Journal
INTERNATIONAL JOURNAL OF HEALTH SERVICES
Volume 46, Issue 1, Pages 53-78Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1177/0020731415621458
Keywords
climate change; cities; public health; adaptation tracking; monitoring and evaluation; systematic assessment
Funding
- CIHR Applied Public Health Chairs Program
- SSHRC Insight Grant
- Trottier Public Science Policy Fellowship (Faculty of Science, McGill University)
- Fonds de la Recherche en Sante du Quebec (FRSQ) Bourse de Carrier
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Climate change will have significant impacts on human health, and urban populations are expected to be highly sensitive. The health risks from climate change in cities are compounded by rapid urbanization, high population density, and climate-sensitive built environments. Local governments are positioned to protect populations from climate health risks, but it is unclear whether municipalities are producing climate-adaptive policies. In this article, we develop and apply systematic methods to assess the state of public health adaptation in 401 urban areas globally with more than 1 million people, creating the first global baseline for urban public health adaptation. We find that only 10% of the sampled urban areas report any public health adaptation initiatives. The initiatives identified most frequently address risks posed by extreme weather events and involve direct changes in management or behavior rather than capacity building, research, or long-term investments in infrastructure. Based on our characterization of the current urban health adaptation landscape, we identify several gaps: limited evidence of reporting of institutional adaptation at the municipal level in urban areas in the Global South; lack of information-based adaptation initiatives; limited focus on initiatives addressing infectious disease risks; and absence of monitoring, reporting, and evaluation.
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