Public health adaptation to climate change in OECD countries

The study analyses the role of national governance in preparing the health sector to climate change. Included are six European countries: Belgium, France, Ireland, Luxembourgh, Switzerland and the UK. The authors examine three key dimensions of national-level health adaptation:

• cross-sectoral collaboration,
• vertical coordination
• national health adaptation planning.

Practical examples from the examined national governances are included. A total of 175 climate change adaptation (CCA) initiatives were gathered through systematic web search, self-reporting (by the countries) and content analysis. Excluded were, i.a., iniatives lacking explicit focus on either health or CCA.

Key findings are:

1. nearly half of the national-level initiatives consider health in general, i. e. do not capitalize on specific health risks, of which …
2. infectious diseases and heat-related risks receive most focus
3. local governments, in contrast, do address flood and storm risks but hardly infectious diseases
4. typically, CCA-efforts at the national level are distributed 2:1 between groundwork (i.e. preparing the ground for CCA) and actual implementation action
5. national governments are often constrained by conflicting or fragmented institutional arrangements and low political and/or public priorisation
6. there is no “silver bullet” for CCA governance in the health sector but rather a country-specific proper allocation and coordination of competencies and ressources among sectors, governance levels and adaptation categories.