Local authority responses to climate and health impacts: policy analysis across four England regions
GA Turner, L O’Connor, E O’Connell, P Coleman, S Hajat, H Sharma-Waddington, R S KovatsAbstract
Background
Climate change poses increasing risks to population health, including heat-related illness, flooding, poor air quality and disruption to essential services. In England, local authorities influence key determinants of climate-related health through responsibilities for housing, transport, environmental protection and public health. However, climate mitigation and adaptation are not statutory duties, and evidence on how climate and health objectives are integrated across local policy is limited.
Aim
To examine how local climate strategies and policies in England consider public health, align objectives across sectors and prioritise interventions to protect population health.
Methods
We conducted a qualitative content analysis of 129 publicly available strategies and plans from 12 local authorities across four English regions. Documents were identified through structured web searches and analysed using an a priori framework covering climate hazards, policy domains, vulnerability, inequality and responses.
Results
Local authorities were implementing diverse interventions, most commonly in transport, housing energy efficiency and urban greenspace. Public health was rarely a primary objective and more often framed as a co-benefit. Strong cross-sector alignment was seen for active travel, housing retrofit, greenspace expansion and flood resilience. Air quality and transport strategies most clearly linked climate and health, while food, greenspace and many health strategies addressed health more implicitly. No authority had a standalone heat strategy, though heat actions appeared across plans. Few documents included measurable health outcomes or monitoring frameworks.
Conclusions
Local authorities are implementing many actions with health benefits, but public health remains weakly integrated within climate governance. Stronger coordination, clearer public health leadership and improved monitoring are needed to maximise health gains.