Colorado’s Health and Climate Policy Agenda

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While climate change impacts all of us, it affects some communities more than others. Health risks from a changing climate are influenced by a person’s age, health status, occupation, income, and physical environment. Children, older adults, people with lower incomes, Black, Indigenous, and Hispanic/Latino Coloradans, people with disabilities, people with chronic health conditions, pregnant people, and people who work outdoors are among those who are particularly at risk. Climate change is likely to exacerbate many existing inequities. 

Acclimate Colorado, an initiative of the Colorado Health Institute, is working to bolster the resilience of Colorado communities to the challenges of a warming climate. Launched in early 2022, Acclimate Colorado has already started to act on climate through: 

Assessing 
Our research work includes the Health and Climate Index, which examines strengths and risks in each of Colorado’s 64 counties. 

Aligning 
We formed the Acclimate Action Team, a convening of leaders from many disciplines and backgrounds to plot Colorado’s course for addressing the health effects of climate change with policy and programmatic solutions. 

Advancing 
We will bring this Health and Climate Policy Agenda to local and state leaders with concrete steps that governments, businesses, health care providers, and community organizations should take to protect their communities. 

These policies focus on preparing for and/or addressing physical and mental health impacts related to extreme heat, wildfires, flooding, drought, and poor air quality — areas identified by the Colorado Health Institute as key climate exposures in Colorado. Being prepared for these exposures can help reduce illness and support health in a changing climate. 

The Colorado Health Institute and the Acclimate Action Team developed these 26 goals and 34 strategies to advance climate justice and health equity, and reflect the needs and solutions identified by people and communities most affected by climate change. 

Guiding Principles 

The Acclimate Action Team and the Colorado Health Institute sought to uphold the following guiding principles when developing this policy agenda: 

1. Prioritize communities disproportionately harmed by climate change and/or currently or historically excluded in adaptation policies and activities. 
2. Develop adaptation strategies, policies, and activities that protect human health and are mindful of mitigation. 
3. Advance equity in climate resilience planning and implementation by breaking down barriers that prevent communities disproportionately harmed by climate change from thriving. 
4. Ensure policies are community-driven and elevate community voices. 
5. Practice language justice by ensuring health and community organizations are equipped to communicate with people from different language backgrounds. 

Guide to Colorado’s Health and Climate Policy Agenda 

Adaptation to the changing climate is a global challenge. The work is complex, but it represents a critical opportunity to improve health outcomes for Coloradans most impacted by a changing climate. This policy agenda offers a place to start by identifying five key categories for developing and advancing solutions: 

1. Grow Colorado’s climate adaptation planning and response capacity. 
2. Improve and invest in infrastructure to support health. 
3. Enhance workforce capacity for climate and health adaptation and response. 
4. Improve data and research to support informed and equitable planning and response efforts. 
5. Develop and share communications tools to educate Coloradans. 

Each of the five categories has goals and the strategies needed to achieve them. Some are simple and can be accomplished quickly. Others will take years. Either way, it is important to start work now to protect people from a climate that is only getting hotter and more extreme. Additionally, all goals and strategies highlighted in this agenda should be pursued and implemented using an equity lens to ensure that communities disproportionately impacted by climate change can benefit from current and/ or upcoming changes to policies, programs, and initiatives. 

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1. Grow Colorado’s Climate Adaptation Planning and Response Capacity

Climate adaptation planning means taking action to prepare for and respond to ongoing and projected impacts of climate change. There is a need for a more coordinated and thorough effort to engage state, community, health systems, businesses, and other actors in planning for impacts to protect health. 

Health and Climate Adaptation Plans 

Goal 1.1 
Cities and counties are equipped to create, update, and implement health and climate adaptation plans. Adaptation plans provide guidance for and include feedback from state and local governments, as well as non-governmental organizations, including health systems, businesses, and community associations, especially those that serve or employ populations identified as particularly sensitive to climate change. 

Strategy 1.1a — Colorado Department of Public Health & Environment and the Colorado Department of Local Affairs, with input from supporting organizations, create a template for local public health agencies, cities, and counties on how to establish a climate adaptation plan. 

Strategy 1.1b — Engage advocacy groups to propose legislation to fund support for cities and counties that need financial aid to create or update a climate and health adaptation plan. Possible groups to engage include the National Resources Defense Council and Healthy Air and Water Colorado. 

Strategy 1.1c — With partners and materials outlined in strategy 5.1, identify counties and cities with no climate adaptation plans, strategies, or ability to consider and integrate climate impacts into systems and planning processes. Engage local businesses, health systems, and community-based organizations by sharing health-related materials to garner local support for creating a climate adaptation plan. 

Coordinated State Efforts and Funding Strategies 

Goal 1.2 
Communities, nonprofits, and advocacy organizations are aware of available public climate funding opportunities and state agencies provide transparency on how these dollars will be distributed. 

Strategy 1.2a — State interagency workgroups and task forces, such as the Colorado Interagency Climate Team, coordinate with public and private stakeholders to increase awareness, coordination, and implementation of available climate funding opportunities. 

Strategy 1.2b — The Colorado Interagency Climate Team creates opportunities for public and private organizations to learn more about each department’s climate funding and coordination plans and offers feedback and/or provides guidance on implementation. 

Community-Driven Activities 

Goal 1.3 
The Colorado Office of Climate Preparedness establishes and convenes a community advisory group to provide information on the most pressing community priorities, challenges, and goals across the state. This group will offer guidance on recommendations and activities for the statewide climate preparedness roadmap that addresses climate mitigation, adaptation, resiliency, and recovery. 

Strategy 1.3 — Using funds allocated through Senate Bill 22-206, the Colorado Office of Climate Preparedness coordinates and/or contracts with supporting partners to create and facilitate a community advisory group. The community advisory group should consist of the following members: 

• Representatives from community organizations that serve urban and rural areas. 
• Representatives from community organizations that serve Coloradans disproportionately harmed by climate change, including individuals with low incomes, older adults, youth, and people of color. 

Group members should be compensated for their time and expertise. 

Wildfire Protection 

Goal 1.4 
Counties and municipalities affected by or at risk of wildfires are equipped with funding and resources to create or update community wildfire protection plans and/or become fire adapted or certified Firewise USA® communities. 

Strategy 1.4a — Local governments, the local fire authority, local Colorado State Forest Service (CSFS) field offices, and other land management agencies coordinate to update or create then adopt a community wildfire protection plan. Local CSFS offices and CSFS grant databases have up-to-date information on potential grant opportunities to support planning and implementation. 

Strategy 1.4b — Property owners, homeowner’s associations, and local businesses can coordinate with the local fire department and/or state forestry office to have an expert speak with residents and businesses about the fire mitigation practices and encourage participation in creating a Firewise or fire adapted community. 

Regenerative Agricultural Practices 

Goal 1.5 
Farmers and ranchers have access to information, resources, and funding to learn about and implement regenerative agricultural practices. Regenerative approaches provide co-benefits for the soil and human health by sequestering carbon, reducing dust, and improving water and nutrient retention within the soil.(3,4) 

Strategy 1.5 — Farmers and ranchers across Colorado have funding and support from state and regional networks to implement recommendations on climate-smart agricultural management from the state’s Natural and Working Lands Strategic Plan. Possible groups to engage and support these efforts include the Colorado State University Extension offices and the Western Regional Agricultural Stress Assistance Program. 

Physical and Mental Well-Being 

Goal 1.6 
Rural workers, especially farmers and ranchers, have access to peer networks, such as AgWell, that support the physical and mental well-being of people in rural and agriculture-based communities. 

Strategy 1.6 — Build and invest in partnerships with organizations supporting physical and mental well-being for farmers, ranchers, and agricultural workers. Possible groups to engage and support these efforts include the Colorado Behavioral Health Administration and Colorado State University Extension offices.  

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2. Improve and Invest in Infrastructure to Support Health

Infrastructure and the built environment can help mitigate the impacts of extreme heat, poor air quality, wildfires, and other climate exposures on health. But in the Rocky Mountain west, policies and practices tend to emphasize keeping people warm in the winter, not cool in the summer. Important steps include expanding access to efficient cooling systems and air filters and creating or improving standards and regulations for cooling. These updated and improved energy policies can reduce energy burden and additional climate pollution by cumulatively reducing energy use from both heating and cooling systems. 

Extreme Heat 

Goal 2.1 
A statewide cooling standard (or a “right to cool”) is established, requiring homes and settings such as homeless shelters, schools, and jails to have energy efficient cooling units or systems. 

Strategy 2.1 — State environmental justice groups develop and pass legislation that would update Colorado’s habitability laws to require all new dwellings be equipped with cooling systems and rental owners to retrofit units without cooling systems. 

Home Weatherization and Energy Efficiency 

Goal 2.2 
Coloradans are made aware of programs created or supported by the Inflation Reduction Act and other federal, state, or local rebate programs that support affordable options to electrify homes and adopt low-emission equipment such as heat pumps to improve air quality and reduce exposure to extreme heat. 

Strategy 2.2 — State agencies coordinate with local media and community-based organizations to promote awareness of benefits from the Inflation Reduction Act. These partners can create online and printable materials that can be understood by community members from all educational backgrounds and languages. Potential state agencies to engage with include the Colorado Energy Office and Colorado Department of Public Health & Environment. 

Goal 2.3 
Industry groups and the state expand access to home weatherization, electrification, and energy-efficiency programs and services through public-private partnerships and funding mechanisms. 

Strategy 2.3a — The Colorado Energy Office, Energy Outreach Colorado, and other supporting stakeholders continue to coordinate with Colorado’s utility companies and cooperatives on strategies to improve access to home weatherization, electrification, and energy efficiency. Strategies might include removing program enrollment barriers that hinder people from accessing program incentives when appliances break or repairs are needed. 

Strategy 2.3b — Industry groups and the state develop legislation to create a state sustainable weatherization funding source that supports pre-weatherization activities to ensure homes are able to have weatherization updates installed. Potential partners to engage in this work include the Colorado Energy Office, Energy Outreach Colorado, and utility companies and cooperatives. 

Tree Canopy 

Goal 2.4 
Communities with limited tree canopy and shade are equipped to plant and maintain trees in the community. Community members are consulted and have opportunities to provide input on tree canopy efforts before planting projects begin. 

Strategy 2.4 — Local parks and recreation departments, in partnership with regional planning organizations, identify and partner with neighborhoods with low tree canopy, using resources like the Tree Equity Score to initiate tree planning projects. Funding for these initiatives can come from the Inflation Reduction Act, which dedicated $1.5 billion to the U.S. Forest Service’s Urban and Community Forestry Program, state resources identified in the Department of Local Affairs Local Community Funding Guide, and local funding sources, such as Denver’s Forest Initiative and Lakewood’s Sustainability Plan. 

Transportation 

Goal 2.5 
Communities establish Complete Streets policies that support the planning and implementation of roadway designs that improve safety for all users, including accommodations for bicyclists, pedestrians, and public transportation. These policies offer opportunities to improve health by creating pathways for physical activity options as a mode of transportation. 

Strategy 2.5 — The Colorado Municipal League, Colorado Counties Inc., and supporting organizations identify and work with communities on Complete Streets planning and development. Funding can be secured through the Rebuilding American Infrastructure with Sustainability and Equity (RAISE) grants, Highway Safety Improvement Program (HSIP), and Revitalizing Main Streets grant program. 

Goal 2.6 
Expand the reach of programs such as Zero Fare for Better Air, which offers free access to public transportation to reduce air pollution during high ozone months throughout the state. 

Strategy 2.6 — Secure funding to support free or low-cost transit initiatives. These efforts can be coordinated between the Colorado Department of Transportation, Colorado Association of State Transit Agencies, and the Colorado Energy Office. 

Goal 2.7 
Every community is equipped to create an electric vehicle readiness plan. This plan can be included within local climate plans created or supported in goal 1.1 or a local transportation plan. This offers communities a roadmap for supporting electric vehicle adoption and installing charging infrastructure by partnering with private companies. 

Strategy 2.7 — City planners and local governments can secure state and federal funds for creating an electric vehicle readiness plan that best suits their community from the 2021 Infrastructure Investment & Jobs Act, the DOLA Local Community Funding Guide. Funds to implement a community’s plan can be secured through Charge Ahead Colorado and the EV Fast-Charging Plazas program. 

Goal 2.8 
Residents of apartment buildings and multifamily homes have access to electric vehicle charging stations within or near their building. 

Strategy 2.8 — Apartment building/multifamily housing managers and owners can apply for funding through Charge Ahead Colorado to adopt community-based electric vehicle charging stations. 

Affordable Housing 

Goal 2.9 
Coloradans have more affordable housing options in walkable neighborhoods with access to jobs and transit. 

Strategy 2.9 — Housing and environmental advocates draft legislation to increase the supply of affordable housing by reducing restrictive land use policies and streamlining regulations for a variety of housing types. The state coordinates with local governments to encourage affordable housing development and increase opportunities for public transit development through zoning law reform. 

"Housing policy is climate policy."
— Colorado Gov. Jared Polis, 2023 State of the State Address

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3. Enhance Workforce Capacity for Climate and Health Adaptation and Response

Medical providers, insurers, private businesses, government, and others have a role to play in ensuring that the state is prepared to respond to climate-related health challenges, including mental health needs and exacerbation of health issues such as cardiac events or asthma from exposure to extreme heat and poor air quality. 

Recruitment and Retention 

Goal 3.1 
Educational and industry groups establish and maintain recruitment strategies to build professions for climate and health adaptation planning and health response. 

Strategy 3.1 — The Colorado Department of Labor and Employment and the Colorado Department of Local Affairs coordinate with leaders within the following professions to create workforce pipelines and retention strategies. Professions include, but are not limited to: 

• Wildland firefighters 
• Public health workers 
• Community health workers, health navigators, and promotores de salud 
• Weatherization technicians 
• Construction workers 
• Mental health professionals 
• Public transportation mechanics and drivers 
• Electric vehicle charger installers 
• Health and Climate Education and Training 

Goal 3.2 
Health care providers, community health workers, and other health workers have the knowledge and skills to monitor, assess, and treat climate-related health risks. This includes providing education about specific illnesses and conditions that are exacerbated by extreme heat and poor air quality and affordable mental health care to people impacted by climate-related events. 

Strategy 3.2 — The Colorado Association of Local Public Health Officials, the Colorado Division of Homeland Security and Emergency Management, and the Colorado Department of Public Health & Environment partner with Colorado medical provider associations and membership organizations to disseminate climate and health resources, including training opportunities with health care and public health providers. 

Goal 3.3 
Fewer home and property owners are underinsured for flood, wildfire, and severe weather damage. 

Strategy 3.3a — The Colorado Division of Insurance and Colorado Division of Homeland Security and Emergency Management identify and target outreach to communities with high risk for wildfire, flooding, or severe weather damage. Outreach should be performed by local, trusted community-based organizations that inform and provide resources to property owners about underinsurance risks related to extreme weather and disasters. 

Strategy 3.3b — The Colorado Division of Insurance continues research on support and better equip home and property owners who are underinsured or at risk of underinsurance. Resulting research may establish greater protections from and better educate home and property owners about underinsurance.  
Workplace Safety 

Goal 3.4 
Workplace safety protocols are updated to protect outdoor workers and those in facilities without adequate insulation or cooling systems from extreme heat and poor air quality. 

Strategy 3.4 — The Colorado Department of Public Health & Environment and the Colorado Department of Labor and Employment identify and update workplace safety protocols for professions with the highest risk for heat and poor air quality exposure. Professions/industries include but are not limited to: 

• Agriculture workers 
• Construction 
• Traffic control 
• Firefighters and emergency response teams 
• Landscapers and horticulturalists 
• Teachers and school administrators 
• Utility and sanitation workers 
• Community-Clinical Linkages 

Goal 3.5 
Referrals and connections between community-based organizations and health systems are improved by the advancement of statewide social-health information exchange infrastructure that better connects people with high-risk health or living conditions (such as inadequate protection from heat, cold, and poor air quality) with needed health and community resources. 

Strategy 3.5 — The Colorado Health Institute and the Metro Denver Partnership for Health coordinate and collaborate with the Colorado Office of eHealth Innovation and other participating partners to advance planning, implementation, and utilization of social health information exchange infrastructure across health systems, community-based organizations, public health agencies, human service agencies, and other participating partners. 

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4. Improve Data and Research to Support Informed and Equitable Planning and Response Efforts

The connection between climate change and human health is not new, but there is a need for more research, information, and analysis to help illuminate key health impacts in real time and over the long term and to understand the implications of potential policies and solutions. 

Long-Term Cost Effectiveness 

Goal 4.1 
An independent cost analysis is conducted to evaluate the long-term cost effectiveness and benefits of climate adaptation plans and disaster-resilient infrastructure to garner buy-in across Colorado. 

Strategy 4.1 — The Colorado Department of Public Health & Environment contracts with the Colorado Fiscal Institute or a similar independent research organization or university to conduct the cost analysis. Cost analyses on plans and infrastructure updates can be conducted by topic, such as wildfire mitigation and adaptation, flooding preparedness and resiliency, heat adaptation and structure tolerance, and water insecurity. 

Local and State Data Collection 

Goal 4.2 
Local and state data-collection instruments, such as the Colorado Health Access Survey, the Behavioral Risk Factor Surveillance System, and Healthy Kids Colorado Survey, are updated to capture trending data on health and climate exposures and impacts to inform ongoing and future climate and health adaptation planning and response. 

Strategy 4.2a — The Colorado Health Institute coordinates with state and national philanthropic foundations to secure funding to include questions about climate change and health on the Colorado Health Access Survey. 

Strategy 4.2b — The Colorado Department of Public Health & Environment collaborates with supporting partners on questions about climate and health that can be added to the Behavioral Risk Factor Surveillance System survey. Supporting partners will assist the department with submitting the application of the proposed questions and determining how they will be funded. 

Strategy 4.2c — An application to recommend climate and health-related questions for the Healthy Kids Colorado Survey is submitted by supporting partners to the Colorado Department of Public Health & Environment. 

National Weather Service HeatRisk Index 

Goal 4.3 
The National Weather Service’s HeatRisk prototype is formally adopted across the state to adequately gauge health risks from extreme heat. 

Strategy 4.3 — All Colorado National Weather Service forecast offices adopt the HeatRisk prototype to inform the community before and during extreme heat advisories and warnings. 

Air Quality Monitoring 

Goal 4.4 
A comprehensive system of air quality monitoring is expanded to counties and regions with no monitoring systems in place. These systems will capture data on air pollution particles that affect human health, such as ozone, particulate matter, volatile organic compounds, nitrogen oxides, and carbon monoxide. 

Strategy 4.4 — Environmental justice groups and local higher education entities coordinate with the Colorado Department of Public Health & Environment to create additional air monitoring stations and expand the types of pollutants being monitored. 

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5. Develop and Share Communications Tools to Educate Coloradans

Less than half of all Coloradans believe that climate change and other environmental challenges will affect their health.(5) Awareness about the connection between climate impacts on health is essential for people to take precautions, but limited information exists about the climate-health connection and approaches to respond to various risks. Providing accessible — and more culturally responsive — information about risks, their causes, and what to do about them can help individuals and communities be more prepared to protect their health. 

Equity-Driven Communication Materials 

Goal 5.1
Comprehensive and equity-focused climate communication materials are developed for community-based organizations, health providers, students, advocacy groups, and other audiences who can drive action to improve health. 

Strategy 5.1 — The Colorado Health Institute develops and designs digestible, illustrative climate communication materials in partnership with the Colorado Department of Public Health & Environment, the Colorado Department of Local Affairs, local public health agencies, and environmental justice groups. Community conversations are conducted before the materials are created to inform the content of these materials and their distribution across the state. Topics for these illustrations and infographics include, but are not limited to: 

• The impacts of heat and poor air quality on human health 
  • Materials specific to sensitive populations 
  • Materials specific to geographic regions 
• Safety measures during heat and poor air quality events 
• Best practices for preparing for and staying safe during a wildfire or high-water/flooding event 
• Ways Coloradans can help small farmers and community supported agriculture in their areas 
• Health care provider-specific information to share with clients and patients 
• How Coloradans can sign up for existing alert systems for their regions, for example, air quality alerts, code red alerts, and other local emergency alert systems 

Goal 5.2
Climate communication is expanded to reach communities with various political beliefs, geographies, languages, cultures, etc. Unique messages are crafted to cater to hard-to-reach populations to garner support for climate adaptation measures. 

Strategy 5.2 — The Colorado Department of Public Health & Environment conducts conversations and forums with communities and local organizations with limited or no current participation in climate and health discussions. The Colorado Department of Public Health & Environment can coordinate with supporting partners to identify unreached community groups and areas of the state to host these conversations. 

Conclusion and Future Directions 

The policy recommendations, strategies, and goals in this first-of-its-kind health and climate adaptation policy agenda for Colorado were intentionally selected, prioritized, and refined to appeal to the diverse array of stakeholders in the climate and health space. The goal is for any actor in this work to be able to see a role for themselves in this policy agenda and identify areas in which they can support these actions and strategies over the next few years. 

Federal climate and health resources are widely available to states. It is essential that action be taken in a coordinated, evidence-driven, and community-focused approach, which this policy agenda sets out to chart. This policy agenda highlights how adaptation work is well underway in some places, but will require new action from the ground up in others. However, a lot of work needs to be done and each strategy in this agenda will require thoughtful discernment of when, who, and how the work will be carried out. Members of the Acclimate Action Team who contributed to this agenda are working with the Colorado Health Institute to explore outreach and opportunities to move this work from strategy to implementation in 2023 and beyond. 

This policy agenda is a living document — one that should be revisited, revised, and evaluated for progress toward these goals of protecting Colorado’s communities from climate impacts.