Federal Agencies Have Undertaken Various Activities to Enhance Understanding of Climate Change Risks to Public Health

Federal agencies have undertaken activities to enhance understanding  about the risks that climate change poses to public health, including  supporting and conducting research on or related to these risks. Agencies have also communicated about  such risks through reporting and outreach efforts to public health officials  and the general public. Providing Data and Decision Support Resources for Examining Risks

Federal agencies have provided some data and decision support  resources—such as guidance and tools—that state and local officials,  and others, can use to examine public health-related risks from climate  change and potential actions to address these risks. The U.S. State and Local Health Departments Have Used CDC and Other Federal Resources to Address the Risks That Climate Change Poses to Public Health

Selected state and local health departments included in our review have  used a CDC climate and health award that addresses the risks that  climate change poses to public health, as well as other federal resources,  to address and plan for the public health risks from climate change. In fiscal year 2014, Initiative awards to state and local health  departments totaled $3.6 million, with individual awards averaging about  $200,000. The officials also stated that they face  challenges in identifying potential health risks of climate change, for  example, as a result of research gaps. Finally, state and local public  health officials said they face other challenges that federal action may not  be able to address, such as having insufficient data on health impacts in  areas where agreements between states and hospitals limit access by  health departments. The officials also identified  opportunities for federal agencies to address these communication  challenges. Federal officials, including those from HHS, told us that they are taking  steps to enhance public awareness. CDC officials told us that they have been focusing on assisting  awardees with resolving methodological and data issues related to  implementing the BRACE framework, such as identifying models for use  in developing projections of climate change in their jurisdictions. Officials from federal agencies told us about actions that they have taken  or that they have planned that could help address some of these  challenges. While some federal programs collect local data and provide  financial resources to selected states and localities, such as CDC’s  National Environmental Public Health Tracking Program, the federal  government does not collect local data on climate impacts or health  outcomes in all locations, and does not make awards to support the  climate and health activities of all state and local health departments. Issuing such guidance would also be in line with the core  functions of CDC’s Climate and Health Program, which include translating  climate change science to inform communities. Recommendation for Executive Action

To enhance HHS’s ability to protect public health from the impacts of  climate change, we recommend that the Secretary of HHS direct CDC to  develop a plan describing when it will be able to issue climate change  communication guidance to state and local health departments, to better  position relevant officials to effectively communicate about the risks that  climate change poses to public health and address requirements of the  Climate Ready States and Cities Initiative. CDC noted its plans to develop and issue  climate change communication guidance to state and local health  departments after HHS finalizes its climate change communication and  outreach strategy, which is expected by July 2016. Specifically, the administration  announced the following actions to address this issue:  1.  creation of a map tool by the Department of Health and Human  Services to improve the ability of health officials and emergency  managers to rapidly identify residential areas where people who  depend on electricity to power life-critical durable medical equipment  live;  2.  development of a national integrated heat health information system  by the Centers for Disease Control and Prevention and the National  Oceanic and Atmospheric Administration, which is intended to provide  a suite of decision support resources that better serve public health  needs;  3.  launch of a climate and health innovation challenge series by the  National Institutes of Health and others to promote innovative  approaches and highlight technologies available for understanding the  health implications of climate change and improving resilience to  adverse effects;  4.  creation of a climate change impacts subcommittee within the Federal  Interagency Working Group on Environmental Justice, and the  workgroup’s launch of a climate justice initiative that is focused on  incorporating equity into climate adaptation planning;  5.  announcement of a local climate and energy webcast series on  climate change, heat islands, and public health, to be hosted by the  Environmental Protection Agency;  6.  plans to highlight examples of policy actions related to children’s  health during national Children’s Health Month;  7.  a commitment by CDP, a private organization, to release publicly  disclosed data from 61 U.S. cities that summarize the climate risks  that the cities are facing and the actions they are taking to improve  resilience; and  8.  an expansion in the number of medical, public health, and nursing  schools that have committed to educate and train their students about  the risks of climate change to public health. We also interviewed officials from the United States Global  Change Research Program and the Council on Environmental Quality. Appendix VI: Examples of Activities Conducted by Awardees of CDC’s Climate Ready States and Cities Initiative

State and local health officials from the 16 state and two local health  departments receiving awards through the Center for Disease Control  and Prevention’s (CDC) Climate Ready States and Cities Initiative told us  that they have conducted a variety of activities to address and plan for the  risks that climate change poses to public health. These include:  1. 2.
Why GAO Did This Study

The World Health Organization projects climate change will adversely affect health significantly over the next several decades. Some health effects of climate change are already being felt in the United States, according to assessments by the National Research Council, USGCRP, and others. Since the federal government is the nation’s largest purchaser of health care services, federal health care expenditures could increase in future years due to climate-related impacts.
GAO was asked to review federal efforts to increase public health system preparedness for climate change. This report addresses (1) federal activities to enhance understanding about the risks climate change poses to public health, (2) federal resources used by selected states and localities to address these risks, and (3) challenges states and localities face and actions federal agencies could take to mitigate them. GAO examined federal, state, and local documents, and interviewed officials from federal agencies such as CDC, NIH, USGCRP, as well as state and local health departments, including all 18 recipients of CDC’s Climate Ready States and Cities Initiative award.

What GAO Found

Federal agencies are enhancing understanding of climate-related risks to public health by (1) supporting and conducting research, (2) providing data and informational resources, and (3) communicating about risks. The Department of Health and Human Services’ (HHS) National Institutes of Health (NIH) supports a portfolio of research directly related to these risks. NIH reports awarding about $6 million for such research in fiscal year 2014, including for one study examining health risks posed by heat and air pollution. Federal agencies have also provided data on climate and health issues, such as the number of extreme heat days that state and local officials can use to assess health risks. They have also reported about these risks, such as through the third National Climate Assessment issued in May 2014 by the U.S. Global Change Research Program (USGCRP).
Selected state and local health departments have used resources from HHS’s Centers for Disease Control and Prevention (CDC) and other federal agencies to address and plan for the risks of climate change to public health. CDC’s Climate Ready States and Cities Initiative awards an average of about $200,000 per year each to 16 state and two local health departments to implement a risk management framework designed to help incorporate climate projections into public health planning. CDC also requires awardees to increase public awareness of the risks climate change poses to public health. Other federal resources used by health departments to prepare for these risks include funding provided through CDC’s National Environmental Public Health Tracking Program.
When asked to identify challenges they face in addressing and planning for the risks of climate change to public health, state and local health officials identified challenges that GAO grouped into the three most frequently mentioned themes. First, the officials said they face challenges communicating about the public health risks of climate change, due to limited public awareness and the complexity of the issue. These officials reported that enhanced federal leadership could help address this challenge. Although HHS plans to develop a climate change communication and outreach strategy, its development has been delayed by over a year. Also, CDC currently does not have plans to issue climate change communications guidance, which state and local officials said would be helpful. CDC’s limited resources are currently focused on resolving methodological and data issues related to its Climate Ready States and Cities Initiative. Given that health departments that have received awards under CDC’s initiative are required to take steps to enhance public awareness, such guidance may help awardees better meet this requirement. Issuing such guidance would also be in line with CDC’s core functions, which include translating climate change science to inform communities. Second, officials said they face challenges identifying health risks of climate change due to gaps in research and difficulties using climate data. Federal officials told GAO about actions they have taken or plan to take that could help address these challenges, such as issuing an assessment of climate change impacts on health, and creating a national heat health information system. Finally, the officials told GAO about other challenges they face that federal action may not be able to address, such as having insufficient local data on health outcomes, because states may not collect or have access to such data, and having insufficient staff resources for these activities.

What GAO Recommends

GAO recommends that HHS direct CDC to develop a plan describing when it will be able to issue climate change communications guidance to state and local health departments. CDC generally agreed with the recommendation, stating that it will issue guidance once HHS’s climate change communication and outreach strategy is final.