Assessing The Implementation Of Climate And Health Adaptation In Pacific Island Jurisdictions Authors: Christopher J. Boyer cboyer10@uw.edu, Kristie L. Ebi, Jeremy J. Hess, Kathryn Bowen, Kathleen Dolan, Calvin Johanes, Mary Hannah Smith, and Nicole A. Errett

https://www.healthaffairs.org/doi/10.1377/hlthaff.2025.01661 Pacific Island Jurisdictions are highly affected by climate change. Across the health sector, implementation of planned adaptation strategies has been uneven. It has been constrained by limited human and financial resources and organizational capacity, inadequate climate-health risk assessments, and imprecise estimates about the effectiveness of climate-related interventions. To fill these gaps, this study assessed the degree of implementation of health adaptation activities in Pacific Island Jurisdictions, using a combination of implementation science and climate change adaptation frameworks. We found that Pacific Island Jurisdictions have made advances in the implementation of health adaptation activities such as establishing coordination mechanisms, building awareness, and conducting assessments. However, less progress has been made in operationalizing targeted policies, programs, and interventions, including monitoring, evaluation, and learning. Our findings offer the potential to increase resilience if applied by practitioners (for example, public health professionals) and decision makers to inform and seek support for additional health adaptation investments.