A Newsletter for FL BRACE Partners, Collaborators & Stakeholders                                                    October 2017

Tracy Ippolito,
FL BRACE Project Mgr.
After almost 12 years without a land-falling hurricane in Florida, the 2017 hurricane season has already given us Hurricane Irma, along with Tropical Storms Cindy and Emily. It has also included the tenth-most intense Atlantic hurricane on record, Hurricane Maria, which did not make landfall in Florida but caused catastrophic damage and fatalities in the Caribbean, including the Virgin Islands and Puerto Rico. The immediate and ongoing impacts of these and other recent extreme weather events serves to reinforce just how important it is that communities in Florida continue working to enhance their resilience to the effects of climate
As we move into the fall months, FL BRACE is preparing a Request for Proposals (RFP) for another round of mini-grants. Florida county health departments and community partners will be eligible to apply for the grants, which will offer $5,000 in support of climate resilience initiatives. Previous grants awarded by FL BRACE were used to support adaptation efforts and implementation activities in five Florida counties: activities ranging from alleviating the urban heat island effect... to working with at-risk populations... to updating comprehensive emergency management plans. The 2018 RFP will focus on supporting evaluation of interventions and adaptation projects, either activities already underway or future initiatives that will address a public health issue related to climate and extreme weather events .

Thank you for your interest in and willingness to help inform our program's efforts. Please feel free to contact me with any comments or questions about FL BRACE activities.

Best regards,  
Collaboration evaluating effectiveness of new heat index thresholds 

FL BRACE is collaborating with the National Weather Service (NWS) and the Florida Department of Health to improve communication about Florida extreme-heat events that have an impact on human health. Earlier work involved changing the heat index thresholds for the issuance of NWS excessive heat advisories and warnings. 

Florida has several NWS Weather Forecast Offices (WFOs), each associated with an area of responsibility. Historically, each WFO had different thresholds for the issuance of these advisories and warnings, and there was concern that they were not providing adequately actionable information to residents so that they could take precautions against exposure to extreme heat. Following a study of heat morbidity and mortality data, meteorologists at the Florida WFOs agreed to adopt Heat Index thresholds of 108 ° and 112 ° Fahrenheit for the issuance of excessive heat advisories and warnings, respectively, for all of Florida.

Current and future work will involve evaluating the efficacy of these changes and developing an integrated monitoring strategy to document the efforts of this collaboration. For more information about this initiative, contact Danny Brouillette, Climate Services Specialist in the Office of the State Climatologist.

Source: National Weather Service, http://www.nws.noaa.gov/om/heat/heat_index.shtml

BRACE The Center for Disease Control (CDC) BRACE framework is a five-step process that can be used by health officials to develop strategies and programs to help communities prepare for the health effects of changing weather patterns. The first step in this process is to identify the scope of climate impacts, associated potential health outcomes, and populations and locations vulnerable to these health impacts. This is followed by an estimation of the additional burden of health outcomes associated with changing weather patterns (Step 2). In Steps 3 and 4, the framework calls for identification of the most suitable health interventions for the identified health impacts of greatest concern and development of a written adaptation plan. Development of an Implementation and Monitoring Strategy (IMS) builds off of interventions and adaptations selected through previous steps of BRACE, detailing a plan of action to put each of them into practice. The IMS describes how each adaptation and intervention will be implemented, communicated, and evaluated; and this then allows a health officials to complete Step 5, which is evaluation of the process to determine the value of information obtained and activities undertaken.

IMS Components
Key components of the IMS
The Florida Department of Health (DOH) in Sarasota County, in collaboration with FL BRACE, recently developed their first IMS. It focused on disaster readiness interventions geared toward increasing their county's preparedness and resilience to the impact of extreme storms and floods as well as protecting the public health of residents. As part of their IMS, Sarasota County public health officials created a health impact assessment survey to assess the barriers and challenges that access and functional needs residents may experience when faced with an emergency. The County Health Department also began conducting a series of All-Hazards Survival and Active Bystander Trainings to help improve disaster preparedness and increase capacity for recovery. Implementation of these strategies is intended to increase disaster resilience to extreme weather events while also mitigating potential negative public health impacts.

As explained in Building Resilience against Climate Effects-A Novel Framework to Facilitate Climate Readiness in Public Health Agencies, "At any point in the implementation of BRACE, process evaluation measures can help to validate methods employed and to reveal flaws in the plan. In addition to assessing the execution of key methods, process metrics can help to determine if the most appropriate stakeholders have been engaged and if the stakeholders' engagement added critical input. Evaluation can also identify the outcomes that resulted from the combined series of activities."

FL BRACE partnered with Sarasota County in development of their evaluation methods and activities to help ensure their IMS can be used not only by their own health department, but by other public health officials considering similar adaptations and interventions. Creating collaborative partnerships such as this one is an effective strategy to achieve common goals, increase program capacity, and leverage resources. For more information about the IMS, contact Ava Holt.
CDC website provides information and links to supporting literature 

"Climate change, together with other natural and human-made health stressors, influences human health and disease in numerous ways. Some existing health threats will intensify and new health threats will emerge. Not everyone is equally at risk. Important considerations include age, economic resources, and location.The health effects of climate disruptions include increased respiratory and cardiovascular disease, injuries and premature deaths related to extreme weather events, changes in the prevalence and geographical distribution of food- and water-borne illnesses and other infectious diseases, and threats to mental health." Read more.

Source: https://www.cdc.gov/climateandhealth/effects/

Individuals and organizations in the community serving vulnerable populations

FL BRACE is working to create and strengthen relationships with agencies or organizations who serve vulnerable populations -- including, but not limited to, lower income households, social service organizations, churches, the homeless, older adults (age ≥ 65), and people with preexisting conditions. So if you or someone you know represents an agency or organization whose work with vulnerable populations would benefit from timely heath and climate information, please encourage them to join our Community Advisory Group (CAG).by contacting Ava Holt, FL BRACE.