In late October, Jamaica was struck by the most powerful hurricane ever recorded to make landfall on the island nation. Hurricane Melissa brought torrential rains and extreme winds, destroying homes and causing power outages across Jamaica and other Caribbean islands. Over 60 people have died.

Climate-driven extreme weather has increased in frequency and ferocity in recent years, and the impact on human health is receiving more attention. Studies show that people experiencing hurricanes, tornadoes, extreme rain, heatwaves or wildfires are at high risk of developing post-traumatic stress disorder and other chronic illnesses. 

At a Monday APHA 2025 session, “Climate Change and Global Health,” climate experts talked about the importance of cities and states creating disaster action plans to mitigate property damage and human injuries and deaths.

In recent years, the United Nations’ Office for the Coordination of Humanitarian Affairs has promoted an “anticipatory action framework” for nations and cities to prepare for extreme weather disasters. The framework includes creating emergency caches of water, food and medical supplies; identifying evacuation routes; creating an action plan and disaster relief staff; and strengthening infrastructure.

Research has shown that anticipatory action offers a proactive approach to reducing injuries, deaths and structural damage for cities and nations, said Marsha Williams, senior director of health care systems planning at New York City Department of Health and Mental Hygiene. 

Williams presented research that identifies barriers to Caribbean island nations adopting anticipatory action plans. She also explored strategies to strengthen disaster preparedness and climate resilience through proactive planning.

Williams found that among the challenges to overcome are lack of funding, staffing, policy enforcement and knowledge about disaster preparedness. She recommends more funding for the Caribbean Disaster Emergency Agency; expanding capacity-building programs, such as through partnerships with universities, nongovernmental organizations and community service programs; and strengthening enforcement of building codes and disaster policies.

Meanwhile, heat-health action plans — or HHAPs — adopted by cities have helped improve life-saving actions when extreme weather strikes, said David M Bishai, director of the School of Public Health at the University of Hong Kong.

But too many cities have no plan. 

“The No. 1 reason climate will kill us is heat, and we are not planning for it,” Bishai said.

Bishai’s presented study assessed the prevalence and quality of HHAPs for 100 cities worldwide with a population of 1 million or more. He found that 77 had no plan. Twelve may or may not have a plan — barriers prevented verification. 

Among the 11 cites with plans are New York City; Tokyo, Japan; Sydney, Australia; Melbourne, Australia; Karachi, Pakistan; Delhi, India; and Dhaka, Bangladesh. 

Among the cities with the most comprehensive plans were those in India, Australia, Pakistan and Japan. Regarding large cities in North America, only New York City has an HHAP.

Bishai said advocates should encourage cities to adopt an HHAP. First steps can be through a meeting with decision-makers or a public discussion about heat action plans.

Photo: Hurricane Melissa damage in Jamaica in 2025. Photo courtesy PAHO via Flickr Creative Commons.