Public Health Adaptation to Climate Change in Large Cities: A Global Baseline.

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.

Democracy underwater: public participation, technical expertise, and climate infrastructure planning in New York City.

This article provides an explanation for how increased public participation can paradoxically translate into limited democratic decision-making in urban settings. Recent sociological research shows how governments can control participatory forums to restrict the distribution of resources to poor neighborhoods or to advance private land development interests. Yet such explanations cannot account for the decoupling of participation from democratic decision-making in the case of planning for climate change, which expands the substantive topics and public funding decisions that involve urban residents. Through an in-depth case study of one of the largest coastal protection projects in the world and drawing on global scholarship on participation, this article narrates the social production of resistance to climate change infrastructure by showing how the state sidestepped public input and exercised authority through appeals to the rationality of technical expertise. After a lengthy participation process wherein participants reported satisfaction with how their input was included in designs, city officials switched decision-making styles and used expertise from engineers to render the publicly-supported plan unfeasible, while continuing to involve residents in the process. As a result, conflict arose between activists and public housing representatives, bitterly dividing the neighborhood over who could legitimately claim to represent the interests of the "frontline community." By documenting the experience of participants in the process before and after the switch in decision-making styles, this article advances a sociological description of public influence in policy: The ability for participants in a planning process to recognize their own input reflected in finished plans.

Readiness for climate change adaptation in the Arctic: a case study from Nunavut, Canada.

There is limited knowledge on institutional factors constraining and enabling climate change adaptation in Arctic regions, or the overall readiness of governing bodies and communities to develop, implement, and promote adaptation. This paper examines the preparedness of different levels of government to adapt in the Canadian Arctic territory of Nunavut, drawing upon semi-structured interviews with government personnel and organizations involved in adaptation. In the Government of Nunavut, there have been notable developments around adaptation planning and examples of adaptation champions, but readiness for adaptation is challenged by a number of factors including the existence of pressing socio-economic problems, and institutional and governmental barriers. Federally, there is evidence of high-level leadership on adaptation, the creation of adaptation programs, and allocation of funds for adaptation, although the focus has been mostly on researching adaptation options as opposed to supporting actual actions or policy change. The 2016 Pan-Canadian Framework on Clean Growth and Climate Change, and increasing emphasis on climate change federally and in the Government of Nunavut, offer opportunities for advancing adaptation, but concrete steps are needed to ensure readiness is enhanced.

Public health adaptation to climate change in Canadian jurisdictions.

Climate change poses numerous risks to the health of Canadians. Extreme weather events, poor air quality, and food insecurity in northern regions are likely to increase along with the increasing incidence and range of infectious diseases. In this study we identify and characterize Canadian federal, provincial, territorial and municipal adaptation to these health risks based on publically available information. Federal health adaptation initiatives emphasize capacity building and gathering information to address general health, infectious disease and heat-related risks. Provincial and territorial adaptation is varied. Quebec is a leader in climate change adaptation, having a notably higher number of adaptation initiatives reported, addressing almost all risks posed by climate change in the province, and having implemented various adaptation types. Meanwhile, all other Canadian provinces and territories are in the early stages of health adaptation. Based on publically available information, reported adaptation also varies greatly by municipality. The six sampled Canadian regional health authorities (or equivalent) are not reporting any adaptation initiatives. We also find little relationship between the number of initiatives reported in the six sampled municipalities and their provinces, suggesting that municipalities are adapting (or not adapting) autonomously.