Extreme weather across the U.S. is leading many states to reassess their climate response strategies. One of those is Washington state, where a record-breaking heat wave in June 2021 led to more than 130 deaths. State leaders have responded to climate change-driven threats to health by developing new policies, strengthening the workforce and raising awareness.

Marnie Boardman, MPH, climate change coordinator at the Washington State Department of Health, talks to The Nation’s Health about how collaborating with local agencies and improving health equity is important in the state’s work to address climate change.

Like other parts of the U.S., Washington is experiencing more extreme weather events. What are the main threats?
In addition to the extreme heat events last summer, the last few years have brought more heavy rain events, flooding, drought, statewide wildfire smoke events, and harmful algal blooms in both fresh and marine waters. We're seeing climate change impacts to health right before our eyes.

It's brought many more people into the fold saying we need to plan for coordinated prevention and response. These stress tests to the public health system are powerfully mobilizing for climate preparedness.

The Washington State Integrated Climate Response Strategy was published in 2012. How has climate and health work changed since then?
A few things have changed dramatically in that time, including our capacity. We had no full-time climate change staff in 2012. By 2016, we had one. The Climate and Health Section formed in 2019. Now we have 10 staff, and other programs consider climate in their work, too. 

Haze from wildfire smoke in Washington state

More broadly, legislation is driving progress and profound change. Since 2019, the state lawmakers enacted several climate policies, including the Clean Energy Transformation Act and Climate Commitment Act. 

The 2021 Healthy Environment for All Act is watershed policy that embeds equity and environmental justice into state decisions and investments. HEAL will infuse all of our climate change work going forward and make sure that everything we do centers the priorities and issues of populations disproportionately impacted by pollution and climate change hazards.

Wildfire smoke is also a growing threat to health in the state. How have Washington health leaders responded?
In 2017 and 2018, after a few wildfire smoke events that blanketed the Northwest, several health partners called for coordinated action. So in response, DOH formed the Wildfire Smoke Impacts Advisory Group with 33 members from around the state to achieve more consistent health messaging across agencies. 

The group has contributed to risk communication products, informed evidence-based guidance for canceling outdoor events and closing schools during smoke events, and evaluated use of low-cost air sensors to inform health actions.

DOH’s climate and health air quality staff are also working with partners in Kittitas County to evaluate use of portable air cleaners to create cleaner air rooms during smoke events. This climate adaptation strategy could be particularly important for households that are either lower income or don't have access to filtration throughout their home.

How is your climate change work addressing health of underrepresented groups?
We are working to make sure that our efforts center on health equity and  communities that bear the first and worst brunt of climate change. The HEAL Act is driving systems change, requiring cross-sector focus on communities facing environmental health inequities and cumulative health impacts. 

On our team, the DOH climate justice coordinator is engaging communities to learn about and help address their climate priorities, and working with government partners to focus climate adaptation efforts on protecting and supporting the health of disproportionately impacted populations.

When looking long-term, what strategies are most useful? How does health in all policies fit in?
One of the most powerful investments we can make to prevent health harms from climate change hazards is to work with the planning sector. Comprehensive plans looking 20-plus years ahead will shape our future communities. This is such an important place to be highlighting climate adaptive, health protective and health promoting measures and equitable investments.

Another important strategy is to build relationships with and following the lead from tribal nations’ climate solutions, as well as those from organizations working to dismantle systemic racism, accelerate energy transitions and envision climate justice. 

Public health practitioners know that relationships influence health. Building relationships to collectively address our biggest problems is the key to a livable future.

For resources on the relationship between climate change, equity and health, visit the APHA website.

Photo caption: Wildfire smoke is visible over the Columbia River separating Washington and Oregon in August. Image by Simon Foot, via Flickr Creative Commons.