Resilience to the public health threats of climate variability and change

Modifications of public health strategies, policies, and measures to enhance health protection to climate-sensitive health outcomes may not increase resilience to future (and different) weather patterns. Communities resilient to the health risks of climate change (1) anticipate risks; (2) reduce vulnerability not just to the hazards associated with climate change, but also with the full range of factors that increase the probability of harm; (3) reduce exposure to weather and climate events through, for example, early warning systems; (4) prepare for and respond quickly and effectively to the consequences of a changing climate, including alterations in the frequency, magnitude, duration, and spatial extent of extreme weather and climate events; and (5) recover faster, with increased capacity to coping with changing weather patterns. Increasing resilience includes top-down (e.g. strengthening and maintaining disaster risk management programs) and bottom-up (e.g. increasing social capital) approaches, and focuses not only on the risks presented by climate change but also on the underlying socioeconomic, geographic, and other vulnerabilities that affect the extent and magnitude of impacts. Incorporating elements of adaptive management into public health practice, including a strong and explicit focus on iteratively managing risks, is an important step in increasing resilience. The most effective strategies and measures are those that provide short-term benefits with long-term vulnerability reduction. Transformational change also may be required in how communities approach and manage risks, taking into account trade-offs between short-term decisions and long-term goals.