It is widely recognized that climate change poses a serious challenge to the field of public health due to the changing frequency and severity of impacts faced by local communities, however, addressing climate change provides the opportunity to implement solutions that build healthy, equitable, and climate-resilient communities. The public health sector works closely with local governments and community partners to address health inequities of environmental change by developing and implementing policies and programs that prioritize health, and often these activities align with climate mitigation and adaptation measures. Local health departments (LHDs) are often at the front lines working with communities disproportionately affected by climate change, therefore the public health sector has a critical role to play in advancing and mobilizing support for health-based climate change strategies that improve health outcomes, address inequities, and reduce greenhouse gas emissions. California’s strategy to reinvest cap-and-trade funds into climate change mitigation and adaptation activities, known as the California Climate Investments (CCI), offers a significant opportunity for the public health sector to integrate health consideration into local climate mitigation and adaptation efforts, however, there has been limited public health sector engagement at the local level. The work presented here evaluates the CCI through a public health practice lens to identify opportunities to increase LHD engagement in the CCI at the local level to ensure that climate action strategies integrate public health consideration and promote environmental health equity. The first section provides a critical review of the literature on climate change vulnerability assessment frameworks to examine the potential climate change-related health impacts within the context of Los Angeles County to inform climate change adaptation planning. The next sections focus on the CCI to identify opportunities to increase LHD engagement and integrate public health consideration in the implementation of CCI funded projects. First, selected CCI program guidelines and publicly available documents were coded and analyzed to examine the programmatic alignment between CCI program requirements and foundational LHD activities to identify opportunities for LHDs to engage and actively support partner organizations. Next, interviews were conducted with selected LHD personnel and key respondents to identify best practices of LHD engagement in urban greening and community forestry initiatives funded through the CCI. Document analysis and interviews demonstrated that there are opportunities for LHD engagement, however, barriers exist. Lack of information about LHD eligible to apply, limited requirements for LHD engagement, and insufficient awareness of LHDs about the CCI limit public health sector engagement at the local level. Recommendations to address these barriers include increasing outreach to LHDs, establishing a more robust role for LHDs, increasing the climate adaptation component of the CCI programs to provide opportunity for greater LHD engagement. California’s approach to implementing the cap-and-trade program and reinvesting auction proceeds in local climate action initiatives to benefit vulnerable communities provides a model for other jurisdictions. As other states look to cap-and-trade, it is critical that California pushes innovation and sets the example of how to effectively integrate public health sector engagement in all levels of climate action to reduce greenhouse gas emissions, help communities adapt to climate change, and advance environmental health equity so that communities can thrive and become climate-resilient.
