Reimagining the Role of Health Departments and Their Partners in Addressing Climate Change: Revising the Building Resilience against Climate Effects (BRACE) Framework

Public health departments have important roles to play in addressing the local health impacts of climate change, yet are often not well prepared to do so. The Climate and Health Program (CHP) at the Centers for Disease Control and Prevention (CDC) created the Building Resilience Against Climate Effects (BRACE) framework in 2012 as a five-step planning framework to support public health departments and their partners to respond to the health impacts of climate change. CHP has initiated a process to revise the framework to address learnings from a decade of experience with BRACE and advances in the science and practice of addressing climate and health. The aim of this manuscript is to describe the methodology for revising the BRACE framework and the expected outputs of this process. Development of the revised framework and associated guidance and tools will be guided by a multi-sector expert panel, and finalization will be informed by usability testing. Planned revisions to BRACE will (1) be consistent with the vision of Public Health 3.0 and position health departments as “chief health strategists” in their communities, who are responsible for facilitating the establishment and maintenance of cross-sector collaborations with community organizations, other partners, and other government agencies to address local climate impacts and prevent further harm to historically underserved communities; (2) place health equity as a central, guiding tenet; (3) incorporate greenhouse gas mitigation strategies, in addition to its previous focus on climate adaptation; and (4) feature a new set of tools to support BRACE implementation among a diverse set of users. The revised BRACE framework and the associated tools will support public health departments and their partners as they strive to prevent and reduce the negative health impacts of climate change for everyone, while focusing on improving health equity.

[1]  Protecting the built environment in a barrier beach and marsh system: A case study of the Hampton-Seabrook Estuary, New Hampshire , 2023, Shore & Beach.

[2]  S. Aytur,et al.  The Institute of Medicine’s call to action revisited: assuring access to public health education for U.S. college students , 2023, Frontiers in Public Health.

[3]  Heather A. Joseph,et al.  Evaluating public health strategies for climate adaptation: Challenges and opportunities from the climate ready states and cities initiative , 2023, PLOS Climate.

[4]  James S. Vickery,et al.  Barriers and facilitators to state public health agency climate and health action: a qualitative assessment , 2023, BMC Public Health.

[5]  James S. Vickery,et al.  Climate Change Adaptation Activities and Needs in US State and Territorial Health Agencies , 2022, Journal of public health management and practice : JPHMP.

[6]  J. Vargo,et al.  Overcoming Barriers to Successful Climate and Health Adaptation Practice: Notes from the Field , 2022, International journal of environmental research and public health.

[7]  L. Cushing,et al.  Racial Disparities in Climate Change-Related Health Effects in the United States , 2022, Current Environmental Health Reports.

[8]  R. Garcia-Herrera,et al.  Public Health Implications of Drought in a Climate Change Context: A Critical Review. , 2022, Annual review of public health.

[9]  Baltazar Solano Rodriguez,et al.  The 2021 report of the Lancet Countdown on health and climate change: code red for a healthy future , 2021, The Lancet.

[10]  J. Malilay,et al.  Building a Comprehensive Approach to Address the Health Effects of Climate Change in CDC's National Center for Environmental Health , 2021, The Journal of Climate Change and Health.

[11]  Frank K. Lake,et al.  Wildfire and climate change adaptation of western North American forests: a case for intentional management , 2021, Ecological applications : a publication of the Ecological Society of America.

[12]  A. Tricco,et al.  The Health Effects of Climate Change: An Overview of Systematic Reviews , 2020, medRxiv.

[13]  T. Weeramanthri,et al.  Is climate change exacerbating health-care workforce shortages for underserved populations? , 2021, The Lancet. Planetary health.

[14]  P. Nicholas,et al.  The intersection of climate change with the era of COVID‐19 , 2021, Public health nursing.

[15]  K. Ebi,et al.  Extreme Weather and Climate Change: Population Health and Health System Implications. , 2021, Annual review of public health.

[16]  M. Maslin,et al.  The 2020 report of the Lancet Countdown on health and climate change: responding to converging crises , 2020, The Lancet.

[17]  P. Schramm,et al.  How Indigenous Communities Are Adapting To Climate Change: Insights From The Climate-Ready Tribes Initiative. , 2020, Health affairs.

[18]  E. Svendsen,et al.  Climate Change and Health: Local Solutions to Local Challenges , 2020, Current Environmental Health Reports.

[19]  S. Clayton.  Climate anxiety: Psychological responses to climate change. , 2020, Journal of anxiety disorders.

[20]  K. Albright,et al.  Dissemination of Information About Climate Change by State and Local Public Health Departments: United States, 2019-2020. , 2020, American journal of public health.

[21]  S. Galea,et al.  COVID-19 and Underinvestment in the Public Health Infrastructure of the United States. , 2020, The Milbank quarterly.

[22]  T. Burke,et al.  Integrating Public Health into Climate Change Policy and Planning: State of Practice Update , 2019, International journal of environmental research and public health.

[23]  Gerjo Kok,et al.  Implementation Mapping: Using Intervention Mapping to Develop Implementation Strategies , 2019, Front. Public Health.

[24]  A. Szema,et al.  Health Effects of Climate Change-induced Wildfires and Heatwaves , 2019, Cureus.

[25]  Alison B. Hamilton,et al.  Innovations in Mixed Methods Evaluations. , 2019, Annual review of public health.

[26]  Ross A. Hammond,et al.  The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report , 2019, The Lancet.

[27]  S. Kenyon,et al.  Can rapid approaches to qualitative analysis deliver timely, valid findings to clinical leaders? A mixed methods study comparing rapid and thematic analysis , 2018, BMJ Open.

[28]  C. Wilkins,et al.  Enhancing translational researchers’ ability to collaborate with community stakeholders: Lessons from the Community Engagement Studio , 2018, Journal of Clinical and Translational Science.

[29]  P. O'Carroll,et al.  Public Health 3.0: A Call to Action for Public Health to Meet the Challenges of the 21st Century , 2017, Preventing chronic disease.

[30]  Beth Resnick,et al.  Integrating Health into Local Climate Response: Lessons from the U.S. CDC Climate-Ready States and Cities Initiative , 2017, Environmental health perspectives.

[31]  Caitlin N. Dorsey,et al.  Psychometric assessment of three newly developed implementation outcome measures , 2017, Implementation Science.

[32]  J. Rocklöv,et al.  Assessing Greenhouse Gas Emissions and Health Co-Benefits: A Structured Review of Lifestyle-Related Climate Change Mitigation Strategies , 2017, International journal of environmental research and public health.

[33]  M. Eliot,et al.  Heat‐related morbidity and mortality in New England: Evidence for local policy , 2016, Environmental research.

[34]  E. Maibach,et al.  Adapting to the Changing Climate: An Assessment of Local Health Department Preparations for Climate Change-Related Health Threats, 2008-2012 , 2016, PloS one.

[35]  Alexander C. E. Aylett.  Institutionalizing the urban governance of climate change adaptation: Results of an international survey , 2015 .

[36]  G. Bernard,et al.  Community Engagement Studios: A Structured Approach to Obtaining Meaningful Input From Stakeholders to Inform Research , 2015, Academic medicine : journal of the Association of American Medical Colleges.

[37]  J. Kaufman,et al.  Review Article: Vulnerability to Heat-related Mortality A Systematic Review, Meta-analysis, and Meta-regression Analysis , 2015, Epidemiology.

[38]  J. Patz,et al.  Climate Change, Human Rights, and Social Justice. , 2015, Annals of global health.

[39]  J. Beebe.  Rapid Qualitative Inquiry: A Field Guide to Team-Based Assessment , 2014 .

[40]  Andy Haines,et al.  Climate change: challenges and opportunities for global health. , 2014, JAMA.

[41]  Julia A. Ekstrom,et al.  Identifying and overcoming barriers in urban climate adaptation: Case study findings from the San Francisco Bay Area, California, USA , 2014 .

[42]  Shubhayu Saha,et al.  Building Resilience against Climate Effects—A Novel Framework to Facilitate Climate Readiness in Public Health Agencies , 2014, International journal of environmental research and public health.

[43]  Carol M. Barnum.  Usability Testing Essentials: Ready, Set...Test! , 2010 .

[44]  Amy E. Chadwick,et al.  Climate Change and Local Public Health in the United States: Preparedness, Programs and Perceptions of Local Public Health Department Directors , 2008, PloS one.

[45]  Jennifer Duffy,et al.  Bridging the Gap Between Prevention Research and Practice: The Interactive Systems Framework for Dissemination and Implementation , 2008, American journal of community psychology.

[46]  D. Richter,et al.  On Linkages: Confronting the Public Health Workforce Crisis: ASPH Statement on the Public Health Workforce , 2008, Public health reports.

[47]  J. Landeta.  Current validity of the Delphi method in social sciences , 2006 .

[48]  A. Delbecq,et al.  The nominal group as a research instrument for exploratory health studies. , 1972, American journal of public health.

[49]  C. Dolea,et al.  World Health Organization , 1949, International Organization.

[50]  Mark T. Anderson,et al.  Chapter 22 : Northern Great Plains. Impacts, Risks, and Adaptation in the United States: The Fourth National Climate Assessment, Volume II , 2018 .

[51]  David R. Easterling,et al.  Impacts, Risks, and Adaptation in the United States: Fourth National Climate Assessment, Volume II , 2017 .

[52]  D. Himmelstein,et al.  Public Health's Falling Share of US Health Spending. , 2016, American journal of public health.

[53]  Shimin Zheng,et al.  Comparing Urban and Rural Vulnerability to Heat-Related Mortality: A Systematic Review and Meta-Analysis , 2016 .

[54]  F. Butera.  Cities and climate change , 2008 .