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To assist with these policy uncertainties, organizations can embed themselves in multilevel governance frameworks that inform, structure, and facilitate strategic development, planning, and action. As part of these networks, organizational representatives also engage in formal and informal forums, a type of interorganizational relationship, which can include industry task forces, policy development committees, interagency groups, and specific climate change committees.

Forums constitute an additional level of governance that influences decision making. The patterns of relationships within these multilevel governance frameworks are examined in this paper, with a focus on the forum level of organizational cooperation. Specifically, we investigate the type of forums operating and their role in supporting organizational responses to climate change. The results indicate that organizations participate in a diverse range of forums.

Further, forums appear to play a key role in the everyday business of organizations by enhancing their ability to plan and address a range of issues, including those associated with climate change. In addition the research highlights some of the barriers and drivers for the development and implementation of climate adaptation practices that emerge from forum discussions.

For example, a lack of government guidance in interpreting climate change policy was described as a barrier yet access to the knowledge and expertise of participants was highlighted as a potential driver. The paper discusses how an ability to create new forums and utilize existing nonclimate related forums assists organizations in addressing climate change impacts. We contend that forums constitute a level of governance deeply embedded in organizational practice that influences both their capacity and motivation to undertake climate adaptation.

Our findings suggest that research investigating the rules that govern forums and the structural properties of the networks in which they are embedded is required to further understand the role of multilevel governance in shaping organizational responses to climate change. Key words: climate adaptation; climate change; decision making; forums; multilevel governance; networks; organization. If accepted for publication, your response will be hyperlinked to the article.

Belgium has taken another approach to national adaptation planning in a federal, decentralized context, where the National Climate Commission comprised of representatives from all government levels will use the federal and regional government adaptation plans as a basis for a future national adaptation plan, thereby using national adaptation planning as a tool to engage sub-national governments [ 52 , 91 , ].

Countries are developing their own policy style, learning from key lessons ascertained in other countries as well as mimicking successful approaches. Whilst constitutionally defined governing structures are important features in the ways public health adaptation are governed, they do not determine the ways in which public health adaptation takes place, therefore showing a great variety of policy initiatives, both substantive as well as procedural. This is not necessarily a bad thing—countries are clearly experimenting with different ways how to best govern public health adaptation across sectors and levels, as the diversity and rapid increase of policy initiatives suggests.

Tracking this progress then becomes of utmost importance to assess and evaluate whether progress is going in the right direction. Using publicly available government documents, this study has examined the reporting of health adaptation as a basis for examining the current state of adaptation in a health context, using an approach consistent with other studies tracking adaptation [ 24 , 28 , 30 , 41 , 57 , 63 , 64 , 67 , 68 ]. This method poses some challenges to comprehensiveness of the dataset as policies or programs that reduce vulnerability or increase resilience to climate change may be underreported or not labeled as adaptation, and not captured by the search methods.

However, initiatives that are not intended as adaptation will not include projected or perceived climate change impacts as the starting point for decision-making and these initiatives risk being maladaptive [ ]. This method also relies exclusively on primary sources, thus we cannot draw conclusions on why national governments decide to frame or design their policies in the reported manner, or what their intentions are in regards to climate change adaptation planning other than explicit objectives.

Moreover, some of the national adaptation plans reviewed do not include explicit plans for how adaptation initiatives will be implemented, demonstrating that we can only review the reporting of health adaptation, not the implementation, output or outcome.

Developing adaptation policy and practice in Europe: multi-level governance of climate change.

Though reporting of adaptation is an imperfect proxy and subject to bias, there are currently few alternatives that provide the level of detail needed to track health adaptation activities across multiple countries [ 18 ]. Though the importance of considering multiple scales has been highlighted in climate change adaptation literature [ 36 , ], in this study we have examined exclusively national-level public health adaptation.

Sub-national governments are important players in adaptation, particularly where some may have the jurisdictional mandate for public health and adaptation; however, their large number makes them outside the scope of this study. We do not make claims to have tracked public health adaptation in the sampled countries beyond the national government, but have examined the ways in which governments create an enabling environment. Focusing exclusively on national governments, however, allows us to compare and contrast national-level approaches to public health adaptation, consider variations with governing structure, and identify possible adaptation options for national governments.

Climate change and the associated public health risks are a formidable challenge for health officials, and national governments have been identified as key players in public health adaptation, yet little research has empirically tracked national-level public health adaptation to climate change across multiple countries [ 24 , 30 ]. Following the adoption of the Paris Agreement and greater momentum in the health community for action on climate change [ 11 , 12 , 17 ], national governments are beginning or continuing to evaluate potential public health adaptation options.

These findings demonstrate that while some countries have yet to report prioritizing, planning or implementing public health adaptation, others can serve as models and provide a learning opportunity for governments to incorporate the key dimensions for national-level governance of public health adaptation. Tracking public health adaptation to climate change is crucial to improve understanding of how adaptation is occurring in practice and across states, and to ensure policy orientated learning. The authors would also like to thank Malcolm Araos for helpful discussions and Julie Jones for her assistance in developing the search methodology.

No financial disclosures were reported by the authors of this paper. The following are available online at www. Stephanie E. Ford conceived the paper and Stephanie E. Austin conducted the data collection and analysis. Stephen Parker and Manon D. Fleury contributed to the early project development. All authors contributed substantially to the discussion and manuscript. This project was originally developed on a contract with the Public Health Agency of Canada.

National Center for Biotechnology Information , U. Published online Sep 7. Ford , 1, 2 Stephen Parker , 4 and Manon D. Fleury 4. James D. Find articles by Stephen Parker. Manon D. Find articles by Manon D. Jan C. Semenza, Academic Editor. Author information Article notes Copyright and License information Disclaimer. Received May 22; Accepted Aug This article has been cited by other articles in PMC. Associated Data Supplementary Materials ijerphs Abstract Climate change is a major challenge facing public health.

Keywords: climate change, adaptation, public health, OECD countries, adaptation tracking. Introduction The health impacts of climate change are expected to be significant, and future climate change is projected to further affect the magnitude and frequency of health risks, including morbidity and mortality due to extreme weather, increased respiratory illness, and changing prevalence, incidence, and distribution of infectious diseases [ 1 ].

Materials and Methods We systematically review public health adaptation to climate change by national governments in ten OECD countries using publicly available information in government documents and websites. Data Collection To consistently and systematically locate health adaptation initiatives in national policy documents, national adaptation plans, and government websites, in March we conducted systematic web searches and assessment of self-reporting, combining two approaches used in other adaptation tracking studies [ 24 , 28 , 57 , 62 , 63 ].

Table 1 Adaptation Typology. Adaptation Category Description Examples of Initiatives in Category Capacity Building Developing human resources, institutions, and communities, equipping them with the capability to adapt to climate change. Educate health professionals about the health impacts of climate change FR, BE Heat risk adaptation guidelines for public health and emergency management officials CA Raise awareness of climate change impacts and social vulnerability IR Management, Planning and Policy Incorporating understanding of climate science, impacts, and vulnerability and risk into government and institutional planning, management, policies and regulations.

Creation or strengthening of centers and networks of expertise at national and international levels SW Establishment of an internal multidisciplinary work group to investigate the occupational safety and health implications of climate change US Heat wave plan UK Practice and Behaviour Revisions or expansion of practices and on the ground behaviour that are directly related to building resilience. Eradication of Aedes japonicus mosquito BE Analyze and adapt the techniques used in building health and social facilities FR Stockpile critical medical supplies and pharmaceuticals US Information Systems for communicating climate information to help build resilience towards climate impacts other than communication for early warning systems.

Open in a separate window. Tracking Reporting of Adaptation Identifying data for comparison of adaptation across countries remains a significant challenge for tracking adaptation across nations [ 18 , 19 ]. Results In total, discrete health adaptation initiatives were identified and reviewed in 53 government documents or webpages see Table S3 of Supplementary Materials. Table 2 Country Information. National Adaptation Planning Typically Does Not Target Specific Health Risks National governments most frequently report planning broad health adaptation initiatives, and otherwise emphasize infectious disease and heat-related risks.

Figure 1. Percentage of health risks addressed by identified health adaptation initiatives. Figure 2. Figure 3. The Role of Inter-Sectoral Adaptation Planning Varies across Countries Based on publicly available information, most adaptation initiatives were planned, initiated or implemented by national health or public health agencies, often in partnership with other bodies including other health agencies. Discussion We examined the state of health adaptation in 10 OECD countries, based on systematic web searches and self-reporting of adaptation. Limitations Using publicly available government documents, this study has examined the reporting of health adaptation as a basis for examining the current state of adaptation in a health context, using an approach consistent with other studies tracking adaptation [ 24 , 28 , 30 , 41 , 57 , 63 , 64 , 67 , 68 ].

Conclusions Climate change and the associated public health risks are a formidable challenge for health officials, and national governments have been identified as key players in public health adaptation, yet little research has empirically tracked national-level public health adaptation to climate change across multiple countries [ 24 , 30 ]. Supplementary Materials The following are available online at www.

Developing Adaptation Policy and Practice in Europe: Multi-level Governance of Climate Change

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Developing Adaptation Policy and Practice in Europe: Multi-level Governance of Climate Change

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