Lateral Public Health: A Comprehensive Approach to Adaptation in Urban Environments

Abstract

The unpredictable nature of climate change poses considerable challenges to public health because it acts as a multiplier on existing exposure pathways and thus exacerbates existing vulnerabilities. Urban settings are particularly susceptible to the impacts of extreme weather events due to high population densities with shared exposure pathways. Moreover, metropolitan areas tend to be at increased risk from heat waves because urban climates are often warmer than un-built surroundings. Three aspects of urban adaptation to climate change are addressed here: (1) social interventions that advance bonding, bridging, and linking social capital in order to enhance community capacity and resilience; (2) interventions that attenuate the negative consequences of climatic events by physically improving the built environment; and (3) social services interventions that integrate multiple sectors through emergency plans for risk reduction of vulnerable populations. These adaptation strategies in urban environments illustrate the concept of lateral public health based on transdisciplinary cooperation and community-based participation. In order to mount an effective response, public health practitioners need to transcend the traditional disciplinary boundaries and embrace lateral public health. This framework farms out public health action to other sectors of society, as well as community members of at-risk populations, in order to promote sustainable adaptation.