title: Public Health Climate Change Adaptation Planning Using Stakeholder Feedback.
abstract: BACKGROUND
  Public health climate change adaptation planning is an urgent priority requiring stakeholder feedback. The 10 Essential Public Health Services can be applied to adaptation activities.
  
  
  OBJECTIVE
  To develop a state health department climate and health adaptation plan as informed by stakeholder feedback.
  
  
  METHODS
  With Centers for Disease Control and Prevention (CDC) funding, the New York State Department of Health (NYSDOH) implemented a 2010-2013 climate and health planning process, including 7 surveys on perceptions and adaptation priorities.
  
  
  METHODS
  New York State Department of Health program managers participated in initial (n = 41, denominator unknown) and follow-up (72.2%) needs assessments. Surveillance system information was collected from 98.1% of surveillance system managers. For adaptation prioritization surveys, participants included 75.4% of NYSDOH leaders; 60.3% of local health departments (LHDs); and 53.7% of other stakeholders representing environmental, governmental, health, community, policy, academic, and business organizations. Interviews were also completed with 38.9% of other stakeholders.
  
  
  RESULTS
  In 2011 surveys, 34.1% of state health program directors believed that climate change would impact their program priorities. However, 84.6% of state health surveillance system managers provided ideas for using databases for climate and health monitoring/surveillance. In 2012 surveys, 46.5% of state health leaders agreed they had sufficient information about climate and health compared to 17.1% of LHDs (P = .0046) and 40.9% of other stakeholders (nonsignificant difference). Significantly fewer (P < .0001) LHDs (22.9%) were incorporating or considering incorporating climate and health into planning compared to state health leaders (55.8%) and other stakeholders (68.2%). Stakeholder groups agreed on the 4 highest priority adaptation categories including core public health activities such as surveillance, coordination/collaboration, education, and policy development.
  
  
  CONCLUSIONS
  Feedback from diverse stakeholders was utilized by NYSDOH to develop its Climate and Health Strategic Map in 2013. The CDC Building Resilience Against Climate Effects (BRACE) framework and funding provides a collaborative model for state climate and health adaptation planning.
authors.affiliation: Office of Public Health, New York State Department of Health, Albany, New York (Drs Eidson and Birkhead and Ms Clancy); and Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, Rensselaer, New York (Drs Eidson and Birkhead).
authors.forename: Millicent
authors.initials: M
authors.lastname: Eidson
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Clancy
authors.forename: Guthrie S
authors.initials: GS
authors.lastname: Birkhead
mesh_terms: D000288:Administrative Personnel; D057231:Climate Change; D004782:Environmental Health; D005246:Feedback; D006285:Health Planning; D006801:Humans; D009518:New York; D011634:Public Health; D011795:Surveys and Questionnaires; D014481:United States