States Can Lead on Mitigating the Effects of Climate Change

April 25, 2023 | Shelbi Davis

As many people around the world celebrate Earth Day, it is a natural time to examine current and future climate change policies that impact human health. There are numerous climate change effects—including clean air, safe drinking water, access to food, and secure shelter—that impact human health conditions. According to the World Health Organization, between 2030 and 2050 climate change is expected to cause approximately 250,000 additional deaths per year from malnutrition, malaria, diarrhea, and heat stress. Other impacts of climate change include heart and lung disease, infectious diseases, heat-related illness, poor pregnancy outcomes, sleep deficiencies, adverse mental health impacts, injuries, and death.

Extreme weather events caused by climate change disrupt healthcare delivery, education, employment, and other social structures, while also displacing people from their homes and communities. Additionally, certain populations are disproportionately impacted by the health impacts of climate change, including communities of color, immigrant populations, tribal communities, children and older adults, people with disabilities or health conditions, low-income communities, and pregnant people.

Federal Legislation and the Inflation Reduction Act

Federal investment to address climate change can have far reaching impact by supporting state and local governments to identify, prevent, and respond to the health impacts caused by climate change. The Inflation Reduction Act (IRA) combines funding, programs, and incentives to transition to a clean energy economy and equip the United States with the resources and clean energy development to reduce greenhouse gas emissions and improve public health outcomes.

Due to the connection between climate and health, investing in climate resiliency will positively affect health outcomes. Reducing air pollutants from the provisions in the IRA could lead to significantly fewer premature deaths, asthma attacks, and lost workdays. Moreover, the IRA contributes $40 billion towards protecting the health of historically disadvantaged communities through environmental justice priorities—defined as the fair treatment and meaningful involvement of all people regardless of race, color, national origin, or income, with respect to the development, implementation, and enforcement of environmental laws, regulations, and policies.

To date, funding from the IRA has mainly been distributed to the Environmental Protection Agency (EPA) and other federal agencies. Federal health agencies and state and territorial health agencies (S/THAs) have yet to receive direct funding from the IRA. However, states are introducing climate change legislation that uses existing funds and redirects funds to this effort.

State and Territorial Health Agency Climate Capacity and Funding

The primary mechanism for S/THAs to build climate and health capacity has been CDC’s Climate-Ready States and Cities Initiative, which funds jurisdictions to implement the Building Resilience Against Climate Effects (BRACE) framework. Sixteen states received this funding in 2020 and nine states received this funding in 2021. A report by ASTHO and the University of Washington also summarizes the efforts of S/THAs to address climate change and extreme weather. Key findings show that of states with at least one staff person designated to spend at least part of their time on climate and health programming, S/THAs provided internal and external education on climate change, conducted climate change and health vulnerability assessments, and incorporated climate change into emergency preparedness plans. Even in states without a designated staff person, S/THAs are conducting climate-related work such as coordinating of disease surveillance, linking the department with other state agencies working on climate change, and providing technical assistance to local agencies.

Some states have passed climate and health legislation to support climate mitigation and adaptation, as well as environmental and climate justice. In 2021, Washington passed the Healthy Environment for All (HEAL) Act, which coordinates environmental justice work conducted by multiple state agencies, including the Departments of Health, Commerce, Natural Resources, and Agriculture. Components of the law include defining a clear and shared definition of environmental justice, creating an Environmental Justice Council, conducting environmental justice assessments, and tracking environmental health disparities across the state. In 2022, Maryland passed SB 630, establishing an Office of Resilience that coordinates and connects multiple state agencies to implement climate resilience activities. The law also coordinates and administers federal prevention, protection, mitigation, and recovery-focused programs, as well as requires the Office to ensure investments prioritize disadvantaged communities.

2023 State Legislative Session

At least 17 states have introduced legislation related to climate change, nine of which (CA, HI, MD, MN, NM, NY, OR, RI, VT) are considering bills that direct funding for climate change related projects and programs. These include proposals to fund climate and environmental justice initiatives as well as other programs that benefit disadvantaged communities.

• Vermont introduced legislation (H 248) that would establish a State Climate Infrastructure Fund, which would create investments in projects and programs that increase climate resilience and adaptation, as well as climate justice.
• New York introduced legislation (S 2129/A 3351) that would establish the climate change adaptation cost recovery program, with no less than 35% of program spending directed towards climate change adaptive infrastructure projects that directly benefit disadvantaged communities.

Seven states (CA, CT, HI, MN, NY, OR, RI) introduced legislation to implement climate change education programs:

• The Hawaii House adopted a resolution (HCR 192) urging the Hawaii Climate Change Mitigation and Adaptation Commission to use IRA funding to develop a public health engagement strategy led by Native Hawaiian communities that communicates how climate change uniquely affects public health in the state.
• Minnesota introduced legislation (SF 476/HF 2297) that would require climate justice instruction for school districts and charter schools.
• Rhode Island introduced legislation (HB 6106) that would invest in youth climate change and ocean protection education programs that increase climate and ocean literacy, as well as understanding of solutions such as climate adaptation and mitigation, climate resilience, and climate and environmental justice.

Ten states (CA, HI, IN, MD, MN, NJ, NY, RI, TX, WA) have introduced legislation that directs state agencies to update and/or publish climate plans, assessments, and/or reports:

• Washington’s legislature passed HB 1181, requiring the Department of Ecology to update its Shoreline Master Program guidelines to address the impact of sea level rise and increased storm severity.
• Texas introduced legislation (HB 3326) that directs various state agencies, including the Health and Human Services Commission, to publish strategies to identify, minimize and prepare for the effects of extreme weather conditions, such as drought and flooding. Texas also introduced legislation (HB 57) directing the Texas Commission on Environmental Quality and the Office of the State Climatologist to prepare a Climate Impact Report that includes the impact of climate change on human health.
• New Jersey introduced legislation (S 1530) that requires hazard mitigation plans to include climate change-related threat assessments, including an evaluation of the disparate impacts of natural hazards, such as increased flooding and development of heat islands, experienced by historically disadvantaged communities.

State legislatures play an important role in responding to the health harms caused by climate change, especially among disproportionately impacted communities. With recent federal investments such as the IRA, S/THAs can ensure they are fully equipped to prevent poor health outcomes caused by climate change.

ASTHO will continue to track federal and state climate policies and monitor IRA and other climate-based federal funding that STHAs can pursue to develop, implement, and maintain climate and health efforts.