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Advance research on how air quality, heat waves, and the transmission of vector-borne diseases will change. Although several efforts have been made to project future morbidity and mortality effects of climate change-related ozone concentrations, there are currently few efforts to model the impact of climate change on other air pollutants (CCSP, 2008a). Refining projections of the frequency and occurrence of hot days and the range of disease-spreading species is necessary for effective adaptation planning and decision making. New science is needed to provide information for dealing with the impacts of climate change on public health, both nationally and internationally, keeping in mind the transboundary transport of air pollutants and disease vectors.

Characterize the differential vulnerabilities and adaptive capacity levels of particular populations to climate-related impacts, and the multiple stressors they already face or are likely to encounter in the future. The likelihood that various people and regions will suffer adverse health impacts related to climate change depends on (1) their exposure to climatic and other changes; (2) their sensitivity to these stressors, some of which are population- or person-specific (e.g., age, race) and some of which are modified (often magnified) by concurrent, nonclimatic multiple stresses; and (3) their capacity to cope, respond, and adapt to extreme events and health-related climatic changes. The latter in particular is affected by the status of and access to local public health infrastructure, including early warning systems, and human, social, and financial capital. Specific features of the local geographic and environmental situation also can affect the capacity to adapt.

Identify effective, efficient, and fair adaptation measures. Incorporating proactive adaptation into public health and health care planning would increase resilience to the health impacts of climate change. Improvements in health care interventions, access to health care, medical technologies, disease-vector surveillance systems, comprehensive heat-health warning systems, and raising awareness among health care providers are examples of such proactive measures. There are many other opportunities, however, for developing additional adaptation options. For example, seasonal and finer-scale forecasts can be used to develop early warning systems that could increase resilience to climate variability and extreme events.

Evaluate and develop effective information, education, and outreach strategies. Linking knowledge to action through partnerships with private, public, and nongovernmental organizations, and faith communities, and carefully building effective information, education, and outreach strategies that bring credible health information to potentially affected populations will be a critical element of increasing adaptive capacity and responses in the health sector. In addition, local and state

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