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Public Health Climate Change Adaptation Planning Using Stakeholder Feedback

Eidson, Millicent MA, DVM; Clancy, Kathleen A. MPH; Birkhead, Guthrie S. MD, MPH

Journal of Public Health Management and Practice: January/February 2016 - Volume 22 - Issue 1 - p E11–E19
doi: 10.1097/PHH.0000000000000243
Original Articles

Context: Public health climate change adaptation planning is an urgent priority requiring stakeholder feedback. The 10 Essential Public Health Services can be applied to adaptation activities.

Objective: To develop a state health department climate and health adaptation plan as informed by stakeholder feedback.

Design: With Centers for Disease Control and Prevention (CDC) funding, the New York State Department of Health (NYSDOH) implemented a 2010-2013 climate and health planning process, including 7 surveys on perceptions and adaptation priorities.

Participants: New York State Department of Health program managers participated in initial (n = 41, denominator unknown) and follow-up (72.2%) needs assessments. Surveillance system information was collected from 98.1% of surveillance system managers. For adaptation prioritization surveys, participants included 75.4% of NYSDOH leaders; 60.3% of local health departments (LHDs); and 53.7% of other stakeholders representing environmental, governmental, health, community, policy, academic, and business organizations. Interviews were also completed with 38.9% of other stakeholders.

Results: In 2011 surveys, 34.1% of state health program directors believed that climate change would impact their program priorities. However, 84.6% of state health surveillance system managers provided ideas for using databases for climate and health monitoring/surveillance. In 2012 surveys, 46.5% of state health leaders agreed they had sufficient information about climate and health compared to 17.1% of LHDs (P = .0046) and 40.9% of other stakeholders (nonsignificant difference). Significantly fewer (P < .0001) LHDs (22.9%) were incorporating or considering incorporating climate and health into planning compared to state health leaders (55.8%) and other stakeholders (68.2%). Stakeholder groups agreed on the 4 highest priority adaptation categories including core public health activities such as surveillance, coordination/collaboration, education, and policy development.

Conclusions: Feedback from diverse stakeholders was utilized by NYSDOH to develop its Climate and Health Strategic Map in 2013. The CDC Building Resilience Against Climate Effects (BRACE) framework and funding provides a collaborative model for state climate and health adaptation planning.

The objective of this study was to develop a state health department climate and health adaptation plan as informed by stakeholder feedback.

Office of Public Health, New York State Department of Health, Albany, New York (Drs Eidson and Birkhead and Ms Clancy); and Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, Rensselaer, New York (Drs Eidson and Birkhead).

Correspondence: Millicent Eidson, MA, DVM, Office of Public Health Practice, New York State Department of Health, 923 Corning Tower, Empire State Plaza, Albany, NY 12237 (

The 2010-2013 Centers for Disease Control and Prevention (CDC) Cooperative Agreement Number 5UE1EH000737 and the CDC/CSTE Applied Epidemiology Fellowship program Cooperative Agreement Number 5U38HM000414 supported this project. This publication is solely the responsibility of the authors and its contents do not necessarily represent the official views of CDC. CDC had no role in study design, collection, analysis, and interpretation of data; writing the report; or decision to submit the report for publication. No other funding supported the project. The authors thank the following members of our Project Coordinating Team in alphabetical order: Marie Desrosiers, Kevin Gleason, Dr Nathan Graber, Claudia Hutton, Dr Syni-An Hwang, Dr Shao Lin, Dr Daniel Luttinger, Dr Faith Schottenfeld, and Dr Jan Storm, New York State Department of Health. The authors acknowledge the contributions to methods and analysis of Danielle Abraham, Eva Pradhan, and Dr Shelley Zansky, New York State Department of Health, and interns Stephanie Mack, Daniel Malashock, Natasha Karim, Asma Madad, and Sakib Bin Aziz, University at Albany.

The authors declare no conflicts of interest.

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