The Roles that Governmental Public Health Staff Can Play to Mitigate Climate Change

Posted on August 7, 2023 by Jocelyn Leung

This entry is part 35 of 43 in the series Wide World of Public Health Systems

Climate change is already here and not a threat in the distant future. As public health departments make plans for mitigating its impacts on the communities they serve, these climate considerations might help governmental public health workers in their current job responsibilities.

I am writing this blog in the middle of July 2023, and I can see the consequences of climate change all around me. The heat indexes in parts of eighteen states are expected to reach 103 degrees Fahrenheit and above. Heat compounded by continual drought is causing more severe wildfires in the West. Many people living in the contiguous United States have already breathed in air pollution from the Canadian wildfires. New York cannot provide natural disaster relief to Vermont because both are dealing with severe flooding. Rare zoonotic diseases, like babesiosis carried by ticks, are spreading northwards and westwards due to warming annual temperatures. These are all threats to our physical and mental health.

This snapshot of current events shows that climate change is already here and not a threat in the distant future. One question that arises is what role public health plays in addressing climate change. I will begin answering this question by sharing what climate change work governmental public health departments already plan to carry out and what climate considerations might help governmental public health workers in their current job responsibilities.

Before delving into governmental public health workers, it is helpful to cover some background information on climate change and its connection to public health. Every community faces unique challenges based on its location, such as some states on the seacoast navigating hurricanes versus semi-arid states dealing with water shortages. However, we know that increased production of heat-trapping greenhouse gas emissions from human activities has led to ubiquitous change at the local level, and these changes can include warming temperatures and increased evaporation leading to dryer soils; summer seasons being longer and winter seasons being shorter; increased or decreased precipitation (eg, rain, snow, and ice) depending on location; and more natural disasters or extreme weather events (eg, droughts, floods, hurricanes, heat waves, or freezes) compared to past decades (United States Environmental Protection Agency, 2023). For instance, extreme heat waves, like the one that we are experiencing in the United States right now, are becoming more frequent when previously they were expected to occur once every 15 years in our region.

These local climate changes in turn affect human health in myriad ways and beyond what this blog could cover. However, it might be helpful to delve into just two ways to see how aspects of climate change can lead to varied impacts on human and public health.

Public health implications from warmer temperatures: Higher than annual temperatures and heat waves increase pollutants in the air and disrupt our body’s ability to regulate temperature. While warmer temperatures will impact us all, socially marginalized communities often face disproportionate climate burden. This is because systemic racism, such as redlining and disinvestment, has already positioned many Black and Brown communities to be next to high sources of air pollution (eg, highways); to live in neighborhoods covered by water-resistant asphalt that absorbs heat; and have less access to air conditioning, green spaces, or other ways to cool off. Consequently, many of these communities already have high rates of respiratory and heat-related diseases, and these rates will rise further as temperatures grow warmer. Warmer temperatures also impact human health by changing biodiversity, or what plants, animals, insects, etc. can survive. This can stress out farmers, who may not be able to plant the same profitable crops as before. Culturally significant species – such as wild rice and Paper Birch trees to the Anishinaabe or Ojibwe people living in Minnesota – may also have trouble adapting or be crowded out by invasives and pests that thrive in warmer temperatures. The decline of these species can disrupt traditions and shared practices that are vital to people staying connected to one another across generations, to their culture, and to ancestors. These traditions are powerful protective factors for mental and social wellbeing. There is also emerging scholarship that people who feel responsible for protecting their ancestral lands and waters may experience profound emotional distress witnessing the physical deterioration of their homes due to climate change (Albrecht et al., 2007).
Public health implications from excessive rainfall: Excessive rainfall can lead to floods in areas, such as primarily asphalt-covered neighborhoods or narrow culverts on farms, that are not designed to absorb higher-than-average precipitation. Physical health can be endangered from floodwaters that can cause injuries, spread water-borne diseases, lead to power outages that are especially dangerous for people relying on ventilation and other medical devices, and lead to harmful mold growing in homes. Floodwaters can also wash toxic pollutants and pathogens into private wells that residents drink from long after the floodwaters recede. Finally, flooding is inherently stressful for farmers losing their crops or people being forced to leave their homes, which can in turn trigger or exacerbate mental illnesses.

As the examples above illustrate, climate change is multifaceted and can feel overwhelming, especially considering how the severity and frequency of extreme weather from climate change are likely to grow in our lifetimes. Even if humanity successfully stopped all emissions today, there would still be enough greenhouse gas emissions in the atmosphere to prevent our climate from returning to previous weather patterns. Although public health departments do not have the power of national governments to dramatically decrease emissions, public health departments are taking actions in three areas: 1) reducing local contribution of greenhouse gas emissions (ie, climate mitigation); 2) helping people grow accustomed to warming temperatures, increased rainfall, and other climate change manifestations that are here and will continue to worsen (ie, climate adaptation); and 3) improving emergency preparedness for the increased frequency of extreme weather events related to climate change (ie, climate resilience).

While I was looking over Community Health Improvement Plans and Climate Action Plans as part of research on areas in which governmental public health staff are practicing health equity, it was exciting to see what climate mitigation, adaptation, and resilience strategies public health departments had written down and intend to pursue. I have listed a few of these strategies in the table below.

Table 1. Strategies and goals for climate change

*Type of Climate Action*	*Governmental Public Health Department*	*Strategies*
Climate mitigation by lowering emissions and reducing humans’ exposure to air pollution	Los Angeles County Department of Public Health	● “Identify and target communities highly burdened by air pollution and toxic emissions.” This can be done through checking which neighborhoods have poor air quality or high hospitalization rates of children due to asthma. ● “Collaborate across sectors on policies and programs to reduce air pollution.” These could include policies reducing emissions from vehicles idling in traffic or improving infrastructure to encourage public transit, biking, and walking. ● “Bring industrial facilities into compliance with toxic emissions regulations” and start with “the 25 most significant toxic emitters.”
Climate adaptation by increasing awareness of health risks associated with climate change	Health Department [City of Lincoln, Nebraska]	● “Continue educational programs for childcare providers on climate-related health issues for young children.” Children’s lungs and bodies are still developing, which puts them at higher risk for being exposed and harmed by environmental contaminants or in natural disasters compared to adults. Childcare providers recognizing physical or mental symptoms earlier can make a real difference in getting help promptly.
Climate resilience during extreme weather emergencies	Public Health Department [City of Columbus, Ohio]	● “Implement resilience hubs within a 15-minute walk for all residents by 2050” and “ensure that all residents will receive time sensitive warnings in a manner that will be accessible to all.” Climate resilient hubs are buildings or even modified shipping containers that have services like phone charging, air conditioning, social services, and medical attention. They provide safe havens during floods, heat waves, and other emergencies. Resilience hubs are accessible to all but are especially important for people of color, houseless people, and people with low incomes, who might otherwise be exposed to the elements or unable to afford air conditioning.

A common theme in these strategies is they do not fall on governmental public health staff alone. Governmental public health staff are expected to work with other government departments (eg, public safety, parks and recreation, housing, and development); elected officials; private businesses (eg, schools, universities, health care systems, and industries); and communities (eg, nonprofits and others working closely with community members most impacted by climate change) to carry out these strategies. Such collaborations are vital to forming strong coalitions that can push for policy and systemic change and creating community trust and buy-in before climate emergencies occur. Therefore, it is important that governmental public health staff pursuing these strategies have the knowledge, skills, and confidence to build relationships with partners and communities, including community members who may be slow to trust public health or government institutions.

So far, I have only talked about strategies and actions that explicitly address climate change, and these might not be carried out by everyone working in a public health department or agency. However, weather affects what we eat; what water we drink; how we exercise, travel, work, and socialize with one another; and what condition our homes and neighborhoods are in. From this perspective, most governmental public health staff could benefit from understanding how climate change manifests in their local area so their programs, policy initiatives, services, and other work would be effective as our weather changes. This is illustrated in the hypotheticals below:

Public health staff may need to make adjustments while writing emergency preparedness plans if climate change has made floods that are supposed to happen once every 500 years now occur every two decades.
Environmental health staff might need to expand public education to cover more vector-borne diseases or work with homeowners more frequently to test well water due to increased flooding.
Healthy eating and active living staff may need to rethink what types of vegetables and fruits they recommend that people incorporate into their diets or whether gardening at home is more appropriate if those crops are not resilient to warming temperatures. When recommending physical activities, these staff might want to consider what activities can be performed safely in warmer climates and especially in neighborhoods covered with heat-absorbing asphalt.
Finally, an increasing number of public health staff is working with other agencies and organizations on social determinants of health, such as developing future housing or built environment in neighborhoods. Public health staff can advocate prioritizing climate proofing environmental justice communities’ infrastructure (eg, storm drains) after decades of disinvestments and neglect, or staff can advocate for reducing asphalt and increasing vegetation and reflective surfaces on sidewalks and buildings to dissipate heat. These planning and design decisions ensure that we are not jeopardizing populations’ health or widening health inequities in the future.

As a public health graduate who stumbled into climate change in a previous job without any background in environmental science, I have seen how valuable a public health perspective is even outside of a traditional “public health” job. While I eventually was able to learn enough about soil health and water sciences on the job to carry out my duties, I never lost my public health perspective on centering the health of human beings, and this deeply informed my work with county staff, water scientists, communities, and natural resources staff as we protected watersheds from climate change and other threats. This past job at an environmental organization taught me that understanding enough about climate change to ask the right questions on how it will impact human health is absolutely doable for governmental public health staff and could be crucial to public health’s mission to protect people’s health today and well into the future.

Author Profile

Jocelyn Leung: Jocelyn Leung is a researcher at the Center for Public Health Systems with over four years of experience practicing community-based participatory research, qualitative research, and evaluation with BIPOC and Greater Minnesota communities. She has facilitated decision-making processes and planning efforts involving communities most impacted by inequities, philanthropy, county governments, and state agencies on social determinants of health, including affordable housing and keeping drinking water safe from contamination. Ms. Leung holds an MPH in Community Health Promotion from the University of Minnesota, a MA in Political Science from the University of Minnesota, and a MSc in Modern Chinese Studies from the University of Oxford.