Climate change adaptation strategies for local public health agencies: The heat vulnerability index

There is no longer argument that global climate change will result in significant public health effects related to ecosystem changes and stressors influencing drinking water, air quality, agriculture output,  disease incidence and extreme weather susceptibility.  The National Association of City and County Health Official’s (NACCHO) Are We Ready Report 2  “Preparing for the Public Health Challenges of Climate Change” states that 8 out of 10 local public department (LHD) directors believe climate change is currently underway.  However, less than 9% felt they had sufficient resources available to protect local residents from climate change related health impacts and less than 5% of departments had programs in place to educate the public.  Lack of funding and technical expertise is often identified as significant challenges for many LHDs in proactively addressing climate change health through cost-effective adaptation strategies.

In 2012, the Centers for Disease Control and Prevention provided funding to several states under the Building Resiliency Against Climate Effects (BRACE) grant program.  Key goals of the BRACE program include engaging diverse stakeholders and communities in developing climate change adaptation strategies and reducing health impacts to already vulnerable populations.  The State of Wisconsin Division of Public Health along with the City of Milwaukee Health Department collaborated in the development of a “heat vulnerability index”  (HVI) as a means of geographically identifying areas within the city that may be most susceptible to extreme heat events.  The HVI utilizes mapping of over 20 variables predictive of heat related illness including built environment, health behaviors, population density and demographics. 

The HVI can be used by LHDs to cost-effectively identify, plan and allocate resources prior to and during an extreme heat event.  The HVI represents a viable climate change adaptation strategy that can be used by LHDs and local policymakers alike to strengthen existing and future preparedness efforts.