title: Environmental health indicators of climate change for the United States: findings from the State Environmental Health Indicator Collaborative.
abstract: OBJECTIVE
  To develop public health adaptation strategies and to project the impacts of climate change on human health, indicators of vulnerability and preparedness along with accurate surveillance data on climate-sensitive health outcomes are needed. We researched and developed environmental health indicators for inputs into human health vulnerability assessments for climate change and to propose public health preventative actions.
  
  
  METHODS
  We conducted a review of the scientific literature to identify outcomes and actions that were related to climate change. Data sources included governmental and nongovernmental agencies and the published literature.
  
  
  METHODS
  Sources were identified and assessed for completeness, usability, and accuracy. Priority was then given to identifying longitudinal data sets that were applicable at the state and community level.
  
  
  RESULTS
  We present a list of surveillance indicators for practitioners and policy makers that include climate-sensitive health outcomes and environmental and vulnerability indicators, as well as mitigation, adaptation, and policy indicators of climate change.
  
  
  CONCLUSIONS
  A review of environmental health indicators for climate change shows that data exist for many of these measures, but more evaluation of their sensitivity and usefulness is needed. Further attention is necessary to increase data quality and availability and to develop new surveillance databases, especially for climate-sensitive morbidity.
authors.affiliation: Center for Chronic Disease Prevention and Health Promotion, California Department of Public Health, Richmond, California 94804, USA. penglish@dhs.ca.gov.
authors.forename: Paul B
authors.initials: PB
authors.lastname: English
authors.forename: Amber H
authors.initials: AH
authors.lastname: Sinclair
authors.forename: Zev
authors.initials: Z
authors.lastname: Ross
authors.forename: Henry
authors.initials: H
authors.lastname: Anderson
authors.forename: Vicki
authors.initials: V
authors.lastname: Boothe
authors.forename: Christine
authors.initials: C
authors.lastname: Davis
authors.forename: Kristie
authors.initials: K
authors.lastname: Ebi
authors.forename: Betsy
authors.initials: B
authors.lastname: Kagey
authors.forename: Kristen
authors.initials: K
authors.lastname: Malecki
authors.forename: Rebecca
authors.initials: R
authors.lastname: Shultz
authors.forename: Erin
authors.initials: E
authors.lastname: Simms
mesh_terms: D000064:Acclimatization; D002980:Climate; D004782:Environmental Health; D006291:Health Policy; D006305:Health Status Indicators; D006801:Humans; D011634:Public Health / Q000379:methods; D018570:Risk Assessment / Q000379:methods; D014481:United States