ADVANCEMENT OF THE PRACTICE
identifying populations that are more vulner- able to climate change and implementing adap- tation and preparedness strategies to reduce the health e ects of climate change. The Building Resilience Against Climate E ects (BRACE) Framework developed by CDC (2024b) has five sequential steps that can help health ocials in developing strategies and programs that better prepare communities for the health e ects of climate change: 1. Forecasting climate impacts and assessing vulnerabilities. 2. Projecting disease burden. 3. Assessing public health interventions. 4. Developing and implementing a climate and health adaptation plan. 5. Evaluating impact and improving the qual- ity of activities. To supplement BRACE and support public health departments and adaptation planners, the National Environmental Health Asso- ciation (NEHA, 2023) produced Integrating Environmental Justice and Climate and Health to provide examples of how environmental justice, climate, and health can be integrated into core environmental public health pro- grams and services to improve health out- comes. Using the Climate and Health Adap- tation and Mitigation Partnership (CHAMP) Program and strategic framework, jurisdic- tions can identify their climate-related health risks, develop responsive climate adaptation plans, and implement targeted adaptation actions to protect their communities from environmental health risks related to climate change (Figure 2; NEHA, 2023). One promising approach is the develop- ment of Indigenous-led management and co- management strategies for lands, waters, and other resources (Frazier et al., 2023). Many Pacific Islander communities are calling for a greater role in decision-making and the integration of traditional resource manage- ment practices into climate adaptation e orts (Winter et al., 2023). According to G. Bare (personal communication, June 10, 2024), when asked about the strengths that the previously-mentioned disaster highlighted within the department, Navarro said: The local community exhibited resil- ience and solidarity in the aftermath of the typhoon. Community organizations, such as religious groups, local clubs, and civic associations, came together to organize and help distribute supplies
FIGURE 2
Diagram of the Climate and Health Adaptation and Mitigation Partnership (CHAMP) Program From the National Environmental Health Association (NEHA)
Jurisdictions Learn BRACE Framework and Assess Needs and Strategies
Jurisdictions Collaborate Wi th NEHA to Share Success Stories
Jurisdictions Build Climate and Health Workforce Capacity
Jurisdictions Develop and
Jurisdictions Evaluate and Enhance Mitigation and Adaptation Plans
C H A M P
limate ealth daptation itigation artnership
Strengthen Cross - Sector Engagement and Partnerships
Program
Jurisdictions Develop Climate Mitigation and Adaptation Plans
Jurisdictions Complete BRACE Framework
Jurisdictions Implement Mitigation and Adaptation Plans
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and assist in rebuilding e orts. In gen- eral, Guam people maintained a positive outlook and continued to work toward rebuilding their homes, infrastructure, and livelihoods. Co-management arrangements, when done right, can create opportunities for assert- ing Indigenous knowledge and practices while building climate resilience (Winter et al., 2020). It is essential, however, that these arrangements prioritize the strengthening of Indigenous capacities, clear and consistent communication, and the uplifting of Indige- nous cultures (Winter et al., 2023). For exam- ple, from 2017–2018, the Commonwealth Healthcare Corporation delivered a climate change training in the Commonwealth of the Northern Mariana Islands, from which sta throughout the agency could build knowledge
and expertise locally. Throughout the project, the team fostered relationships with key part- ners outside of public health (e.g., governmen- tal agencies) who can provide expertise and input on climate and health work across the Commonwealth (CDC, 2020). Similarly, in 2017, the Department of Health and Social A airs for the Federated States of Micronesia hosted educational workshops and hands-on exercises to combine local agricultural and diet-related knowledge and practices with outside technical assistance. The goal was to empower the people of the low-lying islands, such as Chuuk and Pohn- pei, with the knowledge, skills, and abilities necessary to maintain a healthy island diet in a changing environment (CDC, 2020). Local environmental public health depart- ments, programs, and partner organizations
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Volume 87 • Number 9
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