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Review Advance Publication

Environ Health Perspect; DOI:10.1289/ehp.1307396

An Evidence-Based Public Health Approach to Climate Change Adaptation

Jeremy J. Hess,1,2,3 Millicent Eidson,4,5 Jennifer E. Tlumak,1,2 Kristin K. Raab,6 and George Luber1
Author Affiliations close
1Climate and Health Program, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA; 2Department of Environmental Health, Rollins School of Public Health at Emory University, Atlanta, Georgia, USA; 3Department of Emergency Medicine, Emory University School of Medicine, Emory University, Atlanta, Georgia, USA; 4Office of Public Health Practice, New York State Department of Health, Albany, New York, USA; 5Department of Epidemiology and Biostatistics, University of Albany School of Public Health, Albany, New York, USA; 6Environmental Health Division, Minnesota Department of Health, St. Paul, Minnesota, USA
About This Article open

This EHP Advance Publication article has been peer-reviewed, revised, and accepted for publication. EHP Advance Publication articles are completely citable using the DOI number assigned to the article. This document will be replaced with the copyedited and formatted version as soon as it is available. Through the DOI number used in the citation, you will be able to access this document at each stage of the publication process.

Citation: Hess JJ, Eidson M, Tlumak JE, Raab KK, Luber G. An Evidence-Based Public Health Approach to Climate Change Adaptation. Environ Health Perspect;

Received: 19 July 2013
Accepted: 3 July 2014
Advance Publication: 8 July 2014

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Background: Public health is committed to evidence-based practice, yet there has been minimal discussion of how to apply an evidence-based practice framework to climate change adaptation.

Objectives: To review the literature on evidence-based public health (EBPH), determine whether it can be applied to climate change adaptation, and consider how emphasizing evidence-based practice may influence research and practice decisions related to public health adaptation to climate change.

Methods: We conducted a substantive review of EBPH, identified a consensus EBPH framework, and modified it to support an EBPH approach to climate change adaptation. We applied the framework to an example and considered implications for stakeholders.

Discussion: A modified EBPH framework can accommodate the wide range of exposures, outcomes, and modes of inquiry associated with climate change adaptation and the variety of settings in which adaptation activities will be pursued. Several factors limit application currently, including lack of higher level evidence of intervention efficacy and lack of guidelines for reporting climate change health impact projections. To enhance the evidence base there must be increased attention to designing, evaluating, and reporting adaptation interventions; standardized health impact projection reporting; and increased attention to knowledge translation. This has implications for funders, researchers, journal editors, practitioners, and policymakers.

Conclusions: The current approach to EBPH can, with modifications, support climate change adaptation activities, but there is little evidence regarding interventions and knowledge translation, and guidelines for projecting health impacts are lacking. Realizing the goal of an evidence-based approach will require systematic, coordinated efforts among various stakeholders.

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