Building Resilience against Climate Effects—A Novel Framework to Facilitate Climate Readiness in Public Health Agencies

Abstract

Climate change is anticipated to have several adverse health impacts. Managing these risks to public health requires an iterative approach. As with many risk management strategies related to climate change, using modeling to project impacts, engaging a wide range of stakeholders, and regularly updating models and risk management plans with new information—hallmarks of adaptive management—are considered central tenets of effective public health adaptation. The Centers for Disease Control and Prevention has developed a framework, entitled Building Resilience Against Climate Effects, or BRACE, to facilitate this process for public health agencies. Its five steps are laid out here. Following the steps laid out in BRACE will enable an agency to use the best available science to project likely climate change health impacts in a given jurisdiction and prioritize interventions. Adopting BRACE will also reinforce public health’s established commitment to evidence-based practice and institutional learning, both of which will be central to successfully engaging the significant new challenges that climate change presents.

Enabling local public health adaptation to climate change

“…Really good ideas and maybe projects or things to implement" (interviewee, German local public health authority). The need for usable knowledge has been identified elsewhere, and practical examples include the US CDC BRACE framework which proposes five steps for sub-national public health agencies to conduct health vulnerability assessments and adaptation [47] and the BASE project 'Adaptation Inspiration Book' of case studies of adaptation measures in Europe [48]. Lastly, for knowledge to be usable it must be translated into regional languages (e.g., French, German) and be accessible to a public health audience.…”

“…Estimating or quantifying the additional burden on health due to climate change (i.e. projecting the disease burden) is one such data need and has been identified as a challenging but important step in public health adaptation that can be used in cost-benefit analyses [12,47]. Projecting the disease burden of climate change is highly data intensive, however, and requires downscaled and tailored climate projection data, meteorological data and health outcome data for a specific region [50,51].…”

Current medical research funding and frameworks are insufficient to address the health risks of global environmental change

“…These vulnerability and adaptation assessments are being conducted worldwide, with lessons learned on how to increase their effectiveness in the context of health systems [27, 28]. An example is the U.S. Centers for Disease Control and Prevention framework on Building Resilience Against Climate Effects (BRACE) [29]. This five-step process helps state and local health officials in the U.S. anticipate, prepare for, and respond to the health risks of climate change by projecting future health burdens with climate change, assessing interventions to reduce the risks, developing a climate and health adaptation plan, and evaluating the process and improving implemented options.…”

Human Health Impacts of Climate Change: Implications for the Practice and Law of Public Health

“…17 The primary federal framework and funding source dedicated to addressing health impacts of climate change is provided by the Building Resilience Against Climate Effects grants from CDC. 18 Other funding streams, however, may be flexible enough to support adaptation efforts by public health agencies and partners. 19 Existing funding streams potentially amenable to these applications include: transportation, including highway funding; energy, including Weatherization Assistance; community development, including HUD's Community Development Block Grant (CDBG) program; environmental protection, including Clean Water State Revolving Funds; and public health, including Community Transformation Grants.…”