Harvard team launches climate resilience toolkit for front-line health care clinics

A team of Harvard University public health experts has launched an initiative to help front-line medical clinics protect their patients from climate risks.

The project, called the Climate Resilience for Frontline Clinics Toolkit, provides clinical guidance and information on how to develop action plans and alert systems, as well as checklists for staff and tips for patients.

Also included in the toolkit are tailored instructions that aim to protect patients who are pregnant or who have specific conditions from the impacts of extreme heat.

Among those conditions are asthma, cardiovascular disease, chronic obstructive pulmonary disease, kidney disease, diabetes, dementia, multiple sclerosis and mental health issues. 

“What we hear time and again is that frontline clinics are the glue that hold their communities together when disasters strike,” Aaron Bernstein, interim director of the Center for Climate, Health and the Global Environment at the Harvard T.H. Chan School of Public Health (Harvard Chan C-CHANGE), said in a statement.

“But with limited resources, and an ongoing pandemic, many don’t have the funding, training, or tools they need after a climate shock,” Bernstein added.

Bernstein and his colleagues at Harvard Chan C-CHANGE therefore collaborated with the nonprofit Americares — and with funding from the company Biogen — to help clinics in these communities overcome such shocks.

Harvard Chan C-CHANGE and Americares worked to develop the toolkit with front-line health clinics in California, Massachusetts, North Carolina and Texas with the goal of maintaining patient health “before, during and after climate shocks,” a joint statement from the partners said.

Front-line clinics care for millions of the country’s uninsured or underinsured patients, according to the groups.

Yet these same clinics are often overwhelmed by intense heat waves and storms, which destroy infrastructure, interfere with supply chains and cause power cuts, the researchers stressed.

“We know that low-income, uninsured and underinsured populations need more support after emergencies,” Kristin Stevens, senior director of climate and disaster resilience at Americares, said in a statement. 

“This need is accelerating as we experience more intense storms, wildfires and extreme weather,” Stevens added.

Work on the climate resilience toolkit began in 2021 with a survey of more than 450 clinic staff across 47 U.S. states and territories that revealed significant knowledge gaps in patient care during and after climate shocks. 

The researchers found that 81 percent of clinic staff said their workplace endured disruptions due to extreme weather within the past three years.

However, they also discovered that only 20 percent of staff felt that their clinic was “very resilient” in the face of extreme weather.

About 77 percent of clinic staff said they lacked the tools to implement climate change preparedness, while more than 80 percent wanted training to protect their patients during such events, according to the survey.

Over the next five years, Harvard Chan C-CHANGE and Americares researchers said they plan to expand their project globally by adapting the toolkit for use in at least three low- and middle-income countries.

“We find ourselves in unprecedented times in which wildfires may spark and spread overnight,” Jessie Liu, a family medicine physician at La Clínica de La Raza in Oakland, Calif., said in a statement.

“These resources will be useful as a guide for our patients, providers, and clinics to prepare for the increasing wildfire risk for the communities we serve in order to mitigate health impacts,” Liu added.