Building Partnerships to Identify and Address Wildfire Smoke and Extreme Heat Health Effects in Priority Populations

Background: The health impacts of extreme heat and wildfire smoke events are unevenly distributed; climate-sensitive populations are more exposed, more sensitive, and less likely to have the resources to respond. In this article, we describe the process of building a community-academic-local government partnership and conducting a climate survey with climate-sensitive populations to inform city-wide climate adaptation planning efforts in San Francisco, California. Materials and Methods: We formed a Community Stakeholder Group (CSG) with seven representatives from community organizations serving residents disproportionately affected by extreme climate weather events. The CSG identified priority populations, developed conceptual models, and developed and disseminated a climate survey. Results: CSG member engagement and satisfaction were high; 100% agreed that their opinions were valued and that they could talk openly. 95% and 98% of climate survey respondents ( n = 529) experienced at least one negative health outcome during extreme heat and wildfire smoke events, respectively. While 50%–75% of survey respondents implemented simple protective actions, the majority were unable to make substantial material and structural changes to their living environment that could significantly reduce their exposure to extreme heat and poor air quality. Major barriers included the high cost of repairs/materials, being a renter, and being unstably housed or unhoused. Conclusion: Our project is unique in the multi-stakeholder partnership formed between local government, community, and academic partners. A major learning from our engagement process is that climate adaptation interventions designed for climate-sensitive populations should incorporate structural changes to living environments and be codesigned with the community, with careful consideration to avoid maladaptive interventions that deepen existing injustices.