Public Health Services
Climate Change and Health

Welcome to Climate Change and Health website of the Public Health Services (PHS) department, in the County of San Diego Health and Human Services Agency. This website provides a history of climate change and public health work conducted by the department of PHS, current climate and public health efforts, partnership activities, and additional climate and public health resources. 

Introduction

Climate change and extreme weather affect public health in San Diego County in a variety of ways (see Figure 1). In addition, it poses direct threats to human health and exacerbates health conditions. Therefore, the department of Public Health Services (PHS), in the County of San Diego (County) Health and Human Services Agency (HHSA), partners with the community (e.g., community collaboratives, Resident Leadership Academy); local, tribal, and state governments; local universities; and community-based organizations to ensure hazard mitigation planning, climate action planning, General Plan development (e.g., safety element, environmental justice element) to consider population health and the impacts of climate change on human health. Public Health is affected by decisions related to land use, housing, transportation, air filtration, indoor air quality, and indoor temperatures, as well as access to air conditioning, placement of cooling centers, and response to excessive heat events and wildfires. These partnerships ensure public health is included in preparedness and response efforts that affect the health of San Diego County residents. 

Figure 1. Impacts of Climate Change on Human Health.

Source: California Department of Public Health, Adapted from Centers for Disease Control and Prevention, J. Patz.

What is the Problem?

Who is at Risk?

What Is Public Health Services Doing?

Therefore, effective climate change efforts, like all essential public health services, including preparedness and response, must be looked at through an equity lens. Working with partners in the County of San Diego’s Land Use and Environment Group (LUEG), the County’s Vector Control Program (LUEG Department of Environmental Health and Quality (DEHQ)), Office of Emergency Services (OES), the Air Pollution Control District and others is an opportunity to improve population-wide health and advance equity over the short, medium and long term, particularly for chronic health conditions.

History

In 2015, PHS created the Office of Heath Equity, hired its first Health Equity Program Coordinator, published its first ever Health Equity Plan (2015-2020). A PHS Health Equity Working Group was formed, which now includes climate change and public health in its Charter. As of Fall 2021, the PHS Office of Health Equity name was changed to the Office of Health Equity and Climate Change.

CalBRACE

The federal Centers for Disease Control and Prevention (CDC) has funded the Building Resiliency to the Effects of Climate Change (BRACE) program, which has provided funding to some state and local jurisdictions to perform work in this area. In California, the California Department of Public Health (CDPH) Office of Health Equity has been a long-standing recipient of federal BRACE Program funding. This funding supports the CDPH California Building Resilience Against Climate Effects (CalBRACE) Project. Since 2015, CalBRACE has provided technical assistance to the Office of Health Equity and Climate Change of the Public Health Services, in the County of San Diego Health and Human Services Agency. The BRACE Framework facilitates the process for climate change work in public health jurisdictions. This process includes five-steps, as shown in Figure 2:

• Step 1: Anticipate Climate Impacts and Assessing Vulnerabilities.
• Step 2: Project the Disease Burden
• Step 3: Assess Public Health Interventions
• Step 4: Develop and Implement a Climate Change and Health Adaptation Plan
• Step 5: Evaluate Impact and Improve Quality of Activities

With CalBRACE funding, PHS conducted a staff survey which determined the need for training and a Climate Change 101 was developed. All staff in the department are required to take this training and are encouraged to seek opportunities to improve health outcomes for residents with awareness of these environmental health concerns (e.g., excessive heat and air quality). 

Figure 2. BRACE Framework.

Source: Centers for Disease Control and Prevention.

PHS collaborated with the California Department of Public Health (CDPH) on a Vulnerability Assessment for San Diego County, a local Profile Report describing threats, risks and vulnerabilities, a presentation on the vulnerabilities to climate change unique to San Diego County residents, and a template for an Adaptation Plan. Experts from CDPH presented to public health leaders and provided a workshop to PHS Epidemiologists on the State’s Climate Change & Health Vulnerability Indicators for California (CCHVIz) data. 

Partnering for Collective Impact

PHS has taken steps to work with additional state, local, and regional partners to continuously refine and describe a local narrative on the potential public health impacts of climate change and extreme weather, and to develop a public health and climate change adaptation plan and a series of white papers on key health and climate topics (e.g., excessive heat). PHS has provided over a dozen workshops to local collaboratives, Live Well partners at the Live Well Advance, community-based organizations, the Resident Leadership Academy, and others. PHS has partnered with the County’s Office of Emergency Services on the Hazard Mitigation Plan, the County’s General Plan (i.e., Vulnerability Assessment, Environmental Justice, and Safety Sections), and the County’s Climate Action Plan. PHS has provided input to the State on the General Plan Guidelines and legislation on climate, equity, and health. PHS partners with the County’s Department of Environmental Health and Quality on a variety of topics, including the Vector Control Program for tracking and reporting potential vector borne diseases. PHS hosts a vector borne disease conference annually with partners in government and academia on both sides of the border.

In 2023, PHS partnered with the Executive Office of LUEG on community convenings in the 5 supervisorial districts around the Regional Decarbonization Framework and the Public Health Impacts of Climate Change. PHS is currently implementing its first Adaptation Plan and developing a Climate Change and Public Health Policy and Procedure which will be mandatory reading for all PHS staff. 

Vision, Mission, Goal

PHS Timeline

Figure 3. PHS Climate Change and Health Timeline.

Source: Public Health Services, Office of Health Equity and Climate Change, 2023. See text version of PHS Climate Change and Health Timeline.

Current PHS Climate Change and Health Efforts

• Ensure all new staff receive the mandatory Climate Change 101 training.
• Finalize and promote series of white papers on the public health impacts of climate change in San Diego County.
• Continue to implement the PHS Adaptation Plan.
• Develop fliers on health equity and climate topics in collaboration with San Diego State University (SDSU) Research Foundation through the HealthLINK grant.
• Continue collaboration with University of California San Diego (UCSD), SDSU, University of San Diego (USD), and others to advance and promote research on the public health impacts of climate change.
• Promote the results of the collaborative effort between LUEG Planning and Development Services, HHSA, Desert Research Institute and the National Weather Service on communicating with community about the impacts of excessive heat.
• Participate on the San Diego Regional Climate Collaborative.
• Continue to collaborate with LUEG on the Regional Decarbonization Framework effort including additional convenings for community participation.
• Continued partnership on Partner Relay effort including additional workshops for communities.
• Host bi-monthly meeting with local and state partners on public health and climate.
• Provide input to the Regional Report for the 5th Assessment led by UCSD.
• Participate in the Health & Human Services Agency Sustainability Task Force and implement, track and report on PHS sustainability goals.
• Work with LUEG on the Environmental Justice Implementation Plan (part of the County of San Diego’s General Plan).
• Provide workshops and presentations on the Public Health Impacts of Climate Change to community organizations, residents, and stakeholders.

Climate Change Definitions

Public Health and Climate Change Partners

Figure 4. Partners in Public Health and Climate Change: Mitigation, Adaptation, and Resiliency in San Diego County.

Source: Public Health Services, Office of Health Equity and Climate Change, 2023.

Strategic Plans

The County of San Diego Strategic Plan provides a framework for the County to set measurable goals. The County has prioritized climate, resiliency, health equity, environmental justice, safety, and community engagement. PHS Climate Change and Health efforts support these strategic priorities, aim to break down silos, and connect different organizations within the County leading on these priority areas. 

The 2022-24 HHSA Strategic Plan was first published in 2022 and aligns to the County’s Strategic Plan. It was developed using the Agency Playbook, a five-step process in alignment with the County of San Diego Strategic Initiatives, the GMS, and HHSA Vision, Mission, and Values. One of the six Agency Strategic Initiatives is Sustainability: Promote a resilient economy, climate, environment and region for all. 

Climate Change Resources

Local and Regional Resources

• California Building Resilience Against Climate Effects (CALBRACE)
  CALBRACE, based on the Centers for Disease Control and Prevention (CDC) 5-Step BRACE model, aims to enhance a local jurisdiction's capability to plan for and reduce health risks associated with climate change. 
• Climate Action Campaign
  Climate Action Campaign is partnering with PHS, LUEG, and local medical associations to plan a convening of local health systems partners on climate change and health. 
• Climate Education Partners
  "2050 is Calling" was a report that was part of an effort by the Climate Education Partners to develop and implement a climate change education plan for the San Diego region. 
• Consumer Version Excessive Heat Response Plan (sandiegocounty.gov)
  Public Health Services (PHS) is responsible for coordinating the response to excessive heat emergencies via the Excessive Heat Response Plan (EHRP).
• County of San Diego Cool Zones Interactive Map
  This interactive map allows users to locate "Cool Zones" in their area that provide air-conditioned facilities to cool down in the excessive heat experiences during the summer. 
• County's Office of Emergency Services Family Disaster Planning Guide
  This guide provides a personal disaster plan to people who may need assistance in the event of a disaster. 
• County's Climate Action Plan: Chapter 4: Climate Change Vulnerability, Resilience, and Adaptation
  The County's Land Use Environment Group (LUEG) published this in 2018 (although the Climate Action Plan has since been rescinded). LUEG is working on an update to the Climate Action Plan. 
• County of San Diego Live Well Food Systems Initiative
  The Live Well San Diego Food System Initiative (Food System Initiative) is an interdepartmental County group developed to work towards a robust and resilient local food system that builds healthy communities, supports the economy, and enhances the environment. 
• County of San Diego Multi-jurisdictional Hazard Mitigation Plan 2017
  A county-wide plan that identifies risks and ways to minimize damage by natural and manmade disasters (a link to the most recent 2022-2023 plan will be included when available). 
• County of San Diego State of the Food System Report
  This report discusses the food supply chain in the San Diego region and discusses how the food system plays a role in impacting people's health and wellbeing, as well as its effect on environmental sustainability and San Diego's economy.
• County of San Diego Vulnerability Assessment and Adaptation Report
  A report published in 2021 according to the 2020 update to the California Governor's Office of Emergency Services Adaptation Planning Guide.
• Heat and Health Train the Trainer Curriculum
  County of San Diego's Health and Human Services Agency (HHSA) Department of Homeless Solutions and Equitable Communities, Office of Equitable Communities, Community Action Partnership is working with the National Oceanographic and Atmospheric Administration (NOAA), UCSD Scripps Institution of Oceanography (SIO), and the Desert Research Institute (DRI) on a program to teach community leaders and the community about the health impacts of excessive heat in the county. 
• LUEG's Environmental Justice (EJ) Implementation Plan
  The EJ Implementation Plan will implement items relevant to the Environmental Justice section of the County of San Diego's General Plan (for the EJ neighborhoods of the unincorporated area of the County), and PHS will be the lead or support for some of the items pertaining to climate change and health. 
• LUEG Office of Sustainability and Environmental Justice (OSEJ) (formerly Office of Environmental and Climate Justice)
  The OSEJ published a Roadmap that explains the Office's purpose to address equity and environmental and climate justice in communities disproportionately impacted by environmental burdens and related health problems. 
• Pala Band of Mission Indians and Climate Change Adaptation Plan
  The Plan provides information on how members of the Pala Band of Mission Indians can adapt to climate change and the Pala Band of Mission Indians Climate Change Vulnerability Assessment identifies the most significant climate change vulnerabilities for the Pala community with a focus on the health, social, natural and built environments on the Pala Reservation. 
• Partner Relay
  Partner Relay is an initiative to improve communication with Limited English Proficiency (LEP) communities during natural disasters and public health emergencies. 
• Regional Decarbonization Framework (RDF)
  The RDF is a science-based, collaborative effort to lower the region's carbon in partnership with the UC San Diego School of Global Policy and Strategy, the University of San Diego (USD) Energy Policy Initiatives Center, and Inclusive Economics. 
• San Diego County Air Pollution Control District (SDCAPCD)
  The SDCAPCD provides the current Air Quality Index (AQI) for different areas in the County. The SDCAPCD leads the efforts to implement the Community Air Protection Program in San Diego County, which aims to reduce pollution exposure in communities based on environmental, health, and socioeconomic information. 
• SD Emergency App (readysandiego.org) 
  This app is the must-have preparedness app that helps you plan, prepare, get informed, and recover from an emergency (i.e., a climate emergency such as a wildfire or flooding). The County of San Diego has a Know Your Hazards Tool which can help residents discover hazards in their area and AlertSanDiego which is a regional notification system that sends messages to residents and businesses in San Diego County if they are impacted or in danger of being impacted by an emergency or disaster. 
• San Diego Food System Alliance
  The Alliance uses food to fight climate change, build resilience, and cultivate justice in the San Diego Region. 
• San Diego Foundation
  The Foundation aims to build equitable climate resilience and help underserved communities and climate-vulnerable groups. 
• San Diego Regional Climate Collaborative (SDRCC)
  The Collaborative is a network for public agencies that serves the San Diego region to share expertise, leverage resources, and advance comprehensive solutions to facilitate climate change planning. 
• SDSU HealthLINK
  PHS and SDSU HealthLINK are working on three white papers that describe the public health impacts of climate change due to excessive heat, air quality and wildfire smoke, and vector-borne diseases. 
• Vector Control Program
  This countywide program monitors vectors and diseases that they carry, which are public health threats that will be amplified by climate change. 

State Resources

• Cal-Adapt
  Cal-Adapt provides a way to explore peer-reviewed data that portrays how climate change might affect California at the state and local levels. We make this data available through downloads, visualizations, and the Cal-Adapt API for your research, outreach, and adaptation planning needs. 
• California's Fourth Climate Change Assessment
  This report seeks to understand climate-related vulnerability at the local scale and to inform resilience actions, while also informing State policies, plans, programs, and guidance, to promote effective and integrated action to safeguard California from climate change. The report also includes a San Diego Regional Report. 
• California Healthy Places Index (HPI)
  The HPI provides regional-based data to advance health equity through open and easily accessible data. There is also the California Healthy Places Index: Extreme Heat Edition, which provides data on projected heat exposure for different regions in California. 
• California Heat Assessment Tool (CHAT)
  California is facing a warmer climate over the next century. More frequent and severe heat events will pose considerable health risks that disproportionally impact frontline populations. This tool allows users to explore and understand how extreme heat will impact specific communities across the state. 
• California Office of Environmental Health Hazard Assessment (OEHHA): 2022 Report: Indicators of Climate Change in California
  The Indicators of Climate Change in California Report documents observed changes in the state's climate and its impacts in the state. Indicators are scientific measurements that track trends and conditions relating to climate change. Collectively, the indicators portray a statewide picture of how climate change has been impacting the environment and people of California. Through these indicators, the report tells the state's climate change story, starting with the human influences on climate, or "drivers," followed by the changes in climate Californians have been experiencing, and their consequences on the physical environment, on plant and animal species, and on human health. 
• CDPH CalBRACE Adaptation Toolkit
  Public Health Adaptation Planning - A process to identify and assess the health risks from likely climate changes, and the vulnerability of people and places that are likely to be affected; to develop adaptation goals and actions to reduce vulnerability and increase resilience; and to establish a plan to implement and monitor the success of adaptation actions. 
• California Department of Public Health (CDPH), Climate Change and Health Equity Section (CCHE)
  The Climate Change and Health Equity Section (CCHE) embeds health and equity in California climate change planning and embeds climate change and equity in public health planning.
• CDPH Climate Change and Health Profile Report: San Diego County
  This report provides climate projections for San Diego County and identifies vulnerabilities and assets that support local adaptation planning. 
• California Natural Resources Agency - Protecting Californians from Extreme Heat: A State Action Plan to Build Community Resilience
  The plan outlines a strategic and comprehensive set of state actions to address extreme heat and serves as an update to the "Preparing California for Extreme Heat Guidance and Recommendations" report released in 2013. 
• Climate Change and Health Vulnerability Indicators for California (CCHVIz)
  CCHVIz is the interactive data visualization platform for the Climate Change and Health Vulnerability Indicators for California (CCHVIz).
• Climate Change Adaptation Strategy
  This Strategy links together the state's climate adaptation efforts and demonstrates how they fit together to accomplish the State's six climate resilience priorities.
  
• CalOES MyHazards
  CalOES provides the MyHazards tool for the general public to discover hazards in their area (fire, flood, earthquake, etc.)
• Integrated Climate Adaptation and Resiliency Program (ICARP)
  ICARP drives the State's response to climate change impacts and prioritizes equitable approaches that include both climate mitigation and adaptation strategies. 
• Legislative Analyst's Office: Climate Change Impacts Across California: Health 
  This report discusses the impacts climate change will have on the health of California's residents. 
• Wildfire Smoke Clean Air Centers for Vulnerable Populations Incentive Pilot Program (AB-836)
  This Assembly Bill establishes the Wildfire Smoke Clean Air Centers for Vulnerable Populations Incentive Pilot Program to provide funding to create a network of clean air centers to mitigate the adverse public health impacts of wildfires and other smoke events. 
• Wildfire Smoke: Considerations for California's Public Health Officials
  This report includes information about wildfire smoke and its health impacts, strategies to reduce smoke exposure, and other considerations to support community response. 

National and Federal Resources

• American Planning Health Association (APHA) Climate Change
  APHA provides resources on the public health impacts of climate change and states that climate change is a health emergency. The APHA released a 4-minute video explaining why climate change is a public health issue.
• Association of Schools and Programs of Public Health: Climate Change and Health: A Public Health Education Toolkit
  This toolkit is a resource for public health professionals who are tasked with addressing the health impacts of climate change. 
  
• Centers for Disease Control and Prevention (CDC) - Climate and Health Program
  CDC's Climate and Health Program supports state, tribal, local, and territorial public health agencies as they prepare for the health impacts of a changing climate. 
• CDC Climate Change and Extreme Heat: What You Can Do to Prepare
  This booklet answers some of the key questions about extreme heat and climate change, including why extreme heat is on the rise, how it might impact people, and what can be done before and after an extreme heat event to reduce health risks. 
• Climate Change, Health, and Equity: A Guide for Local Health Departments
  This guide provides information and resources for local health departments as they seek to manage the impacts of climate change on their communities. 
• National Institutes of Health (NIH) Climate Change and Health Initiative
  The NIH Climate Change and Health Initiative is an effort to reduce human health threats from climate change and seeks to build health resilience in individuals, communities, and nations around the world, especially among the most vulnerable.  
• National Integrated Heat Health Information System (NIHHIS) 
  NIHHIS serves as the national source of health and health information for the country to reduce the health, infrastructure, and economic impacts of extreme heat. 
• National Weather Service (NWS)
  The NWS provides data on weather, water, and climate, and provides forecasts, warnings, and impact-based decision support for the protection of life and property. 
• Office of Climate Change and Health Equity (OCCHE)
  The Office of Climate Change and Health Equity addresses the impact of climate change on the health of the American people. Exercising powers of convening, coordination, and collaboration, the Office serves as a department-wide hub for climate change and health policy, programming, and analysis, in pursuit of environmental justice and equitable health outcomes. 
• United States Environmental Protection Agency (EPA) Climate Change Impacts on Health
  The mission of the EPA is to protect human health and the environment, and the EPA acknowledges that climate change poses many threats to the health and well-being of all Americans.
• U.S. Call to Action on Climate, Health, and Equity: A Policy Action Agenda
  In 2019, 74 groups, including the American Medical Association and the American Heart Association described climate change as the "greatest public health challenge of the 21st century." 
• U.S. Global Change Research Program - The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment
  This scientific assessment examines how climate change is already affecting human health and the changes that may occur in the future.

Global Resources

• Intergovernmental Panel on Climate Change (IPCC): Sixth Assessment Report: Climate Change 2022: Impacts, Adaptation, and Vulnerability
  The Working Group II contribution to the IPCC Sixth Assessment Report looks at the impacts of climate change, by assessing ecosystems, biodiversity, and human communities at the global and regional levels while reviewing vulnerabilities and limits of the natural and human worlds to adapt to climate change. 
• Sustainable Development Goals 
  Seventeen Sustainable Development Goals (SDGs) were created as an urgent call for action by all countries - developed and developing - in a global partnership. It is recognized that ending poverty and other deprivations must go together with strategies that improve health and education, reduce inequity, and spur economic growth - all while tackling climate change and working to preserve our oceans and forests. For more information, view the 2030 Agenda for Sustainable Development.
• World Health Organization (WHO) - COP266 special report on climate change and heath: the health argument for climate action
  The 10 recommendations in the COP26 Special Report on Climate Change and Health propose a set of priority actions from the global health community governments and policy makers, calling on them to act with urgency on the current climate and health crises. 
• World Health Organization (WHO) - Department of Environment, Climate Change, and Health (ECH)
  ECH pursues a healthier environment by strengthening health sector leadership, building mechanisms for political and social support, and monitoring progress toward the Sustainable Development Goals regarding environmental threats to health. 
• World Health Organization (WHO) - Climate and Health Team
  The WHO Climate Change and Health Team focuses on advocacy and partnership, monitoring and evidence, supporting countries to protect human health from climate change, and building capacity on climate change and human health. 
• World Health Organization (WHO) - Monitoring science and evidence on climate change and health
  WHO coordinates reviews of the scientific evidence on the links between climate change and health and helps to share a global research agenda. 

PHS Climate Change and Health Timeline

• 2014, California Department of Public Health (CDPH) selected the County of San Diego (County) Health and Human Services Agency (HHSA) to be a pilot site for the two-year initiative CalBRACE Local Health Department Partnership Program. 
• 2015, PHS hired its first Health Equity Coordinator, published its first-ever Health Equity Plan (2015-2020), and created a Public Health Services Office of Health Equity (now named Office of Health Equity and Climate Change (OHECC)). In 2015, PHS established the Health Equity Working Group (HWEG). The Charter for the HWEG includes the public health impacts of climate change. 
• 2015 OHECC hired a student with CalBRACE funding, developed and issued a staff survey on climate change and health. Survey findings indicated need for training on climate change and health. PHS developed the first departmental training on climate change and health and made this training mandatory for all PHS staff (i.e., climate change 101). 
• 2015 PHS participated in a convening at UCSD related to climate change and health and PHS began collaboration with UCSD. (Scripps Institute of Oceanography). 
• 2015 OHECC participated in a convening of local health departments in Richmond California hosted by CDPH through BRACE funding. 
• 2015 PHS participated in the process to develop the County's Climate Action Plan. 
• 2015-2016 PHS presented at San Diego Foundation event on climate change (e.g., San Diego Climate Education Partners). 
• 2015 OHECC joined the Partner Relay efforts, a collaboration between PHS and the County's Office of Emergency Services to get messages to communities whose first language is not English in emergencies. 
• In 2016 PHS developed a 2-pager describing partners in the climate change and health effort locally (see Figure 4 above).   
• 2016-2017 PHS collaborated with CDPH on Vulnerability Assessment which led to the Profile Report and the CCHVIZ data portal. 
• 2016-2017 PHS joined the San Diego Regional Climate Collaborative. 
• 2016-2017 PHS collaborated with the UCSD-led Regional Report for San Diego, part of California's Fourth Climate Change Assessment. 
• 2017 CDPH published a profile for San Diego County on their website.
• In 2017, PHS developed a series of mandatory Public Health 101 trainings for PHS staff including a Climate Change 101. 
• 2017-2018 CDPH, PHS, and 427 collaborated on the development of an adaptation plan template for local health departments to use. CDPH provided technical assistance to PHS on drafting adaptation plan for the department. 
• 2017-2018 CDPH, PHS participated in the Climate Summit at UCSD. 
• 2018 CDPH technical experts presented to PHS public health leaders and provided a workshop to PHS epidemiologists on CCHVIZ data. 
• 2018 CDPH encourages PHS to work with local experts and climate and health scientists to build on the vulnerability assessment presentation to include data from local partners. 15 organizations collaborate on a Master slide deck to tell the local story with data and the workshop presentation was complete. 
• 2018-2022 PHS collaborated with local health departments across California in monthly meetings to share emergency practices and efforts funded through the CalBRACE program.  
• 2019 PHS presented a 2-hour workshop on the public health impacts of climate change in San Diego to the HHSA Program Threading Group including AIS, BHS, Regional Office of HHSA, Office of Border Health, and others. Presentation is based on the Master slide deck from 15 partner organizations. 
• 2019 PHS provided input to the updating of the County's Office of Emergency Services Family Disaster Planning Guide. 
• 2019 PHS provided input to the State's General Plans Guidelines used throughout the State by County and City Planning departments. 
• 2019 PHS presents at the  Live Well San Diego Advance, with a panel of local experts on public health impacts of climate change (i.e., County Parks and Recreation, Food Systems Alliance of San Diego, Scripps Institution of Oceanography). PHS promoted the County's updated Family Disaster Planning Guide and asks all branches to disseminate the guide with patients and partners where possible.
• 2019 PHS and UCSD co-present on public health and climate change at California's Transportation Planning Conference and the National Conference for the American Medical Association. 
• 2019 PHS presents to the County's Land Use and Environmental Group, Department of Environmental Health and Quality and others using the Master slide deck. Feedback from County staff indicates desire for partnership between LUEG and PHS on community presentations and convenings on the topic of climate change and health. Planning is underway to deliver convenings on key topics. University of San Diego, Scripps Institute of Oceanography, CDPH, National Weather Service, Vector Control, Air Pollution Control District, and others are onboard for future collaboration and convening. 
• 2019 PHS (Dr. Wooten) presents the County's approach to climate change and health at the California Conference of Local Health Officers (CCLHO) and Health Officer's Association of California (HOAC) annual meeting. 
• 2019 PHS OHECC is invited to participate in the County's Hazard Mitigation Planning Process for the first time, led by the County Office of Emergency Planning along with staff from PHS Preparedness and Response (PHPR) Branch who represent for PHS. 
• 2020 PHS presents to Stay Cool for Grandkids and the local chapter of the Girl Scouts of America. 
• 2020 PHS (Dr. Wooten) joins the Technical Advisory Committee of Integrated Climate Adaptation and Resiliency Program (ICARP). 
• 2020 PHS collaborates with Community Health Improvement Partners (CHIP), USCD, Pala Band of Mission Indians, and HHSA Community Action Partnership on a 3-hour workshop for Resident Leaders through the Resident Leadership Academy. 
• In 2020 PHS provides input to the white paper on need for coordinated planning in San Diego region on climate. This effort was led by UCSD and consultant from the American Planning Committee. 
• 2021 PHS updates the Excessive HealtH Plan and creates a consumer version of the plan. 
• 2021 PHS presents to the El Cajon Collaborative with UCSD and others. 
• 2021 PHS collaborates with the local chapter of the NAACP and USCD school of public health on a workshop. 
• 2021 PHS adds "Climate Change" to the name of the Office of Health Equity to create the new "Office of Health Equity and Climate Change."
• 2021 PHS presents with Los Angeles Department of Public Health, San Francisco Department of Public Health, and the State of Oregon at the national conference of the American Public Health Association on public health impacts of climate change. 
• 2021-22 PHS collaborates with the Desert Research Institute on a series of focus groups on Excessive Heat. 
• 2021-22 participates in the State's consultation on its Extreme Heat Action Plan and Vulnerability Assessment. 
• 2022 PHS provides a letter of support for the SDSU Research Center for funding under the HealthLINK grant and signed an MOA with the SDSU Research Center to collaborate on building the research infrastructure locally for minority populations. Work under the MOA included coordinating input and developing on a series of health equity and climate fliers and white papers on the public health impacts of climate change in partnership with USCD and others. 
• 2020-2023 PHS continues collaboration with the Land Use and Environment Group , Planning and Development Services on the next County Climate Action Plan. 
• 2022 The County, HHSA, and PHS establishes sustainability goals. 
• 2022 PHS presents at the Health Officer's Association of California (HOAC) on its efforts on climate change and health. 
• 2022 PHS co-presents to the Partner Relay Network with Planning and Development Services (LUEG). 
• 2022 PHS presents to the local chapter of the League of Women Voters. 
• 2022 PHS participates in the first-ever National Integrated Heat Health Conference. 
• 2022 PHS meets with SDSU Big Ideas CCAN group. 
• 2022 PHS meets with California Office of Environmental Health Hazard Assessment to discuss data on climate and health and update the Master slide deck with the local narrative for San Diego County. 
• 2023 the County Publishes the Hazard Mitigation Plan with input from PHS. 
• 2023 PHS collaborates with the LUEG Executive Office on five (5) community convenings in the 5 supervisorial districts on the Regional Decarbonization Framework and the Public Health Impacts of Climate Change. UCSD and SDSU researchers co-presented with PHS and LUEG experts. 
• 2023 PHS provides input on the Board Letter for the Regional Decarbonization Framework. 
• 2023 PHS partners, with LUEG, Climate Action Campaign, and local media associations to plan convening of local health systems partners on climate and health. 
• 2023 PH updated Climate Change 101 to be in alignment with the new Core Competencies for Public Health Professionals. PHS delivers training to new staff and made the training available to all staff through the County of San Diego Learning Management System. 
• 2023 PHS promotes and participates in the second National Integrated Heat Health Conference.