Climate change and public health: barriers and levers for implementation of climate adaptation in Europe

BACKGROUND: Climate adaptation policies (to reduce health impacts from climate change) are being implemented across Europe driven by political action, public support, and more extreme weather. All EU countries have national climate adaptation policies but the the role of addressing public health in implementation varies by country and is often undervalued. AIM: Identify key issues in climate adaptation implementation by public health professionals in Europe. METHODS: Key informant interviews were undertaken with decision makers in international, national, and local government across 20 European countries. Participants were recruited if working in public or environmental health, and in climate adaptation policy. Interviews addressed these key themes: barriers, health agenda, levers, networks, evidence needs. Interviews were conducted online, recorded, transcribed, and analysed thematically. RESULTS: 32 interviews were completed between June-October 2021; 4 international, 5 national level and 23 city-level stakeholders. Most reported inadequate resources for health adaptation implementation (funding, training, and personnel) and the marginal role of health in climate adaptation policy development. A clear mandate to act was key for adaptation implementation and resource allocation. A reported challenge was departmental cross-collaboration, and city-level stakeholders’ awareness of the public health role in climate policy. European-level stakeholders reported strength in ability to coordinate expertise to national and regional-level governance partners highlighting the importance of interagency collaboration. CONCLUSIONS: Across Europe, there is varied progress in implementation of climate-health adaptation. Providing appropriate resources, inter-departmental collaboration, training, knowledge mobilisation, and multi-level governance support will facilitate climate and health policy implementation.