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Many public health adaptation strategies have been identified in response to climate change. This report reviews current literature on health co-benefits and risks of these strategies to gain a better understanding of how they may affect health.A literature review was conducted electronically using English language literature from January 2000 to March 2012. Of 812 articles identified, 22 peer-reviewed articles that directly addressed health co-benefits or risks of adaptation were included in the review.The co-benefits and risks identified in the literature most commonly relate to improvements in health associated with adaptation actions that affect social capital and urban design. Health co-benefits of improvements in social capital have positive influences on mental health, independently of other determinants. Risks included reinforcing existing misconceptions regarding health. Health co-benefits of urban design strategies included reduced obesity, cardiovascular disease and improved mental health through increased physical activity, cooling spaces (e.g., shaded areas), and social connectivity. Risks included pollen allergies with increased urban green space, and adverse health effects from heat events through the use of air conditioning.Due to the current limited understanding of the full impacts of the wide range of existing climate change adaptation strategies, further research should focus on both unintended positive and negative consequences of public health adaptation.

Abstract: Objective: It is now recognized that climate change affects human health. The question is how to adapt. This article examines mainstreaming climate considerations into public health programs and the utility of climate change and health adaptation frameworks, using Ontario, Canada, as a case study. Methods: A literature review identified climate change and health adaptation frameworks for comparison with the Ontario Public Health Standards. Key informant interviews gauged the extent to which climate change risks are currently considered in policy and planning. Results: Ontario’s Public Health Standards already require many of the risk management activities identified in climate change and health adaptation frameworks. However, public health officials require additional information about linkages between climate change and health to manage risks. Conclusions: Risk management activities such as population health assessments, surveillance and public education and outreach can address many key risks related to climate hazards when information about the risks, vulnerable populations and time scales is made available to health officials. The development, analysis and transfer of this information should be considered a priority at all levels within the public health sector.