The Role of Health in Urban Climate Adaptation: An Analysis of Six U.S. Cities

Climate change threatens the health of urban residents in many ways. This qualitative study aims to understand how six U.S. cities are considering health adaptation when responding to climate change; 65 semi-structured interviews were conducted with salient stakeholders across six U.S. cities (Boston, Massachusetts; Los Angeles, California; Portland, Oregon; Raleigh, North Carolina; Tampa, Florida; and Tucson, Arizona), and transcripts were analyzed to identify common themes. Each city's (or county's) most recent climate action plan was also analyzed. This study found that interviewees' ability to understand the connection between climate and health was a major determinant for health adaptation implementation. In addition, institutional fragmentation in governance made it difficult to incorporate health concerns into broader climate planning. However, cross-sectoral collaborations and considerations of health cobenefits were shown to help overcome these barriers. These findings offer valuable insight regarding how policy makers and practitioners can safeguard public health from the effects of climate change.