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CDC's Building Resilience Against Climate Effects (BRACE) Framework

Climate change affects us by:

  • Increasing deaths and illnesses from heat stress as temperatures rise.
  • Increasing risk of injuries and illnesses due to extreme weather events, such as storms and floods.
  • Increasing respiratory and cardiovascular illness and deaths caused by smoke from heat-related and drought-related wildfires, as well as changes in air pollution, particularly ozone smog.
  • Increasing cases of allergic disease brought about by elevated levels of pollens caused by more vigorous weed growth and longer pollen seasons.
  • Changing the rates and ranges of infectious diseases carried by insects or in food and water.
  • Threatening the safety and availability of food and water supplies.
  • Inducing greater levels of mental and emotional stress in response to climate change and extreme weather-related emergencies.

The most vulnerable among us—children, elderly people, those living in poverty, people with underlying health conditions, people living in certain geographic areas—are at increased health risk from climate change.

Building Resilience Against Climate Effects (BRACE) – a framework for public health agencies

Using the BRACE framework a jurisdiction can develop strategies and programs to confront the health implications of climate change. In approaching the health implications of climate change it is of paramount importance to find ways to understand and incorporate complex atmospheric data and both short and long range climate projections into public health planning and response activities. Coupling atmospheric data and projections with epidemiologic analysis enables a jurisdiction to more effectively anticipate, prepare for and respond to a range of climate sensitive health impacts. A health department’s approach to planning for, rehearsing and responding to climate and weather related health impacts can be greatly enhanced by incorporating emerging integrated models that incorporate atmospheric science.

CDC has developed a framework that supports health departments to incorporate advanced models such as these into otherwise routine planning and response activities. The Building Resilience Against Climate Effects (BRACE) framework is a five step process that enables a health department to incorporate the best available atmospheric science into a process designed to improve the quality of inputs and assumptions made during the traditional planning process, and supports the development and implementation of a unified climate and health adaptation strategy for a jurisdiction.

CDC provides funding for state, territorial, and tribal health departments to conduct analytic and programmatic activities aimed at reducing the health consequences of climate change and variability by developing public health adaptation strategies using the BRACE framework.

There are five sequential steps in the BRACE Framework:

Step 1: Forecasting Climate Impacts and Assessing Vulnerabilities where a health department identifies the scope of the most likely climate impacts, the potential health outcomes associated with those climatic changes, & the populations and locations vulnerable to these health impacts within a jurisdiction.

Step 2: Projecting the Disease Burden where a health department, as best as possible estimates or quantifies the additional burden of health outcomes due to Climate Change – to support prioritization and decision making.

Step 3: Assessing Public Health Interventions where a health department seeks to identify the most suitable health interventions for the health impacts of greatest concern. The health impacts will have been quantified or better defined in the previous health risk assessment step.

Step 4: Developing and Implementing a Climate and Health Adaptation Plan where a health department develops and implements a health adaptation plan for climate change that addresses health impacts, gaps in critical public health functions/services, and a plan for enhancing adaptive capacity in the jurisdiction.

Step 5: Evaluating Impact and Improving Quality of Activities step for the Framework – whereby a health department can evaluate the processes it has used, determine the value of utilizing the framework and the value of climate and health activities undertaken. This step is also important for quality improvement and to incorporate refined inputs such as updated data or new information.

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