We Go Deep: Health Equity Frameworks for Community Climate Action

Posted on June 23, 2025 by Julian L. Watkins

This entry is part 13 of 16 in the series July 2025

Public health in the US is facing unprecedented challenges and an increasingly hostile environment. Agencies are facing major losses of funding, political repression, and the breakdown of public confidence, all while responding to increasingly complex, intersectional sociopolitical issues that impact the public’s health like climate change. To protect and promote the health of the communities we serve, public health practitioners must look for different applications of the tools and resources we have at our disposal. In my latest publication “Fostering Community-Led Climate Action,” I describe some practical applications of health equity for the public health workforce to consider as they work with communities to address climate change as a public health issue.

I am an Internal Medicine physician and Assistant Commissioner in the Center for Health Equity and Community Wellness at the NYC Department of Health and Mental Hygiene. In my role, I lead a bureau with a broad scope. I led community engagement efforts during both the COVID-19 and Mpox emergency responses in NYC. Most recently, I oversaw the relaunch of the City of New York’s, Be a Buddy program, a community-led social resiliency program that connects residents most susceptible to the health impacts of climate change to vital information and resources. I’ve found that no matter the size or urgency of the public health issue, health equity has consistently proven to be one of our greatest and most effective frameworks at my disposal. A growing body of evidence shows that a deeper understanding of health equity is essential for public health practice in the 21st century.

Health equity is a set of ethical and moral principles that motivate efforts to eliminate health inequities.

We Go Deep: Health Equity Frameworks for Community Climate Action

Read the Article in JPHMP

The Centers for Disease Control and Prevention defines health equity as “the state in which everyone has a fair and just opportunity to attain their highest level of health;” this definition is significant and the embrace of equity over the last few years is something to be celebrated. This framing also has serious limitations because it fails to capture the richness of health equity. I’ve found that the true potential of health equity is unlocked when we deepen our understanding, beyond an achievement or destination, and embrace it as a moral and ethical concept, such as liberty or justice. This framing comes with its own unique challenges, as moral concepts are difficult to describe, outside of religious or philosophical spaces, leaving these essential concepts vulnerable to misinformation and disinformation efforts to undermine and weaponize language for personal or political gain. The benefits outweigh the risks — moral concepts can serve as bridges across vast interpersonal and ideological differences and a fertile ground for new communities of care and concern to take root.

Health equity is a lens to raise standards and illuminate disciplinary knowledge gaps.

Effective communication is an essential public health service. Over the years we have seen the limits in traditional approaches to health communications. Applying an equity lens to communications helps us understand the importance of community voice. Our work requires an expansion of skills to meet community standards. Equitable communication practices prioritize tailored communication strategies to reach specific audiences, which requires bidirectional feedback from communities and collaboration with a variety of stakeholders.

Though the threat of climate change is increasingly appreciated for the existential threat it presents, climate education is inconsistently integrated into public health curricula worldwide. Education must therefore be a foundation of climate action in public health. Public health agencies should actively pursue opportunities to facilitate climate education for their staff and the communities they serve. Framing climate change in the context of equity highlights the ways that discriminatory policies shape health outcomes and can illuminate knowledge gaps and biases.

Health equity is the corrective action taken to actively de-marginalize communities.

Our advocacy efforts must go beyond informing people about the threat; we must align our efforts with community priorities and create points of access for others to see how they can get involved in meaningful ways. Civic engagement for public health can provide health benefits for individual participants and positively impact the community through empowerment, capacity building, and creating shared goals around new and existing problems.

Health equity is a movement.

Health equity is difficult work and can feel isolating. In times of disconnection, it’s especially important to remember that we stand on the shoulders of giants; we are part of something bigger than ourselves. This work spans decades despite constant threats and competing priorities. Health equity builds on and is in conversation with a robust body of work created by an international community of scholars, researchers, activists, and organizers both inside and outside public health.

In “Fostering Community-Led Climate Action,” I lay out a framework and vision for individuals and organizations at any point in their community engagement journey. My focus on the “people business” of community engagement is a recognition that for many of us, our training didn’t prioritize learning hard and soft skills for deep engagement. Organizing our coalitions around the values of equity provides a sturdy foundation for when our commitments are inevitably tested because of setbacks or disagreements. My hope is to support public health practitioners as they find ways to use their unique skills for social change. There is no one solution, there are many right answers to the problems we face. Our communities and environments depend on us remembering that.

About the Author

Julian L. Watkins: Julian L. Watkins, MD, is Assistant Commissioner of the Bureau of Health Equity Capacity Building at the NYC Department of Health and Mental Hygiene. He leads citywide efforts to promote community wellness, reduce health inequities, and empower communities through tailored engagement and community-centered program design. He is a fellow with the Medical Society Consortium on Climate and Health.