Climate Silence on the Web Sites of US Health Departments

As we write this, the world is facing a public health crisis of biblical proportions: COVID-19. A key feature of the pandemic has been communication—a challenge, given considerable uncertainties, a rapidly evolving knowledge base, and craven politicization by some elected officials and social media bottom-feeders. Public health communication has been widespread, creative, and often courageous. The public has valued expertise and welcomed scientific evidence as never before.

The coronavirus crisis will end at some point. But another health crisis of biblical proportions—climate change—will continue. The health impacts of climate change are if anything considerably more varied, far-reaching, and catastrophic than those of SARS-CoV-2. In climate change, as in coronavirus, effective communication is indispensable. And in the aftermath of COVID-19, with public appreciation of public health arguably greater than ever, the time will be highly opportune for health communication on climate change.

In this issue of AJPH, Albright et al. (p. 1184) have given us a meticulous assessment of one communication channel on climate change and health: the Web sites of state and local health departments. They found that

Fewer than half (40%) of all state health department Web sites, and only 1.6% of county and 3.9% of city [health department] Web sites, provide a clear way to find information on climate change, whether through original content or links to external agencies. Furthermore, of the relatively few . . . Web sites providing original information on climate change, 48% provide no explanation or attribution of its causes. Indeed, some Web sites present the connection between human activity and climate change as an unresolved issue. (p. 1186)

This is a surprising finding because many in the public health community have recognized, and actively discussed, the links between climate change and health for at least two decades.

Two major questions emerge. First, why don’t health department Web sites have much climate content? What are the barriers, and how might they overcome them? Second, what should that content be?

WHY THE LACK OF CLIMATE CONTENT

The people who staff the nation’s health departments and manage their Web sites are neither lazy nor incompetent. Quite the contrary. We suggest that there may be several barriers to including robust climate change content on health department Web sites—and, for each, a path to overcoming it:

• Lack of leadership: Health department directors may not be championing communication about climate change and empowering their staff to do so. Directors should do so, and the Association of State and Territorial Health Officials and the National Association of County and City Health Officials—their professional organizations—should encourage and facilitate this commitment.

• Lack of courage: In some jurisdictions climate change may be considered too political to touch. Health departments should take inspiration from other public health battles, such as those for tobacco cessation, vaccines, and seat belts, and fearlessly tell the public health truth even if some special interests oppose them.

• Lack of mandate: The environmental health sections in many health departments are funded with dedicated revenues from sanitarian functions (e.g., restaurant and septic tank inspections). Structural, budgetary, and, in some cases, legal changes are needed to enable environmental health sections to transcend their traditional sanitarian siloes (taking on not just climate but also housing, transportation, greenspace, and other 21st-century environmental health issues).^1,2

• Lack of content: Health department staff may not feel they have the climate change content with which to populate their Web sites. Not so! Excellent free resources are readily available to health departments (see the box on p. 1122) and can be easily incorporated into health department Web sites.

• Lack of specific local knowledge: Health department staff may hesitate because they want their information to be locally relevant but don’t know how climate change will play out in their jurisdictions. That shouldn’t stop them from providing general information, but soon every health department should assess risks in its jurisdictions, using approaches such as the Centers for Disease Control and Prevention’s (CDC’s) Building Resilience Against Climate Effects framework (https://www.cdc.gov/climateandhealth/BRACE.htm). In the meantime, some local information is already available (see the box on this page), and leading state and local health departments provide useful models (see the box, list at CDC Web site).

• Lack of time and funds: It is true that health departments are underresourced,³ but with content readily available, the cost of adding it to a Web site is minimal.

Free Public Sources of Information on Climate Change and Health for Health Departments.

Source	URL
US Global Change Research Program, Impacts of Climate Change on Human Health in the United States, 2016	www.globalchange.gov/browse/reports/impacts-climate-change-human-health-united-states-scientific-assessment
Fourth National Climate Assessment, Chapter 14: Human Health, 2018	https://nca2018.globalchange.gov/chapter/14
US Centers for Disease Control and Prevention, Climate and Health Program	https://www.cdc.gov/climateandhealth
American Public Health Association, Climate Change	https://www.apha.org/topics-and-issues/climate-change
National Association of County and City Health Officials	https://www.naccho.org/programs/environmental-health/hazards/climate-change
Association of State and Territorial Health Officers, Climate Change	https://www.astho.org/Environmental-Health/Natural-Environment/Climate-Change
Climate Central, Climate Matters (produced for TV weathercasters)a	https://medialibrary.climatecentral.org
Yale Program on Climate Change Communication, Yale Climate Opinion Maps, 2019a	https://climatecommunication.yale.edu/visualizations-data/ycom-us

^aProvides local-scale information.

WHAT SHOULD BE SAID ABOUT CLIMATE CHANGE

Research has shown that the five most important climate change facts for members of the public to understand are

1. it’s real (our climate is changing, rapidly),

2. it’s us (primarily our fossil fuel use and deforestation),

3. experts agree (97% or more of the experts, based on overwhelming evidence, are convinced that human-caused climate change is happening),⁴

4. it’s bad (climate change is harming us in many ways), and

5. there’s hope (there are actions we can take to protect ourselves and our climate).⁵

Public health voices can and should reinforce that it’s real, it’s us, and experts agree, and we must also take the lead in explaining how it’s bad for our health (including who is most likely to be harmed) and why there’s hope—because the most important actions that must be taken will help stabilize our climate and thereby avert future harm, and they will help clean our air and water and improve our health, locally, as soon as we take them.

In addition, four specific kinds of content are especially appropriate for health department Web sites:

1. The current health impacts and future health risks of climate change here in our jurisdiction,

2. How we can protect ourselves from these risks (i.e., strategies for adaptation),

3. How we can help prevent climate change (i.e., strategies for mitigation), and

4. How these preventive actions will help us be healthier (i.e., the health benefits of climate solutions).

One of the most valuable strategies for helping organizations, communities of practice, and societies improve their performance is to establish a clear goal—or, in the words of Heath and Heath, to point to a destination.⁶ We respectfully suggest the following destination: by January 1, 2022, every US state, city, and county public health department will have educational, actionable information on their Web site about the local relevance of climate change to health.