Two weeks ago, President Joe Biden quietly announced his initial budget request for 2022. The discretionary funding request, which is just a blueprint for the budget Biden hopes Congress will pass later this year, has been overshadowed by the president’s bigger and flashier $2 trillion green infrastructure plan. But the 58-page budget packs its own climate punch. If Biden gets his way, federal and state public health departments will get a big boost in funding to better address the public health impacts of climate change in fiscal year 2022.

Deep in Biden’s budget blueprint, a section on funding for the Department of Health and Human Services, or HHS — the agency that houses the Centers for Disease Control and Prevention, or CDC, and the National Institutes of Health, or NIH — has serious implications for the intersection of climate change and public health in years to come. Biden wants Congress to direct $110 million to the CDC’s Climate and Health program and another $110 million for climate and health research at the NIH, the federal government’s health research arm. What’s more, the budget requests funding for a new Office of Climate Change and Health Equity in HHS, which would “focus on decreasing effects of climate change on vulnerable populations.” 

This isn’t the first time a president has tried to bolster funding for research into the effects of climate change on health. George H.W. Bush started the National Climate Assessment, a huge study that comes out every four years on the domestic effects of climate change, including its impact on health. President Obama held the first-ever summit on climate change and health in 2015. Biden’s budget builds on the work his predecessors did and also charts new territory. 

Public health officials and researchers have long warned of health impacts of climate change — heat waves, extreme weather like hurricanes and wildfires, infectious diseases, and more. The 4th National Climate Assessment, published in 2018, concluded that climate change is already causing suffering and even death across the U.S. Every year, heatwaves claim lives, particularly in warm states like Arizona, Florida, and Texas. Diseases spread by mosquitoes and ticks make people sick with Zika, Lyme disease, and Rocky Mountain spotted fever. Drought exacerbates water and food insecurity. These impacts aren’t distributed equally among Americans — low-income communities of color are the most vulnerable. This suffering is largely preventable, experts say, if the country invests in prevention measures. 

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Dedicated climate funding at HHS is a “a good first step,” Kristie L. Ebi, a professor of environmental and global health at the University of Washington, told Grist. “It is not sufficient.” More needs to be done to ensure that the U.S., which Ebi says is a decade behind Europe in climate and public health preparedness, addresses the health effects of global warming. Nevertheless, she says that Biden’s spending request, if approved by Congress, would make “quite a difference” in the short term. 

The public health outfit best equipped to hit the ground running with new funding is the CDC’s Climate and Health program, which was established in 2009 and weathered the Trump administration’s effort to eliminate its funding entirely in 2020. It administers an initiative called Climate-Ready States and Cities. With the program’s funding and technical assistance, state and local health departments implement a framework called the Building Resilience Against Climate Effects, or BRACE, a five-step program that requires departments to come up with a climate and health adaptation plan. The framework helps states identify threats that might affect public health locally, rank them according to their severity so health officials in those states can address the direst risks first, and work across multiple state government departments to coordinate a response. Arizona’s climate and health adaptation plan, developed using the BRACE framework, includes specific policy recommendations, such ascreating a medical surveillance program to track how environmental factors like heat affect maternal and child health outcomes and developing hazard response plans for extreme heat and poor air quality in schools.

But with its current level of funding, the CDC has only been able to help 18 city and state health departments protect their citizens from climate-related hazards. That’s a big problem — all 50 states face climate-related health impacts, but only a handful even have a plan to address those impacts. “During the last four years, the program was somewhat constrained,” Patrick Kinney, a professor of environmental health at Boston University’s School of Public Health, told Grist. “Rebudgeting it is a quick way to get things jumpstarted.” 

Biden’s budget would allow the CDC to administer its BRACE initiative to all 50 states, which could significantly improve regional responses to climate change. “Understanding vulnerabilities within their own states or jurisdictions is a really key first step to then applying adaptation measures to combat or lessen the health threats of climate change,” Surili Sutaria Patel, former director of the Center for Public Health Policy at the American Public Health Association, a professional organization for public health workers, told Grist. “Expanding funding to all 50 states is phenomenal.” 

The benefits of the program, Ebi said, go beyond just the funding that the CDC provides. The CDC’s climate and health program holds meetings where BRACE participants can share and get feedback on what worked and didn’t work in their respective states. That “provides an enormous opportunity to learn from what other people are doing,” Ebi said. States that aren’t a part of the program don’t have access to that knowledge base. 

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“Being affiliated with the CDC brings credibility, technical assistance, training, and ongoing learning communities that advance our understanding and knowledge, as well as introducing us to the many different methodologies for addressing climate change and health from our colleagues in tribes, states, and cities,” the California Department of Health, a member of the BRACE program, told Grist via email.

Biden’s budget proposal would foster a similar expansion of climate and health knowledge at the National Institutes of Health, something experts say is sorely needed. “The NIH has not really gotten their hands dirty with climate and health yet,” Kinney said, noting that the research that has been done by the NIH on climate change and public health has been relatively limited, and little funding has been set aside for that kind of research at the department. Ebi expressed a similar sentiment. “There is low awareness across NIH about climate change and health and very limited technical understanding,” she said. Dedicated funding for climate and health research at the NIH could help bring the American medical establishment up to speed on the many health risks posed by rising temperatures. 

“For the nation to really build the knowledge base and also the cadre of professionals who know how to deal with interactions between climate change and health, we really have to be investing in that,” Kinney said. “$100 million is a good start. The need is much greater than that, but it’s a good start.”