Planning for climate change impacts on public health in a urban coastal community

The Cambridge Public Health Department has brought a philosophy of prevention, an emphasis on cross-sector and regional collaboration, and a strong track record of public health preparedness planning to the vulnerability assessment planning process. Due, in part, to the health department's active participation in developing the scope of work for the vulnerability assessment, the final product will identify estimated health impacts such as heat-related morbidity and mortality, gastrointestinal and respiratory illnesses, new or expanded risk vector-borne diseases, and the emotional and psychological effects of exposure to extreme weather events. It also will consider how major climatic events will impact the local healthcare infrastructure, including loss of power at hospitals and clinics, surges in patient populations, and the difficulty of serving homebound residents at heightened risk of adverse outcomes. The long-term environmental health risks to building structures associated with flooding and sea level rise are also under consideration. The final assessment will model the location of at-risk populations and neighborhoods, essential services, public infrastructure, transit options, and power sources that could be compromised during extreme weather events. Unfortunately, the ability to model health impacts with a high degree of confidence is limited. Instead, the assessment is using scenario modeling to understand the City's current capacity to respond to rare but high-impact events and to identify areas in need of improvement. Superstorm Sandy brought both into high relief in 2012, in addition to increasing the sense of urgency among City residents that it is time to start building adaptive capacity citywide. The results of the vulnerability assessment will set the stage for the future development of long-term adaptation planning.