8. Overview: Adaptive Management for the Health Risks of Climate Change

Climate change is expected to increase health risks in all countries. Although public health agencies and organizations have impressive records of controlling the burden of climate-sensitive health outcomes, current and planned programs and activities may need to be modified to address the additional risks of climate change. Programs and activities need to take an iterative risk management approach if they are to maintain current levels of health burdens as diseases change their geographic range and incidence in response to changing temperature and precipitation patterns and as the risks of adverse health outcomes from extreme weather events increase. Public health can learn from the experiences in ecosystem management with adaptive management, a structured and iterative process of decision-making in the face of imperfect information, with an aim of reducing uncertainty through monitoring and evaluation. Although many of the steps in adaptive management are familiar to public health, key differences include: a stronger emphasis on stakeholder engagement; taking a systems-based approach; developing interventions based on models of future impacts; and a strong and explicit focus on iterative management that can facilitate the capacity for further adaptation. Incorporating these elements into public health programs and activities will increase their effectiveness to address the health risks of climate change.