over 70 actions as a lead or supporting agency. These actions include establishing a data monitoring system, engaging with the community to address social determinants of health affected by climate (such as food access, housing, and employment), and addressing preparedness for extreme heat and wildfire smoke.

However, a core challenge remained in determining how PHSKC could take on these additional responsibilities, given the limited budget, resources, and the ongoing COVID pandemic. In 2021, the King County Council approved the 2020-2025 SCAP and tasked PHSKC with preparing a report on how it would resource and support current and future SCAP actions.

Solution: In 2021, PHSKC formed a cross-divisional team to write the report over six months, involving the environmental health, chronic disease, and policy divisions. The team prepared the council report through the following three strategic approaches: first, leadership co-sponsorship, with the team holding monthly meetings with the three division directors and their administrative leads; second, a PHSKC-wide listening tour, where the team engaged all division and section directors in hour-long interviews, and included their ideas, resources, and staffing needs in the phased-in approach; and third, PHSKC director briefings were provided by the team to gain early and sustained buy-in and ultimate sign-off. The final report to the Council laid out the staffing and resources needed to take on the actions and objectives laid out in the SCAP and Blueprint.

The plan proposed scaling the climate and health program over three phases: 1) Capacity Building and Response, 2) Foundational Implementation, and 3) Full Implementation. The plan also included details accounting for additional staffing and resource needs across the department to help advance efforts to reduce health impacts and disparities resulting from climate change.

Results: PHSKC allocated sustained funding, leveraging discretional and state Foundation Public Health Services funding, for three climate-dedicated staff to support the department and represent the department in cross-agency climate meetings that include all departments within King County government.

In 2022, PHSKC identified climate change as a department-wide, top priority and launched a full climate and health program, securing the resources to launch Phase 1 - Capacity Building and Response. The new Climate & Health Equity Initiative (CHEI) secured a budget commitment for 3.0 Full Time Equivalent (FTE) of climate-dedicated staff positions in the first year, and an additional 0.5 FTE in the second year. This staffing enabled the establishment of a core team to fulfill the following roles of a program manager, epidemiologist, adaptation strategist, community partnership strategist, and communications strategist. With a dedicated program manager, CHEI laid a foundation to have a core, centralized program to support PHSKC to take on more climate-focused actions. The team continued to be supported by the cross-divisional and cross-agency Climate and Health Action Team advisory group.

PHSKC’s CHEI followed NACCHO’s Guide to Climate and Health Programs to design a Climate and Health Committee and Full Climate and Health Program. Some divisions began to identify staff leading climate related work, amplifying CHEI reach and stepping into an early part of Phase 2, Foundational Implementation. The first two years of the initiative included a few key milestones: development and launch of an online climate and health data dashboard; distributing more than 4,500 air filters and clean indoor air education in advance of wildfire events; broad multilingual and multi-media health communication campaigns during the heat and smoke season across 15 media outlets; building connections between our health care sector partners and climate change opportunities; and 9 successful grant applications with community and academic partners. CHEI aligns projects and activities with the County’s Executive Climate Office to support work across climate change mitigation and adaptation programming, updating the 2025-2030 SCAP, and applying for federal, state, and private funding.

Conclusion: Over 7 years, PHSKC moved from a Climate and Health Committee started in 2015 to initiation of a Full Climate and Health Equity Program in 2022. Together, the Blueprint, community voices, and county-wide strategic plans helped to elevate the priority and mandate to include public health in the county’s efforts to confront climate change. PHSKC leadership, central administrative buy-in, and climate-dedicated staffing were important to gain support across all divisions. The PHSKC strategic plan now contains climate change as a cross-cutting priority. Since the launch of its Climate & Health Equity Initiative, PHSKC has been able to advance implementation of the county’s Strategic Climate Action Plan mandates and begin the integration of efforts that address climate change into all public health programs.

Contact Information

Bradley Kramer, PhD MPA
[email protected]
Public Health – Seattle & King County, Washington