This study reviewed first available frameworks for climate change adaptation in the public health arena. The authors propose a conceptual framework with a three‐step procedure to assess climate change vulnerabilities.
First, the study team identified and modeled heat stress, environmental, social, and health factors that are closely related to climate change and vulnerability. Second, the team quantified the cumulative impacts of four high‐priority factors at regional level using the cumulative environmental hazard inequality index. Third, the team applied the environmental justice screening tool to map the four high‐priority factors to identify areas with increased vulnerability to the health impacts of climate change.
In addition to the heat stress estimated using air monitoring data, the team applied satellite data to create models of the land surface temperature at 30‐meter resolution and provided a measure of small‐scale variations in the urban heat island.
Regionally, based on the cumulative environmental hazard inequality index, adaptive capacity had the greatest cumulative inequality in both the San Francisco Bay Area and Fresno regions, and those inequalities were largely contributed by inequalities from tree canopy shading. Social and health vulnerability had the second largest cumulative inequality in both regions. Lack of car ownership was the major impact in creating such inequalities. Air pollution inequality came third, based on the main pollutants in both regions, and this was mainly contributed by inequalities from diesel particulate matter exposure. By contrast, cumulative inequalities in heat stress were the least. However, heat stress inequality was still significant different from the equality line.
Locally, based on the environmental justice screening tool, downtown urban areas for both Fresno County and the San Francisco Bay Area showed cumulatively higher vulnerability than more outlying areas, with the exception of the rural western portion of Fresno County. The cumulative inequalities calculated by the cumulative environmental hazard inequality index and the environmental justice screening method can be a useful tool for highlighting areas of greatest vulnerability for targeting adaptation planning.