Evaluating obstacles to preparedness for climate change: The case of West Nile Virus

An increasing number of experts and public health officials are concerned about the health impacts of climate change. Some of these health impacts are already occurring. Yet, there is little empirical research regarding past responses to emergent disease. This research assesses the social and institutional responses to the emergence and management of West Nile Virus, an illness linked to climate change. The aim is to assess obstacles to preparedness for illnesses linked to climate change. Semi-structured interviews were conducted with public health officials, both in New York City, the initial site of emergence, and in multi-level agencies, as well as residents in communities with high risk, and victims of West Nile Virus. These data were combined with a quantitative analysis of entries in the Federal Register, scientific reports in Ebsco, and a print media analysis from 1999 to the present. Four main types of obstacles to preparedness for West Nile Virus and other illnesses linked to climate change were identified, including: 1) lack of medical training and action that slowed diagnosis and increased community-level suspicion, 2) institutional barriers across relevant agencies that decreased a coordinated response in diagnosis and prevention, 3) disjuncture between official public health and community-level responses through a lack of participatory institutional mechanisms for engagement, and 4) scientific uncertainty about West Nile itself and best strategies to prevent its occurrence. These barriers resulted in the need for public health emergency declarations across the United States, and the subsequent development of the most comprehensive vector-borne disease surveillance system in American history. This study indicates that there are unacknowledged social dimensions of preparedness that should be accounted for in planning.