Promoting Resilience to Climate Disruption

Climate change—or “climate disruption,” as Dr. John P. Holdren, Director of the White House Office of Science and Technology Policy, more aptly describes it in our Q&A with him in this issue—is an urgent and growing threat to global health security. Even with immediate and drastic intervention, average global temperatures will continue to rise for decades to come, resulting in rising sea levels, altered disease vector ranges, and weather extremes that will amplify existing health hazards and result in the emergence of new health threats.

Heat waves, droughts, floods, and more frequent extreme storms are already affecting human health. Changing vector ranges are altering the transmission of infectious diseases. Rising sea levels are intensifying coastal flooding and storm surge. In addition, extreme weather is disrupting the delivery of health services by damaging healthcare facilities and the infrastructure—such as energy and transportation—upon which they depend. There is an urgent need to respond to and recover from the effects of climate disruption that are already occurring and to prepare for the even greater effects that are sure to come in the foreseeable future.

In this special issue of Health Security, we present a spectrum of articles that reflect innovative work being done to promote health resilience to global climate disruption. We begin with our discussion with Dr. Holdren, who has spent decades studying and warning of the dangers of climate disruption. We include 2 enlightening commentaries, one from McCabe and Burke from the US EPA and the other from Rebecca Ruggles, a passionate grassroots public health climate activist. These are followed by a timely commentary concerning the need for prospective studies of the Zika virus and microcephaly.

We move on to articles that examine how to assess the magnitude of one climate-related health problem: extreme heat mortality. McCormick and colleagues and Matte et al. explore practices in attributing deaths to and measuring excess mortality from extreme heat, respectively. Then Martin discusses how one local jurisdiction is mitigating the impacts of extreme heat through its Code Red response program. McGinty and colleagues systematically analyze legal preparedness for another effect of climate disruption, intensifying coastal flooding and storm surge, and Chrétien describes how the US Department of Defense is adapting for the health impacts of climate change. Finally, Kirsch et al. present a longitudinal analysis of public health response to wildfires. We conclude with a report from the public health frontlines of the Washington State wildfires.

We hope this special issue will catalyze further discussion—and, more important, action—regarding the threat climate disruption poses to health security. Those of us who work in public health emergency management have a clear responsibility to prepare for and respond to the effects of climate change, which are too late be avoided. We also have a duty, as McCabe and Burke say, to “act on climate”—that is, to ensure significant reductions in greenhouse gas emissions in order to mitigate the accelerating threats to health security.