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MVP Toolkit: Public Health and the Healthcare Sector

Discover ways to address the impacts of climate change hazards on public health and the healthcare sector through the MVP grant program.

Note regarding COVID-19 from the MVP Team: In light of the current public health emergency, it is more important than ever to take steps to safeguard our future public health. With climate change expected to exacerbate current and future vulnerabilities in our communities, municipalities may benefit from approaching their MVP Planning Grant and Action Grant projects with a strong public health focus. The MVP team developed this toolkit to help prospective grant applicants consider ways to craft proposals that address the intersection of climate change and public health. While we acknowledge that it may not be possible to take every step in this toolkit during this current crisis (e.g., asking for participation of overburdened healthcare workers in MVP Planning Grant workshops), there is value to thinking through how these perspectives may be included once it is appropriate to do so. Please share your thoughts and feedback with us as we work to improve this “living document” as a resource for Massachusetts communities. 

How can I use the MVP program to address climate change impacts on public health?

Climate change presents new challenges for our medical and public health sectors, and demands a new approach for our communities to proactively prepare and manage these impacts. In parallel, public health and healthcare professionals have been working to improve the social determinants of health including efforts to address the impacts of climate change. By engaging with partners in the healthcare and public health fields and using public health data, municipalities can craft competitive MVP proposals with strong public health co-benefits. 

Definitions of key terms: Healthcare, Public Health, and Social Determinants of Health

Whether a municipality is embarking on the initial MVP Planning Grant process or is ready to implement their priority actions with an MVP Action Grant, consider the steps outlined in this toolkit to integrate public health into your project. A printable PDF of this toolkit is available here: MVP Toolkit: Public Health and the Healthcare Sector Printable PDF

Table of Contents

Step 1: Learn about the intersections of climate change hazards and health in your community.

Climate change hazards experienced in communities across the Commonwealth impact our health and our healthcare sector's ability to provide necessary services. Some of these impacts are illustrated in the graphic below (found on page 3-8 in the Massachusetts State Hazard Mitigation and Climate Adaptation Plan).  A history of systemic injustices means that climate change hazards disproportionately impact high-minority low-income neighborhoods (as defined in EEA’s 2017 EJ Policy), which further results in disproportionate negative health impacts for these communities. For more information on the ways in which rising temperatures, changes in precipitation, extreme weather and sea level rise generally impact public health across the Commonwealth, please visit the "Public Health Sector" page on the MA Climate Change Clearinghouse available here

Infographic on the impacts of climate change hazards (storms, brushfire, sea level rise, increasing temperatures, chages in precipitation and drought) on medical/physical health, mental health, and community health.
The impacts of climate change on human health in the United States. Source: U.S. Global Change Research Program (2016)

Below are some other resources to guide public health- and healthcare-focused MVP projects, including general information on climate change impacts on public health and healthcare, guides for local health departments and health professionals, example resilience projects that include public health components, and suggestions for locating community-specific health information.   

Printable PDF of MVP Toolkit: Public Health and the Healthcare Sector Step 1

Step 2: Team up with local partners to integrate public health data into your MVP process.

Health partners: Who in your community could provide expertise on the public health needs and vulnerabilities in your community? These experts may include:
  • Municipal Public Health Director/ Local Board of Health
    Infographic from US Center for Disease Control that illustrates community partners who may play a role in climate adaptation.
    There are many community health partners who can play a role in climate adaptation. Source: U.S. CDC (2019).
  • Healthcare professionals who work at a variety of facilities (i.e., hospitals, rehabilitation centers, nursing homes, outpatient surgical centers, clinics, medical offices, urgent care facilities, dialysis centers)
  • Independent healthcare professionals (i.e., home healthcare workers)
  • Mental health professionals
  • Non-profits or community-based organizations with a focus on public health and/or healthcare
  • Emergency and/or facility managers at healthcare facilities
  • Healthcare staff and other community stakeholders serving on a Community Benefits Committee at a local non-profit hospital
  • Public health and/or healthcare faculty and researchers at nearby higher education institutions
  • Social advocacy groups
  • Public Housing Authority
  • Food bank/pantry volunteers or staff
  • Farmers and food system workers
  • Regional Planning Agencies 
  • Individuals with health needs or vulnerabilities that are particularly sensitive to climate change impacts (i.e., those with asthma)
Community partners: Who in your community could provide expertise on a sector that supports public health in your community? These experts may include:
  • Utility companies
    Woman in hard hat standing in front of construction site.
    There are many people in our communities who are experts in fields that impact public health, such as public utilities.
  • Wastewater treatment professionals
  • Sewer/septic professionals
  • Department of Public Works staff
  • Drinking water professionals
    • Local water district
    • Municipal water department
    • MWRA
  • Pest control experts
  • Landscape professionals
  • Local Parks Department staff
  • Regional Transit Authorities
  • Local Planning Department staff, including transportation and economic planners
  • Chemical safety/hazardous waste disposal professionals
  • Private companies that produce hazardous materials/waste
MVP Partnership Spotlight: Plymouth and Beth Israel Deaconess Hospital
Image of invitation to Plymouth's "Climate Ready Healthy Plymouth" community workshop
Invitation to Plymouth's CRB Workshop. Source: MAPC (2020)

Plymouth is currently undertaking the MVP Planning Grant process with a focus on public health. In broadening the scope of the traditional MVP planning process, they have branded the effort Climate-Ready Healthy Plymouth. The Plymouth branch of Beth Israel Deaconess (BID) Hospital has served as a key partner throughout their MVP process. The Senior Director of Public Safety and Support Services for BID-Plymouth is a member of Plymouth’s MVP Core Team. Prior to the COVID-19 crisis, BID-Plymouth had offered to host the traditional MVP planning workshop (the workshop is now being held via an innovative online platform). Plymouth also drafted a Climate Change and Health Vulnerability Assessment and held four focus groups in early 2020 with neighborhood steering committees, businesses, residents, and other stakeholders to understand their priorities for public health in the face of climate change.

Printable PDF of MVP Toolkit: Public Health and the Healthcare Sector Step 2

Step 3: Implement health-related MVP Action Grant projects based on your priority actions.

Look through the priority action items described in your municipality’s Community Resilience Building Workshop Summary of Findings Report that was produced during the MVP planning process. Consider which priority action items directly or indirectly relate to some aspect of public health or healthcare. How could that priority action item be adjusted to strengthen its public health benefits? Then, with your project partner(s), decide which Action Grant Project Type best suits this priority action item.

  • Type 1. Planning, Assessments, and Regulatory Updates
    • Is there an assessment or analysis that could be performed to improve your understanding of the intersection between climate hazards and public health in your community?
      • These assessments may include but are not limited to:
        Cover image for MVP FY18 Action Grant Report from the Town of Natick, Mitigating the Heat Island Effect.
        Natick's MVP FY18 Action Grant Report, Mitigating the Heat Island Effect: Strategic Tree Planting Plan.
        • Heat islands in socially vulnerable areas of your community and how they could be addressed with green infrastructure (see Natick's FY18 MVP Action Grant Project report here) 
        • Drinking water supply and how increased droughts may impact your community (see Gloucester's FY18 MVP Action Grant Project report here)
        • Vulnerability of wastewater, sewer or septic infrastructure in your community considering climate hazards (see Scituate's FY18 MVP Action Grant Project report here, and Newburyport's FY18 MVP Action Grant Project report here)
        • Impact of flooding on transportation networks used to access to healthcare and emergency services
        • Risk of mold development and its impacts on residents in public/low-income housing developments 
        • Risks of vector-borne disease
        • Other assessments that further study public health risks of climate change in your community
          Infographic illustrating the five steps of the US CDC's Building Resilience Against Climate Effects planning framework.
          The five steps of the BRACE Framework by the U.S. CDC (2019).
      • In addition to the Community Resilience Building Framework and other more targeted health/climate assessments, consider using the BRACE Framework offered through the MA Department of Public Health. This includes a planning process focused specifically around climate change impacts on public health.
    • Would your community or certain groups within your community benefit from additional education or engagement surrounding a particular climate-driven public health risk?
      • Consider developing an outreach plan to educate your community on reducing exposure to vector-borne disease, coping with asthma and other chronic respiratory issues aggravated by environmental allergies, etc.
    • Are there guidelines or regulations that could be improved or developed to protect public health in light of climate change hazards?
      • Consider developing guidelines or zoning regulations that promote low-impact development/nature-based solutions in your community that will improve and/or protect both ecological and public health, particularly for Environmental Justice populations (further described in project type 2 below; also see the following MVP FY18 Action Grant Project reports: Boston, Brookline, Natick, and Mendon).
        Diagram of Low-Impact Design recommendations for Longwood Playground in Brookline.
        Low-Impact Design recommendations for Longwood Playground in Brookline from their MVP FY18 Action Grant report.
  • Type 2. Nature-based solutions for Ecological and Public Health
    • Are there natural resources that, if enhanced or preserved, would significantly improve public health?
      • Through supporting healthy ecosystems, nature-based solutions offer multiple public health services to communities. Consider:
        • Planting trees to reduce air pollution and resulting asthma occurrences, as well as reducing nitrogen dioxide and particulate matter. Trees planted in developed areas can also reduce heating and cooling needs of adjacent buildings.
        • Identifying parcels in environmental justice neighborhoods for “climate smart” park development, providing opportunities for cooling, exercise, stress reduction, and help with healing. In addition to these public health benefits, “climate smart” parks can also incorporate green infrastructure to improve water quality, air quality, and more.
          Image of wetlands scientist completing a salinity profile across the mud flats of Central Pond in Manchester-by-the-Sea.
          Completing a salinity profile across the mud flats of Central Pond for Manchester-by-the-Sea's ecological restoration project.
        • Restoring wetlands and water systems to protect against damaging floods and provide clean drinking water to residents (see Manchester-by-the-Sea’s FY18 MVP Action Grant Project report here).
        • Implement regenerative agricultural practices to support ecological health and provide food security to our growing population.
  • Type 3. Redesigns and Retrofits for Critical Facilities and Infrastructure
    • Are there healthcare facilities or other infrastructure that, if damaged by a climate change related hazard, would severely threaten public health?
      • Consider wastewater treatment plants, sewer and/or septic systems, drinking water supplies, transportation networks surrounding hospitals, evacuation routes, pieces of the medical and pharmaceutical supply chain, and food distribution network. Also consider improving energy resilience for any of these facilities.  
    • Is there a community space or facility that could serve as a strong "Resilience Hub"?
      • Resilience Hubs are enhanced community centers that also provide resources for residents that help them to cope with climate hazards. For more information on resilience hubs, check out this white paper from the Urban Sustainability Directors Network, as well as the City of Cambridge’s 2018 MVP Action Grant project
        Header image from Cambridge's MVP FY18 Project, Resilience Hub Business Plan for Cambridge Community Center.
        Cambridge created a resilience hub business plan for the Cambridge Community Center for their MVP FY18 Action Grant project.
    • Are there public housing/affordable housing developments in your community that are particularly vulnerable to climate hazards?
      • Consider a project that will explore ways to enhance the adaptive capacity of affordable housing facilities to continue to provide a safe environment to its residents during extreme weather events.

Printable PDF of MVP Toolkit: Public Health and the Healthcare Sector Step 3

References for non-Mass.gov and non-EEA Sources

American Public Health Association. (2020). What is Public Health? https://www.apha.org/what-is-public-health.

American Public Health Association.(2020). Public Health vs. Clinical Health Professions: What’s the Difference? https://www.apha.org/professional-development/public-health-careermart/careers-in-public-health-newsletter/job-searching-salaries-and-more/public-health-vs-clinical-health-professions-whats-the-difference.

Rudolph, L., Harrison, C., Buckley, L. & North, S. (2018). Climate Change, Health, and Equity: A Guide for Local Health Departments. Oakland, CA and Washington D.C., Public Health Institute and American Public Health Association. https://www.apha.org/-/media/files/pdf/topics/climate/climate_health_equity.ashx?la=en&hash=14D2F64530F1505EAE7AB16A9F9827250EAD6C79

U.S. Centers for Disease Control and Prevention. (2019). BRACE: Building Resilience Against Climate Effects [Infographic]. https://www.cdc.gov/climateandhealth/BRACE.htm

U.S. Centers for Disease Control and Prevention. (2019). Health Harm Cards: Climate’s Effect on Health [Infographics]. https://www.cdc.gov/climateandhealth/site_resources.htm

U.S. Centers for Disease Control and Prevention. (2019). Infographic: Climate and Community Health [Infographic]. https://www.cdc.gov/climateandhealth/site_resources.htm

U.S. Global Change Research Program. (2016). The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment. Crimmins, A., J. Balbus, J.L. Gamble, C.B. Beard, J.E. Bell, D. Dodgen, R.J. Eisen, N. Fann, M.D. Hawkins, S.C. Herring, L. Jantarasami, D.M. Mills, S. Saha, M.C. Sarofim, J. Trtanj, and L. Ziska, Eds. U.S. Global Change Research Program, Washington, DC, 312 pp. http://dx.doi.org/10.7930/J0R49NQX

Disclaimer: The use of and links to U.S. CDC materials in this toolkit does not constitute an endorsement or recommendation for this toolkit by the U.S. Government, Department of Health and Human Services, or Centers for Disease Control and Prevention..

Contact

Phone

Kara Runsten (617) 312-1594

MVP Program Manager

Courtney Rocha (617) 877-3072

MVP Southeast Regional Coordinator

Michelle Rowden (857) 343-0097

MVP Northeast Regional Coordinator

Carolyn Meklenburg (617) 894-7128

MVP Greater Boston Regional Coordinator

Hillary King (617) 655-3913

MVP Central Regional Coordinator

Andrew Smith (617) 655-3874

MVP Greater Connecticut River Valley Regional Coordinator

Carrieanne Petrik (617) 875-0911

MVP Berkshires & Hilltowns Regional Coordinator

Online

Kara Runsten kara.runsten@mass.gov
Courtney Rocha courtney.rocha@mass.gov
Michelle Rowden michelle.rowden@mass.gov
Carolyn Meklenburg carolyn.meklenburg@mass.gov
Hillary King hillary.king@mass.gov
Carrieanne Petrik carrieanne.petrik@mass.gov
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