Pioneering Health-Informed Heat Action: North Carolina's Model for Climate Resilience

Amidst the growing challenge of extreme heat events accentuated by climate change, North Carolina has launched an innovative initiative designed to bolster local governments' capacity to develop and enact comprehensive heat action plans. This collaborative effort introduces a novel paradigm for heat resilience, resulting from collaboration between the North Carolina Office of Recovery and Resiliency, the North Carolina State Climate Office; the Carolinas Collaborative on Climate, Health and Equity (a NOAA CAP/RISA team); the North Carolina Department of Health and Human Services; and the Heat Policy Innovation Hub at the Nicholas Institute for Energy, Environment and Sustainability at Duke University.

Central to this initiative is the formulation and implementation of health-based outcome thresholds. These thresholds - derived from correlating emergency department visits and climate data to ensure a direct link between heat events and their health impacts - establish the specific temperature thresholds at which response to extreme heat should be initiated and heat warnings be issued and communicated to stakeholders and the public. This methodological innovation refines the warning process and enhances the content of action plans with precise, data-driven insights.

At the core of this initiative is the dynamic Heat Action Plan template, structured to guide communities through the multifaceted process of planning for, responding to, and mitigating the effects of extreme heat – alongside determining when certain responses should be initiated. This template delineates specific strategies across several key areas:

• Preparation for Heat Season: Outlining measures for readiness, emergency response, and long-term resilience.
• Emergency Heat Forecast Response: Activating immediate actions in anticipation of forecasted extreme heat events.
• Building Long-term Resilience: Enhancing infrastructure and public awareness to reduce heat vulnerability over time.

In the Summer of 2023, this team held a convening with representatives from 10 counties to introduce the heat action plan template. This was instrumental in refining the template, drawing upon their firsthand experiences to assess strategy feasibility and identify effective solutions for heat management. This engagement highlighted the critical need for plans that are adaptable to the unique challenges of different communities, emphasizing strategies that are both practicable and impactful. The insights gained from these discussions were instrumental in refining the template, making it a versatile tool for statewide implementation in the Summer of 2024.

Through sharing the journey of developing health-based thresholds and the collaborative process of enhancing the heat action plan template, this initiative strives to serve as a model for others. It underscores the significance of community engagement, informed decision-making, and the adaptability of action plans to local needs, setting a precedent for comprehensive heat resilience planning.