Step 4: Develop and implement a climate and health adaptation plan

Climate Change and Health, Justice, Equity, Diversity and Inclusion PlaybookApplying climate change adaptation knowledge and planning from multiple levels of governance, with an overriding focus on community engagement

Step 4’s goal is to create and implement the adaptation plan selected in Step 3. A comprehensive plan will include particular consideration of the jurisdiction’s environmental risks, health threats, and at-risk populations and will be updated regularly. Once you have selected an intervention strategy, bringing the following resources together can provide a comprehensive picture that can help you get started:1

  • Table of recommended adaptation actions indicating priority, lead program/partner responsibility and progress measure/metric (if available)
  • Any predetermined criteria used to prioritize potential adaptation plans
  • Community profile which includes background information related to the intended intervention and climate risks that it will address
  • A summary of regional/municipal climate change scenario(s) related to the climate hazards addressed
  • Maps showing risks and priorities, such as EJSCREEN or the CDC / ATSDR Social Vulnerability Index
  • Summary of relevant local climate change impacts
  • Identification of risks and opportunities specific to the adaptation plan
  • Results of a racial equity impact assessment
  • A logic model reflecting the theory of change for the adaptation action
  • Action plan for tasks to be accomplished, using project management tools such as Gantt charts and RACI matrices and a gap analysis if applicable
  • List of key community partners and project participants who will contribute to the implementation or who could potentially be involved

Develop a logic model that shows how the adaptation plan will achieve its goals and reduce health disparities

A logic model is a visual depiction of how a program or project’s activities will achieve its expected outcomes. This is a good moment to develop and incorporate explicit program objectives and goals, if they do not already exist, especially in relation to JEDI. The logic model should also reflect how the adaptation plan will contribute to health equity goals. Consider the logic modeling sessions as opportunities to invite participation from diverse stakeholders, including community members experiencing health inequities.

Thinking of Logic Models as a Series of If...Then Statements

Figure courtesy Centers for Disease Control and Prevention, Tuberculosis


Tap into existing networks and governance resources to maximize the positive impact of your adaptation plan

Understand the strengths and limitations of your department and consider how you can take advantage of resources at multiple governance levels and non-health focus departments impacted by climate change to reach at-risk populations. See below for suggested approaches to maximize the positive impact on your adaptation plan:

  • Implement the adaptation plan at various levels relying on the resources and network of each implementer.
  • Engage non-health partners in government. Health in All Policies could be an approach to collaboratively address complex factors that influence health and equity.
  • Define the role of the state in supporting local health departments’ investment in at-risk populations.
  • Delegate leadership roles of adaptation planning and implementation to local public leaders who are more familiar with their jurisdiction’s at-risk populations and needs.
  • For example, to engage with tribal communities, practitioners can use existing protocols and a collection of resources from the Tribal Public and Environmental Health Think Tank, National Congress of American Indians, National Indian Health Board, Tribal Epidemiology Centers, Native American Research Center for Health, Indian Health Service and the Institute for Tribal Environmental Professionals.


The Minnesota Department of Health’s climate adaptation plans are based on information about the particular community the plan intends to serve and input from all the divisions at the department. The department has not yet worked directly with at-risk populations to develop adaptation plans, so there is a potential opportunity for future evaluation and engagement. Since the department’s work is primarily focused on state-level action, they infuse climate and health priorities within city and county planning and emergency management efforts. The department uses a “health and climate in all policies approach” by working with other professionals to elevate climate and health across all public policies. The department provides technical assistance to cities, counties or other agencies that are directly involved in community engagement and are developing their own adaptation plans.2


Consider these resources from different areas that have implemented community adaptation programs to mitigate the impacts of climate change, with a specific focus on vulnerable populations. Inclusion of resources does not imply endorsement from CDC or APHA.

New York City Department of Health and Mental Hygiene Community Engagement Framework
The Community Engagement Framework allows staff across the agency to establish a common language for discussion and refining agency work related to community engagement. The framework can be used as both a planning and an assessment tool.
CDC's guidance on cross-sectoral collaboration
This guidance serves as a practical starting point for initiating and furthering adaptation planning to reduce climate-related health risks in our communities.
Climate Adaptation Knowledge Exchange (CAKE) Resources
CAKE provides a variety of resources, including over 150 documents, over 50 case studies, and over 20 tools for climate adaptation program planning.
Maryland Public Health Strategy for Climate Change
This slidedeck provides insights into Maryland’s Public Health strategy utilizing the CDC BRACE framework.
Northern Arizona University Tribal Adaptation Planning Tool Kit
The toolkit provides a collection of templates and other resources developed by the institute for Tribal Environmental Professionals to assist tribes in their planning process for climate change adaptation.
Climate Change and the Jamestown S'Klallam Tribe: A Customized Approach to Climate Vulnerability and Adaptation Planning
The Jamestown S'Klallam Tribe initiated a project to identify and begin addressing the risk the community faces from climate change. The project used a collaborative approach to identify vulnerabilities, select and prioritize key areas of concern, and develop adaptation strategies to reduce vulnerability and increase resilience.
Tribal Climate Adaptation Guidebook
This guidebook builds on the ongoing climate-related work in tribal communities, provides a framework for climate change adaptation planning in the context of existing tribal priorities, and directly considers the unique issues facing Indigenous communities.
CDC/ATSDR Principles of Community Engagement, Second Edition
Principles of Community Engagement (Second Edition) provides public health professionals, health care providers, researchers, and community-based leaders and organizations with both a science base and practical guidance for engaging partners in projects that may affect them.
Oregon Health Authority Climate Change Resilience Planning Toolkit
The toolkit provides guidance to local health jurisdictions on how to integrate climate change work into local public health practice.
Climate Change & Health: Assessing State Preparedness
This report assessed all 50 states and the District of Columbia on their level of preparedness for the health effects of climate change and found a great deal of variation in their preparedness to protect residents’ health. Some states have made significant preparations, while others have barely begun this process.



1. Marinucci GD, et al. Building resilience against climate effects- A novel framework to facilitate climate readiness in public health agencies. International journal of environmental research and public health. 2014 June. 11. 6433-6458. 10.3390/ijerph110606433.

2. Adapting to climate change in Minnesota. 2017 Report of the interagency climate adaptation team. 2017 May. Retrieved from https://www.pca.state.mn.us/sites/default/files/p-gen4-07c.pdf