Addressing climate change and local public health: the Austin Climate Protection Program and the CDC Working Group on Climate Change collaboration.

Editor’s note: NEHA strives to provide up-to-date and relevant information on environmental health and to build part­ nerships in the profession. In pursuit of these goals, we feature a column from the Environmental Health Services Branch (EHSB) of the Centers for Disease Con­ trol and Prevention (CDC) in every issue of the Journal. In this column, EHSB and guest au­ thors from across CDC will highlight a variety of concerns, opportunities, chal­ lenges, and successes that we all share in environmental public health. EHSB’s objective is to strengthen the role of state, local, and national environmen­ tal health programs and professionals to anticipate, identify, and respond to adverse environmental exposures and the consequences of these exposures for human health. The services being de­ veloped through EHSB include access to topical, relevant, and scientific infor­ mation; consultation; and assistance to environmental health specialists, sani­ tarians, and environmental health pro­ fessionals and practitioners. The authors are from TKC Integrated Service Consulting (Natasha Prudent), the Centers for Disease Control and Pre­ vention (Maggie Byrne and George Lu­ ber), Adele Houghton Consulting (Adele Houghton, who is an Environmental Public Health Leadership Institute Fel­ low), and the Austin Climate Protection Program (Jake Stewart, Alexander [Sas­ cha] Petersen, and Rachel Thompson). The conclusions in this article are those of the authors and do not neces­ sarily represent the views of CDC. I n the December 2007 issue of the Journal, scientists from the Centers for Disease Control and Prevention (CDC) framed the public health impacts of climate change (Luber & Hess, 2007). They noted that costly catastrophic weather events (Gre­ enough et al., 2001) and vectorborne-disease outbreaks (Gage, Burkot, Eisen, & Hayes, 2008; Greenough et al., 2001; Gubler et al., 2001; Patz, Vavrus, Uejio, & McLellan, 2008) are expected to become more frequent, wide­ spread, and lengthy. The potential health ef­ fects of extreme heat (Luber & McGeehin, 2008), respiratory diseases (Kinney, 2008), injuries from extreme weather events (Gre­ enough et al., 2001), and adverse mental health impacts (Balbus & Wilson, 2000) are also of concern. Climate change will threat­ en traditional public health infrastructure. It will stress environmental health services, such as efforts to respond to severe weather events and disease outbreaks, provide assur­ ance of drinking water safety, and implement vector control measures. As the reality of climate change becomes apparent, many government entities are tak­ ing proactive measures. These measures are broadly defined by two aspects: greenhouse gas emissions reduction (mitigation) and reducing the harm associated with climate change impacts (adaptation) (Frumkin & McMichael, 2008). Mitigation initiatives such as the Cities for Climate Protection (CCP) campaign, sponsored by the Interna­ tional Council for Local Environmental Ini­ tiatives (ICLEI, 2008), have developed five milestones in addressing climate change. Par­ ticipating cities must do the following: 1. conduct a baseline emissions inventory and forecast, 2. adopt an emissions reduction target for the forecast year, 3. develop a local action plan, 4. implement policies and measures, and 5. monitor and verify results. As cities tackle climate change and its threat to local infrastructure, efforts linked to mitigation as well as adaptation present op­ portunities (Frumkin & McMichael, 2008) for co-benefits in public health. For example, traditional combined sewage overflow sys­ tems that experience heavy rainfall events may discharge contaminants into water bod­ ies, resulting in increased incidence of water­ borne diseases (Curriero, Patz, Rose, & Lele, 2001). As cities begin to upgrade sewage sys­ tems to reduce their carbon footprints under campaigns like CCP, a more resilient sewer infrastructure that will withstand extreme weather events is enhanced by the co-benefit of reducing incidence of waterborne diseases (Curriero, Patz, Rose, & Lele, 2001; Patz, Vavrus, Uejio, & McLellan, 2008). The public health effects of climate change are influenced by dynamic interactions among environmental-climatic factors, bio­ logical systems, and human elements (Rose et al., 2000). With more than 100 U.S. cities participating in CCP, environmental health practitioners have opportunities to improve public health by integrating public health frameworks, such as the Ten Essential Pub­ lic Health Services (Frumkin, Hess, Luber, Malilay, & McGeehin, 2008), with existing climate change programs. The framework outlines the following actions: