Background: The National Association of County and City Health Officials, supported by a grant from the Centers for Disease Control and Prevention, surveyed a sample of local health departments (LHDs) across the country to better understand the scope and frequency of climate-related public health activities at the local level.

Methods: The survey was sent to a nationally representative sample of 1,009 LHDs. It contained 14 total items. A version of this survey was last fielded in 2012, and prior to that, completed in 2008 for the first time. While not all results are directly comparable between different versions of the survey, general trends were compared over time.

Results: In 2023, nearly 90 percent of LHDs reported no full-time staff dedicated to climate change, and nearly 70 percent reported no community outreach on climate and health. Lack of funding emerged as one of the key barriers to building a climate-ready public health system. Without funding, and in the absence of trained and dedicated staff, LHDs cannot fully address the health challenges their communities face as temperatures around the country continue to climb, bringing with them an increased risk of floods, wildfires, hurricanes, and other dangerous weather events. When the results of the 2008, 2012, and 2023 surveys are compared over time, the central finding of all three assessments remains the same: most LHDs across the country are still not ready to respond to the health effects of climate change. The proportion of LHDs that reported they have the necessary expertise to assess the public health effects of climate change has declined over time.

Conclusion: The findings in this report suggest an urgent need to invest in a climate-ready public health system, one that is fully equipped to keep communities safe, informed, and healthy under the rapidly changing environmental conditions of the 21st century.

In the U.S., chronic exposure to indoor air pollutants, often 2-5 times worse than outdoor air, contributes to respiratory illnesses, lung cancer, and chronic lung disease exacerbations. Healthcare providers play a critical role in assessing exposure to and educating patients on ways to minimize their exposure to indoor air pollution, but few providers actively engage with their patients on this topic.

A 2024 nationwide survey by the American Lung Association assessing healthcare professionals understanding and clinical experience with indoor air pollution showed that only 1 in 4 respondents were satisfied with their current knowledge of the health impacts of indoor air pollution and only 2 in 5 reported feeling well-prepared to discuss this topic with their patients. Providers cited lack of time and knowledge as the primary reasons for not discussing indoor air pollution-related health issues with patients.

To equip healthcare professionals with the knowledge and confidence to effectively assess and counsel patients on indoor air pollution risks and mitigation strategies, the Lung Association developed a suite of clinical tools on various indoor air pollutants. These clinical tools were reviewed and pilot tested in the clinical setting in the spring of 2025.

This presentation will detail pilot testing findings and early lessons learned on engaging with healthcare professionals on this topic. This presentation will also highlight additional Lung Association programs and offerings aimed at empowering healthcare professional to play a larger role in assessing and educating patients on indoor air pollution.

BACKGROUND

On February 1, 2022, six hundred tons of ammonium nitrate ignited at the Winston Weaver Company in Winston-Salem, North Carolina. Surrounding homes and businesses were evacuated while the fertilizer burned for two days. Members of the Piney Grove Neighborhood (PGN) – a historic African American community located 0.4 miles from the now defunct Winston Weaver Company – were concerned about the long-term health impacts of exposure to the chemicals from the fire. At the request of the community (1) members from the Young Lab conducted soil quality tests in PGN (2) a public health and sustainability strategist was invited to communicate the environmental data to PGN. The objectives of this study were to determine and communicate residual concentrations of soil pollutants associated with the fire in the PGN.

METHODS

Soil Sampling: Core samples were collected from six PGN properties and processed for heavy metals and nutrients standards methods.

Community Engagement: The public health and sustainability strategist led a meeting with the PGN residents to communicate the data of the soil sample collection. PGN community members provided feedback and shared long-standing environmental quality (air, soil, and well water quality) concerns about their neighborhood.

RESULTS

Soil Quality: Results from the soil heavy metals test showed that the highest concentrations of arsenic, cadmium, copper, and lead were below the World Health Organization (WHO) action levels, with concentrations of nickel and zinc close to the WHO action levels. Ammonia, nitrate, and phosphorus were, notably, within acceptable ranges.

Community Engagement: Community residents successfully interpreted the findings from the soil samples. Dialogue between community members and the researchers took place discussing current environmental observations, concerns, and future recommendations for future sampling endeavors.

CONCLUSION

By integrating community voices, researchers can ensure effective collaborative partnerships are established to address the most pervasive environmental issues impacting communities similar to PNG.

In 2022, the American Medical Association’s (AMA) House of Delegates adopted a policy declaring climate change (CC) a public health crisis. As a result, the AMA has taken several steps to further engage on this topic, including developing and distributing a survey to assess physician perspectives on CC and health.

The objectives of this survey effort were to: (1) understand the level of importance and relevance of CC to physicians; (2) understand day-to-day effects of CC that physicians may be experiencing or anticipate experiencing in the future; and (3) explore what the AMA’s role should be in supporting physicians on CC.

AMA partnered with WebMD to conduct a 15-minute survey of U.S. physicians and residents. WebMD’s survey platform was utilized for data collection. Invitations to complete the survey were sent via email and respondents received a $30 incentive upon completion. Data collection took place in early December 2024 and had a 36% response rate.

There was a total of 550 respondents; 89% were physicians and 11% were residents. Respondents skewed towards being male (63%), White (66%), between the ages of 35-54 (45%), and from the U.S. South (35%). Nine in ten believe that CC is happening and of those that believe it is happening, 81% are extremely or very confident that it is happening. Over half of physicians reported adverse mental health impacts from CC among their patients. Only 52% reported they were very or moderately knowledgeable on the association between CC and health. Under a quarter of physicians discuss CC with their patients and less than 20% advocate for climate and health solutions.

An overwhelming majority of physicians believe CC is happening and are concerned about its current and future impacts but many lack the education to engage in this topic with their patients or in the policy-making arena.

As one of the deadliest natural disasters in the United States, a growing body of evidence has shown that drought is responsible for a number of negative health outcomes. As research into the broad health consequences of drought continues, there is an urgent need for effective tools to support public health and healthcare professionals in their preparedness and response efforts. To address this critical need, our team has developed a tailored messaging and response tool focused on the health impacts of drought. This tool provides an overview of drought and its associated health risks, identifies recommended partnerships to enhance drought response and preparedness, and includes messaging maps grounded in communication best practices, aligned with the U.S. Drought Monitor stages. The tool is adaptable and intended to assist public health and healthcare professionals in crafting tailored messages and response strategies for those affected by drought. With the overarching goal of strengthening nationwide capacity to address the health impacts of drought, this tool offers practical, actionable steps that can be customized to fit the needs of specific service regions or healthcare practices. In this session, attendees will gain an understanding of the health implications of drought, insight into the development process behind the drought and health messaging framework, and participate in an interactive exercise. Participants will engage in a community drought scenario, creating sample messages and outreach materials for various stages of drought. This hands-on exercise will enable attendees to explore the practical applications of the messaging framework and its potential use in their own communities or professional environments.

Introduction: Ticks and tick-borne diseases (TTBDs) pose a significant public health problem in Virginia, yet awareness among the general public remains low. Recommendations from the National Tick-borne Disease Working Group and strategies outlined in the 2024 National Public Health Strategy to Prevent Vector-borne Diseases in People call for increased geographically and audience-tailored education to improve early detection, prevention, and management of tick-borne diseases.

Methods: Between April 2023 and April 2025, TTBD educational outreach activities were implemented in Virginia and aligned with the intrapersonal, interpersonal, organizational, community, and policy levels of the social ecological model. Activities were tailored based on their age, geographic location, language, and profession. Implementation process surveys were used to document and measure reach and impact.

Results: Fifteen organizations and over 2,000 people, ranging from preschoolers to seniors, participated in the events. Over 2000 TBD prevention supplies were distributed, including tick-bite safety kits, tweezers, magnifying glasses, and repellent. Overall, engagement in activities was considered high. Across all activities, most participants shared being personally impacted or knowing someone who had been impacted by TTBDs. A logic model was created to illustrate inputs, outputs, and short-, medium-, and projected long-term outcomes.

Conclusions: Geographically tailoring TTBD education to specific audiences and implementing activities at multiple levels of influence can increase awareness of ticks and tick-borne diseases among diverse population groups in Virginia. New, innovative collaborations and partnerships are needed to expand TTBD education to reach additional populations and regions at risk for these endemic and emerging diseases.

Approximately 500,000 US children have elevated blood lead levels (EBLLs) ≥5 µg/dL resulting in permanent damage to the body. Most children with EBLLs are contaminated through exposure to deteriorating lead paint in their homes. In Lancaster County, PA most (56%) of the homes are at risk for having lead paint components due to old home age and are located in areas with higher rates of EBLLs among children. Lancaster City has the 3^rd highest rate of EBLL among major municipalities in Pennsylvania. Evidence indicates that lead abatement before child exposure is the most effective strategy to prevent lead poisoning. In Lancaster County, Pennsylvania a healthcare system implemented a large-scale, evidence-based lead poisoning prevention program over a ten-year period (2021 – 2031). The multifaceted initiative incorporates education, partnerships to enhance screening, case management, in-home lead inspections, lead remediation, ongoing EBLL monitoring, case management and follow-up until the BLL is at a safe level. Eligibility requirements include, living in a home built prior to 1978, having a child < 6 or being pregnant, and earning a household income < 400% of the Federal Poverty Level. Children with EBLLs are prioritized. A total of 634 home units were made lead-safe between August 2021 and mid-March 2025. Prior to home remediation, 366 children had an EBLL over 3.5. Among those, 241 (65%) experienced a lowered BLL and 166 (45%) experienced a decrease in an EBLL under 3.5 after project completion. A program strength is that it’s funded by a health system, allowing for broadened eligibility, an emphasis on education and alignment with clinical settings, compared to traditional HUD-funded programs. Referrals from clinical providers, lead screenings, and interaction with primary care is seamlessly incorporated into the program. This program can serve as a model for healthcare systems interested in establishing their own comprehensive lead prevention program.

The World Health Organization recognizes climate change as the greatest threat facing humanity.

Methods:

NH Healthy Climate, a non-profit, conducted a web-based survey of healthcare workers in New Hampshire to better understand their perceptions of climate change and its impact on the populations they serve. Responses were received from n=355 healthcare workers. Descriptive statistics, logistic regression, and qualitative analysis were used.

Results:

The majority of respondents perceived that climate change is extremely or very important to them personally compared to other social or environmental issues, and more than 75% of respondents stated that they are very concerned about climate change.

The majority of respondents stated that climate change currently has a major or moderate impact on the patients and communities they serve.

Healthcare workers who serve a higher proportion of persons of color were more likely to perceive specific health impacts to their patients, compared to those who do not: vector-borne disease (72% vs 28%); asthma/allergies due to high pollen counts (75% vs. 25%); heat (69% vs. 31%); cold (75% vs. 25%); flooding/storms (71% vs. 29%) and mental-health impacts (72% vs. 28%).

Fewer than half of healthcare workers talked to their patients about climate change and chronic health conditions (48.7%) or provided anticipatory guidance (42.2%). Fifty-three percent talked to their patients about how climate change might affect their job/occupation or work environment.

Over 50% of behavioral health professionals and those practicing in community-based care health talked to their patients about climate change and chronic conditions,
compared to 48% of primary care professionals, 47% in emergency/urgent care, 41% of outpatient specialty care, and 26% of inpatient care. Nurses were more likely to provide anticipatory guidance (68%) compared to physicians (53%) or other health professionals (44%).

Conclusions:

Tailored education, outreach, and communication strategies may be needed for different health professionals in different settings.

Background

Extreme heat and humidity due to climate change leads to heat-related illnesses and other negative health outcomes. Most heat related illnesses and deaths are preventable. C40 Cities Heat, Health and Equity Challenge Fund selected We the People Community Health Worker Coalition (WTP-CHWC), an organization established to reduce health disparities in Washington DC, to develop a Heat Ambassador program that integrates climate resilience with public health and equity.

Purpose:

WTP-CHWC trained volunteers, Heat Ambassadors, are deployed to increase heat safety awareness, providing support and resources to reduce incidence of heat-related illnesses. Heat Ambassadors reach out and check in with those most at risk to extreme heat, due to climate change, to provide heat safety advice, resources, care or emergency assistance to build preparedness and climate resilience.

Objectives

Heat Ambassadors demonstrate reduced incidence of health-related illnesses, deaths and other negative health outcomes by identifying and assisting those at greatest risk and by developing a database of participants that can benefit from additional resources.

Methods

WTP-CHWC facilitates training for local community-based organizations and individuals to serve as Heat Ambassadors who will reach out, provide, during extreme heat events, heat safety support and resources and, in extreme cases, initiate emergency medical services for those most at risk during extreme heat events, such as unhoused, seniors, those with disabilities living alone, no air-conditioning, chronic conditions. Training includes Mental Health First Aid, CERT, CPR/AED/First Aid, Extreme Heat Safety, Leadership Development.

Outcomes

Heat Ambassadors are frontline community public health volunteers performing a wide variety of duties during climate-related stressors of extreme heat to engage, support, educate and provide resources to those most at risk that reduce heat-related illnesses, deaths and other negative health outcomes.

Conclusion

Heat Ambassadors play a role in reducing heat-related illnesses by providing support and resources to those most at risk to increase climate resilience.

The Promotoras are skilled relationship builders and experts in an array of local issues impacting health access, local systems, and community resources. Promotoras have identified environmental health awareness as a crucial area of concern in their communities, particularly, in agricultural areas such as the Central Valley and Central Coast of California where the lack of knowledge around these issues hinders the ability to address health risks. The importance of environmental health increases in areas where agricultural practices, such as intensive irrigation, pesticide application, and industrial farming, can directly affect both the environment and public health. Over the past two years, VyC has partnered with the Office of Community Partnerships and Strategic Communications of California (OCPSC) and the California Governor's Office of Emergency Services (CalOES) to provide vital information about water conservation, extreme heat awareness, and emergency disaster preparedness; issues that are exacerbated by agricultural activity.

Through door-to-door canvassing, community events in agricultural sites, phone banking, workshops, and training, VyC has reached over 200,000 community members. The outreach efforts are tailored to meet the availability and needs of local populations, ensuring that individuals in agricultural communities receive the support and information needed to navigate environmental health risks. These efforts are part of a broader commitment to improving public health, particularly in regions where the intersection of agriculture and environmental issues has significant public health implications. As environmental health remains a national priority, VyC is committed to expanding these initiatives nationwide, nurturing partnerships across states, and promoting policy advocacy to strengthen the resilience of communities throughout the country. Through continued outreach, education, and collaboration, VyC aims to elevate environmental health awareness as a key public health issue, as we continue to work towards a healthy and dignified life for all.