Major cities are not involving public health agencies in their climate adaptation plans

Overall, implementing agencies reported climate plans for 22 major cities that are highly health-adaptive, across five health-related activity areas. Credit: Sheehan et al., 2022, PLOS Climate, CC-BY 4.0 (

Major cities are not involving public health agencies in their climate adaptation plans

A review of 22 major cities’ climate adaptation plans found that while most include significant measures to promote public health, fewer cities have engaged public health agencies in these plans.

Mary Sheehan of the Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland, and her colleagues presented their findings in the open-access journal PLOS Climate on March 3.

Public Science Library*

With climate change, city dwellers are exposed to increased risks from a range of hazards, including heat, floods and droughts. Many cities have chosen to develop climate adaptation plans that emphasize public health. However, given the limitations of the research, the extent to which highly targeted city health plans are integrated with public health actions and the involvement of public health agencies is unclear.

To improve understanding, Sheehan and his colleagues assessed climate adaptation plans in 22 major cities that were already known to focus on adaptations that promote public health. They analyzed the extent to which these cities’ plans include actions that fall under five categories seen as promising to improve public health, such as severe storm preparedness or early warning systems for infectious diseases.

The analysis revealed that 90% of the plans include actions in at least three of the five health-related categories. However, of these plans, only 73% include the involvement of a public health agency. Cities in low- and middle-income countries were more likely to involve public health agencies in climate change adaptation plans than cities in high-income countries, although cities in which public health agencies were those most involved also included Barcelona, ​​Baltimore and São Paolo. Frances. Plans involving greater involvement by public health agencies often included an early heat warning, followed by weather preparedness measures and risk mapping.

The analysis also looked at different approaches to climate change adaptation plans. For example, the Baltimore Plan is coordinated by its Office of Sustainability and includes a primary focus on extreme climate preparedness, while the London Plan is coordinated by the Mayor’s Office and includes a broader focus on environmental strategies . The Barcelona Plan illustrates the integration of different city agencies in adaptations aimed at protecting public health.

The researchers say their findings support efforts to engage public health agencies more deeply in climate change adaptation and identify additional opportunities for major cities to integrate public health into adaptation plans.

The authors add, “Local regions drive climate adaptation, and in this study we found that involving local public health in climate adaptation plans can make a difference. Extreme heat is the most common. The presence of public health brings data, for example, on health impacts and vulnerability, which can lead to a greater focus on people – and better protection for those who need it most. Looking ahead, we see an opportunity for increased public health engagement in areas such as weather preparedness and vulnerability mapping, in partnership with emergency management and weather services. and other agencies.


Sheehan MC, Khudairi F, Swaich GS, Hines W, Mehta S, Fox MA (2022) Climate management and urban health: Mapping the role of public health in the adaptation plans of major global cities. More Climate 1 (3): e0000012.

Henrique Cortez * Translation and editing.

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