2014 public health law conference: intersection of law, policy and prevention • spring 2015 79 R educing greenhouse gas emissions is an urgent priority. While few would argue that action to mitigate the causes of climate change should be led by public health practitioners, public health has a critical role in adaptation eforts. Adaptation seeks to lessen human vulnerability to extreme weather and to increased variability in temperature and precipita- tion. Climate change as an emerging health issue pro- vides a test case for new approaches to public health: approaches that emphasize both collaboration with other government and private entities and application of innovative legal strategies. In 1994, the Centers for Disease Control and Pre- vention (CDC) introduced “10 Essential Services of Public Health.” 1 Rather than focusing upon traditional divisions of public health into branches such as infec- tious disease, injury prevention, and environmental health, this model focused upon activities such as diagnosing and investigating health hazards in the community and mobilizing community partnerships to solve health problems. This approach subsequently informed national accreditation standards adminis- tered by the Public Health Accreditation Board. 2 It can also guide the public health approach to climate change. 3 The emerging concept of “heath in all poli- cies” additionally provides a lens to focus on partner- ships across sectors and incorporation of legal and policy strategies into adaptation. 4 A recent article analyzing over 50 studies on cli- mate change and human health summarizes six cat- egories of public health concern: heat-related health problems; respiratory problems; infectious diseases; waterborne diseases; food insecurity; and mental health problems. 5 The most marked increases in mor- bidity and mortality are predicted to occur within vul- nerable populations such as the young, the poor, the medically frail, and the elderly. Despite these recognizable threats, a study by the National Association of City and County Health Of- cials (NACCHO) shows that while 8 out of 10 health directors surveyed believe that climate change is occurring, 76% of directors do not believe they have the expertise to assess health impacts within their community, and 87% do not believe they have suf- cient resources to address climate change impacts on local residents. 6 These gaps in public health expertise and resources must be flled in order to address seri- ous implications of climate change for human health. Classic Public Health: Milwaukee Legionellosis Outbreak Some health impacts of climate change may be addressed by the practice of core public health compe- tencies. For example, the assessment and investigation of infectious, vector-borne, and other reportable dis- eases is one of the essential services of public health. Educating epidemiologists about climate impacts will facilitate their work, but health departments need not add a “climate change program” in order to carry out these investigations. 7 A recent outbreak of legionello- sis in Milwaukee provides an apt example. Between June-September 2013, the City of Mil- waukee Health Department (MHD) recorded 58 cases of Legionellosis (Legionnaires disease), a bac- Jill Krueger, J.D., is the Director of the Northern Region of the Network for Public Health Law, based at the Pub- lic Health Law Center at William Mitchell College of Law. Paul Biedrzycki, M.P.H., M.B.A., C.I.H., is the Director of Disease Control and Environmental Health for the City of Milwaukee Health Department. Sara Pollock Hoverter, J.D., LL.M., is a Senior Fellow and Adjunct Professor at the Harrison Institute for Public Law at Georgetown Law. Human Health Impacts of Climate Change: Implications for the Practice and Law of Public Health Jill Krueger, Paul Biedrzycki, and Sara Pollock Hoverter