Public Health

Category Description & Vulnerability Overview

Description

The Public Health category refers to the risk and exposure of residents to potential toxins and/or hazards through acute or chronic conditions. Climate change will impact human health through numerous ways including: temperature-related death and illness, air quality impacts, extreme events, vector-borne diseases, water-related illness, food safety/nutrition/distribution, mental health and wellbeing. It refers to both individual and population-wide health.

Emergency management is an important component of public health; moreover, it continues to be imperative that emergency management officials and public health officials coordinate their preparation, response, and recovery plans for hazardous conditions.

Vulnerability Overview

Limited shelters with capacity for special care residents.
Limited shelters that allow family pets.
Some habitual roadside maintenance activities may increase erosion and run-off, destabilizing road-side banks
Longer growing season and increased moisture may expand opportunities for existing pests such as mosquitoes and ticks.
Greater prevalence for pests can increase vector-borne diseases such as equine encephalitis, West Nile Virus, Lyme Disease, babeosis, etc.
Possible increased range for southern pests and diseases like dengue and Zika.
Elderly and low-income may have limited cooling and heating options.
Changes to precipitation may limit groundwater recharge and reduce water for residential wells.
Blue-green algae and milfoil may increase presence in waterbodies.
Increased number of low air quality/high ozone days.
Flooding, electricity outages, and cost impacts on private wells
Lack of consistency among cartographic data such as critical facilities, flooding locations, private drinking water well location, drought clusters that threaten private wells, etc.

Potential Partners & Funding Streams

Please send any suggested partners, grants, or resources to info [at] joannaw1.sg-host.com.

Potential Funding Streams

Connecticut Health Foundation
DEHMS/FEMA Flood Mitigation, Pre-disaster Mitigation, and Hazard Mitigation Grants
FEMA (Federal Emergency Management Agency) Preparedness (Non-Disaster) Grants
EPA Local Governments Reimbursement Program
US Department of Commerce
US Department of Health and Human Services
US Department of Housing and Urban Development
US Department of Labor

General Tools

Connecticut Rural Health Report

Preparing for the Public Health Challenges of Climate Change

Connecticut Local EMD and Municipal Official Handbook – March 2018

EPA Climate Change Impacts on Human Health

The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment – A scientific overview of the impacts of climate change on human health from temperature-related death and illness, air quality impacts, extreme events, vector-borne diseases, water-related illness, food safety/nutrition/distribution, mental health and wellbeing or check out the Impacts of Climate on Human Health Executive Summary.

CDC Climate and Health Project– A resource by Centers for Disease Prevention and Control that outline health risks and health strategies related to climate change. Also is information on the CDC’s Climate – Ready Cities and States Initiative, in which NH and VT are participating.

CDC’s Social Vulnerability Index

American Public Health Association (APHA) – Climate Change

APHA “Adaptation in Action: Grantee Success Stories from CDC’s Climate and Health Program Communities across the nation are taking action to reduce the effects of climate change on health. Adaptation in Action: Grantee Success Stories from CDC’s Climate and Health Program (PDF) highlights successful ways communities have responded to the challenge of climate change.

Plan4Health Success Story: Disasters Toolkit for Texas Rural Communities

Vermont Department of Heath Environmental Public Health Tracking: Climate Change– As part of its Environmental Health Tracking Program, the department has recently begun tracking the incidences of heat stress and heat-related fatalities. While Vermont has not yet experienced the number of prolonged extreme heat events that many other states have, heat stress is expected to become a more significant risk in the lives of Vermont residents.

Rhode Island Climate Health Program

NHDES Strategic Plan to Address the Health Impacts of Climate Change in New Hampshire–The Environmental Health Program worked with the state public health system and conducted a needs assessment to better understand the capacity to address climate change. The results of the needs assessment were used to develop a strategic plan to assist the public health system in being better prepared for the impacts of climate change.

Massachusetts Environmental Public Health Tracking – Climate and Health Profiles

EPA Climate Change and Health Factsheets

FEMA Emergency Management in a Changing Climate

George Mason University Center for Climate Change Communication -Conveying the Human Implications of Climate Change

Case Study Town of Brookfield Tick Communication Campaign

Case Study Minnesota Climate and Health Program

“While all Americans are at risk, some populations are disproportionately vulnerable, including those with low income, some communities of color, immigrant groups (including those with limited English proficiency), Indigenous peoples, children and pregnant women, older adults, vulnerable occupational groups, persons with disabilities, and persons with preexisting or chronic medical conditions.”

Source: Crimmins, A., J. Balbus, J.L. Gamble, C.B. Beard, J.E. Bell, D. Dodgen, R.J. Eisen, N. Fann, M.D. Hawkins, S.C. Herring, L. Jantarasami, D.M. Mills, S. Saha, M.C. Sarofim, J. Trtanj, and L. Ziska, 2016: Executive Summary. The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment. U.S. Global Change Research Program, Washington, DC, page 1–24. http://dx.doi.org/10.7930/J00P0WXS

Actions

The section is divided into the following major categories:

Best management practices
Research, monitoring, and education
Policy, Legislation, Regulation & Funding
Emergency Management

A tabular version of the actions is also available.

Best management practices

1Ph Incorporate climate change into local and regional public health programs. Coordinate among local, regional, and state health departments to monitor impacts and identify climate change adaptation strategies.

Partners: Health departments, sanitarians, health districts, CT DPH
Tools: NACCHO Essential Actions for Resilience
NACCHO 12 Steps to Operationalize Climate Change in a Local Health Department
Minnesota Climate & Health Case Study

2Ph Conduct public health vulnerability studies. Identify populations, communities, and geographic areas most at risk for the identified health risks. Consider the public health needs of vulnerable populations in climate change adaptation planning. Identify locations of vulnerable residents. Coordinate with utilities to reduce shut-offs during high heat or extreme cold events.

Partners: Health departments, sanitarians, emergency managers, REPT, CT PURA, electrical utilities
Tools: CDC Health Vulnerability
Appendix G: G. Mapping 101: Joining census data for beginning GIS users from Minnesota Extreme Heat Toolkit.
Antioch University New England Webinar Enhancing the Resilience of Seniors
Climate Change, Health, and Populations of Concern

3Ph Continue to develop and update all municipal emergency preparedness plans for extreme weather events. Evaluate current early extreme weather events warning system and emergency response plans. Develop or strengthen joint protocols for multi-jurisdictional response to a broad spectrum of climate-related emergencies and disasters. Establish communication mechanism to coordinate efforts between disaster relief and public health agencies. Partner with health districts/departments to exercise pandemic response plans.

Comments/Descriptions: Coordinate with regional NWS offices for correct coverage locations. Cross Reference with Sustainable CT Action 7.2 Provide Effective Community Communications.
Partners: CEOs, EMDs, CT DPH, CT DESPP, REPT, DEHMS
Tools: Coming soon.

4Ph Manage municipal properties to reduce heat island affect. Provide potable water and shaded areas in public spaces during community events. Consider adding lighting to allow for use of recreational facilities at cooler points of the day. Seek state criteria for school closings and outdoor play during extreme heat events. Research and follow cooling station best management practices. Develop a strategy for providing and communicating heat wave behavioral adaptations such as air conditioning availability and increased fluid intake. Develop communications plan for extreme heat for the public and vulnerable populations through schools, daycares, landscape/construction businesses, sports teams/camps, and senior living facilities, etc.

Comments/Descriptions: Cross-reference with Infrastructure
Partners: Public Works, CEOs, School districts, health departments
Tools:: Potential Heat Island areas in NHCOG Region
EPA Heat Island Effect
Excessive Heat Events Guidebook
RI Heat Safety
Minnesota Extreme Heat Toolkit Appendices "Messages should include information on what to do (e.g., how to prevent illnesses from extreme heat) (see Appendix E for a tip sheet), symptoms of heat-related illnesses (see Table 2 on page 2-3), characteristics of persons more vulnerable to extreme heat (see Table 3 on page 2-5), and where to go for more information." and Appendix J for sample media release

5Ph Manage municipal properties to eliminate or reduce vector habitat (e.g. standing stagnant water). Implement management strategies in public spaces to reduce disease-carrying pests such as ticks and mosquitoes. Enhance preparedness for disease prevention of vector-borne and water-borne diseases following floods and storms. Develop communication plan for residents about on-property tick and mosquito management.

Comments/Descriptions: Cross Reference with Sustainable CT Action 7.2 Provide Effective Community Communications.
Partners: DOT, Public Works, health districts, local health depts
Tools: Brookfield CT Health Department Tick Outreach
Vermont Tick Tracker

6Ph Reduce public exposure to algal blooms in recreational swimming areas

Partners: DOT, Public Works, health districts, local health depts., local land use commissions
Tools:Health districts' Sanitarians perform water sampling and visual assessments for algal blooms and advise as necessary. Management of storm-water run-off through Low-Impact Development Practices reduce their occurrences.

7Ph Develop communications for visitors and seasonal/permanent residents about evacuation routes and heating/cooling/emergency shelter locations esp. if animal-friendly. Provide information to pet owners on protecting their pets from extreme heat. If possible, identify a local cool place that may be willing to accept people and their pets. Encourage residents and businesses to use Town social media/web sites for information sharing. Ensure senior centers and shelters have cooling systems. Consider extending hours at municipal buildings, public spaces, and commercial areas like movie theaters and shopping malls where air conditioning is available. Also consider free public transportation to shelters.

Comments/Descriptions: Cross Reference with Sustainable CT Action 7.2 Provide Effective Community Communications.
Partners: health districts, local health depts, EMDs, CEOs, Parks & Rec, Public Works
Tools:Improving ADA access to cooling centers: Chapter 7 of the ADA Best Practices Tool Kit for State and Local Governments
Minnesota Climate & Health case study

8Ph In the aftermath of extreme events, prepare for additional trauma due to dispossession, mental health challenges and post-traumatic stress disorder.

Partners: DESPP, DEHMS, health depts./districts
Tools: Coming soon.

9Ph Assess food security for all sectors of society in the state/region.

Comments/Descriptions: Support local sustainable agriculture to improve food security; cross-reference with agriculture
Partners: CT DPH, CT Dept of Ag
Tools: USDA Food Security Assessment Toolkit

10Ph Develop partnerships and/or policies to prevent power and water companies from shutting off services to their customers due to nonpayment of bills during extreme heat events.

Partners: CEOs, social service agents, PURA
Tools: Coming soon.

11Ph Institute extreme weather protocols for municipal employees especially for high-heat and low air quality days. Develop communication plan for residents about poor air quality and high ozone days. Coordinate with CT DEEP about maintaining regional air quality.

Comments/Descriptions: CT DEEP and Cross Reference with Sustainable CT Action 7.2 Provide Effective Community Communications
Partners: EMDs, health departments, CEOs, Public Works
Tools: EPA EnviroFlash Air Quality Alert Program

12Ph Develop an education campaign for students, residents, and visitors on natural hazards and preparedness. Provide outreach to seasonal home-owners on how to protect against frozen pipes and water damage during the winter with the loss of electricity, including information on automatic shut-off switches or alarms (LHNHMP). Distribute resources through town hall, community events, local/regional websites, social media. September is National Preparedness Month.

Comments/Descriptions: from Litchfield Hills NHMP & Burlington Annex of Hazard Mitigation Plan for the Former Central Connecticut Region
Partners: NHCOG, health districts, CT DPH, CEOs, EMDs, Public Works, Building Department, local/regional schools
Tools:Litchfield Hills NHMP
RI Citizen Preparedness Flood Safety
RI Citizen Preparedness
FEMA Training
Ready.Gov
CT DPH Hurricane Prep
Red Cross thunderstorm prep
Red Cross Generator Use
FEMA Avoiding Hurricane Damage: A Checklist for Homeowners

13Ph Increase public awareness and education on opioid abuse and misuse.

Partners: health districts & depts., NHCOG Prescription assistance network
Tools: TAHD is currently administering a DEMHS grant entitled SPF-Rx which is designed to help combat the opioid crisis and an ad campaign called “Change the Script”.

14Ph Develop plans to deal with vector-born diseases from ticks and mosquitoes especially in case of need for rapid response. Implement educational programs for schools and the public on how to help control vector (e.g. ticks and mosquitoes) breeding sites.

Partners: REPT, health districts, local health depts.
Tools: Vermont Tick Tracking Program
Brookfield CT Tick Communication Program

15Ph Review potable water vulnerabilities in both private well and public water supply systems across community. Encourage private well owners with vulnerable well locations to seal well and to grout the space between the casing and bore hole and/or relocate the well on the property. Develop GIS database of private wells or parcels with wells. Track and communicate incidences of private water well failures with health departments especially in drought conditions. Encourage residents to sample their wells on an annual basis, especially following significant storm events. Encourage private well owners extend well casing above flood level if in a delineated FEMA flood zone or commonly known flooding area even if above 1ft above grade. Research possibility of solar-powered or hand-powered pumps for residents/facilities dependent on potable well water. Well depth will determine feasibility of different technologies.

Comments/Descriptions: Cross reference with Sustainable CT Action 2.6
Partners: Dept of Consumer Protection, DPH Private well program, local health departments and districts, building departments
Tools: "Drinking Water Vulnerability Assessment and Resilience Plan" by CT DPH & CIRCA
Fairfield CT GIS private well parcel database
CT DPH Well Casing Extension

16Ph Coordinate with water utilities to protect reservoirs and aquifer protection areas.

Partners: WUCC, CT DPH, local water utilities

17Ph Develop a database of morbidity and mortality caused by climate change.

Partners: health districts, CT DPH

18Ph Intensify vector associated disease monitoring from vectors such as ticks and mosquitoes.

Partners: health districts, local health depts

19Ph Develop GIS StoryMap that communicates the multiple ways that climate change intersects with public health.

Partners: CT DPH
Tools: RI Climate Health Storymap

20Ph Seek funding to provide for adequate updates to municipal water & sewage infrastructure.

Partners: CT DAS, DPH, USDA, Local Public Works

21Ph Review existing septic system regulations for capacity from increased soil saturation from storm events.

Partners: CT DPH, health districts, local health depts
Tools: CT Public Health Code

Research, monitoring, and education

12Ph Develop an education campaign for students, residents, and visitors on natural hazards and preparedness. Provide outreach to seasonal home-owners on how to protect against frozen pipes and water damage during the winter with the loss of electricity, including information on automatic shut-off switches or alarms (LHNHMP). Distribute resources through town hall, community events, local/regional websites, social media. September is National Preparedness Month.

13Ph Increase public awareness and education on opioid abuse and misuse.

14Ph Develop plans to deal with vector-born diseases from ticks and mosquitoes especially in case of need for rapid response. Implement educational programs for schools and the public on how to help control vector (e.g. ticks and mosquitoes) breeding sites.

Partners: REPT, health districts, local health depts.
Tools: Vermont Tick Tracking Program
Brookfield CT Tick Communication Program

15Ph Review potable water vulnerabilities in both private well and public water supply systems across community. Encourage private well owners with vulnerable well locations to seal well and to grout the space between the casing and bore hole and/or relocate the well on the property. Develop GIS database of private wells or parcels with wells. Track and communicate incidences of private water well failures with health departments especially in drought conditions. Encourage residents to sample their wells on an annual basis, especially following significant storm events. Encourage private well owners extend well casing above flood level if in a delineated FEMA flood zone or commonly known flooding area even if above 1ft above grade. Research possibility of solar-powered or hand-powered pumps for residents/facilities dependent on potable well water. Well depth will determine feasibility of different technologies.

16Ph Coordinate with water utilities to protect reservoirs and aquifer protection areas.

Partners: WUCC, CT DPH, local water utilities

17Ph Develop a database of morbidity and mortality caused by climate change.

Partners: health districts, CT DPH

18Ph Intensify vector associated disease monitoring from vectors such as ticks and mosquitoes.

Partners: health districts, local health depts

19Ph Develop GIS StoryMap that communicates the multiple ways that climate change intersects with public health.

Partners: CT DPH
Tools: RI Climate Health Storymap

Policy, Legislation, Regulation & Funding

20Ph Seek funding to provide for adequate updates to municipal water & sewage infrastructure.

Partners: CT DAS, DPH, USDA, Local Public Works

21Ph Review existing septic system regulations for capacity from increased soil saturation from storm events.

Partners: CT DPH, health districts, local health depts
Tools: CT Public Health Code

Emergency Management

22Ph Work with FirstNet (public safety broadband network) to improve communications coverage. Communicate with vulnerable populations on cooling centers, emergency shelters, and transportation options to avoid exertion in heat. Expand use of existing communication tools and develop a comprehensive contact list of organizations representing vulnerable populations as a resource for preparedness and response to extreme events. Encourage all businesses and residents, particularly older adults, to sign up for emergency information systems in your community (Nixel, Everbridge, etc.).

Comments/Descriptions: Cross Reference with Sustainable CT Action 7.2 Provide Effective Community Communications and POCD Goal 2.
Partners: CEOs, social service agents, local health departments, EMDs, volunteer emergency responders, senior centers
Tools: CA DOH Climate change & Health Equity Program
Kern County California -utility and county government to sponsor cooling centers.
Building Older Adults' Resilience
firstnet.gov

23Ph Consider developing a Memorandum of Understanding with schools or school bus company to utilize school buses for mass transportation during an emergency. Ensure regional evacuation plans include health care facilities, senior housing, disabled residents, and those without transportation.

Partners: REPT ESF-1 Transportation working group, EMDs, school bus companies, Transit Districts
Tools: Coming soon

24Ph Partner with health departments/districts to promote health services like flu shots, inspections for issues that exacerbate respiratory illnesses.

Partners: health districts, local health districts, pharmacies
Tools: TAHD's "Healthy Home" Program

25Ph Develop plan to insure uninterrupted prescription refills for residents with chronic medical conditions.

Partners: Pharmacies, NHCOG Prescription Assistance network

26Ph Create and assist community-supported neighbor-to-neighbor networks across the community that are accessible to all income levels (e.g., villages, fraternal organizations, faith-based communities, neighborhood associations).

Partners: EMDs, volunteer emergency responders, senior centers, Community Foundations

27Ph Develop redundant back-up power systems, possibly via renewable energy (solar, wind) for critical facilities to keep those facilities operational and avoid outcomes of displaced or decreased workforce and increased social/health stress for extended power outages. Develop redundant infrastructure, backup power, and increase system storage and conduct more comprehensive emergency response planning to improve resiliency. Reach out to buildings where vulnerable populations reside, such as hospitals, nursing homes, etc. to evaluate back up power generation during extreme heat or cold events and extended power outages.

Comments/Descriptions: Cross reference with Microgrid Action in Infrastructure and WUCC "Prioritization and Implementation for Non-Capital Improvement Recommendations"
Partners: CEO, EMDs, volunteer emergency responders, senior centers, REPT

28Ph Encourage residents over 18 to join community emergency response teams or medical reserve corps.

Comments/Descriptions: Cross reference with health districts Medical Reserve Corps outreach efforts.
Partners: CERT, REPT, senior centers

29Ph Increase frequency and expand topic coverage of Community Emergency Response Team (CERT) trainings to better respond to natural hazard events.

Partners: EMDs, CEOs, REPT
Tools: Coming soon.

30Ph Create a Community Hub to assist in relay of critical information, especially during disaster. Community Hub identifies needed equipment such as generator, storage space, amateur radio network, etc.

Partners: Regional Emergency Planning Team ESF -2 Communications Chair Steve Savage; CT ARES (Amateur Radio Emergency Service)
Tools: Larimer Community Hub

31Ph Develop Time to Recovery Goals Matrix with minimal, operational, and functional time goals to identify priority restoration locations.

Partners: REPT, DESPP, DEHMS
Tools: Resilient Design Performance Standard

32Ph The Town should continue to require the installation of fire protection water in new developments. Establish a maintenance and testing schedule for dry hydrants/fire ponds and require an annual budget funding for maintenance and repairs. Towns should also consider mutual aid tankers and properly maintain key waterholes for refilling emptied tankers.

Comments/Descriptions: from Litchfield Hills NHMP
Partners: CEOs, local fire departments, land use commissions

33Ph Establish a designated area for brush disposal following storm related events that generate debris and/or storage of snow. Identify methodology for tracking cost of debris management for potential FEMA reimbursement.

Comments/Descriptions: from Litchfield Hills NHMP
Partners: local Public Works

34Ph Provide public information on safe fire practices (check with DEEP fire rating, fire extinguisher availability, etc.)

Comments/Descriptions: from Litchfield Hills NHMP
Partners: local fire departments