Small steps creating larger impact: an investigation of Building Resilience Against Climate Effects (BRACE) plans and practitioners

This study examined the climate and health planning activities of public health practitioners participating in the U.S. Centers for Disease Control and Prevention’s Climate-Ready States and Cities Initiative during the 2010–2021 funding period. The purpose of this project is to provide an investigative overview of this longstanding federally led effort to support and advance climate and health adaptation implementation and evaluation practice. The study took place at the end of the 11–year grant cycle and used a combination of climate and health adaptation plan analysis and semi-structured interviews to gain insight into the praxes generated by practitioners. Analysis of climate and health adaptation planning documents informed semi-structured interviews with Climate Ready States and Cities Initiative grantees. Comprehensively, the study is conducted through general qualitative inquiry and abductive analyses to triangulate intensive discourses with practitioners, plan analysis, and literature. Themes of partnership building and collaboration emerged across grantees. As the health effects of climate change become more pronounced, understanding the advantages and limitations of climate and health adaptation planning can guide future related planning. The Climate Ready States and Cities Initiative was the only federally led effort that provided significant material investment to plan for the health impacts of climate change.