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The Risk:

Climate Crisis

The damage that can be inflicted by a changing climate makes it one of the most dangerous, yet preventable, risks to human health. The World Health Organization projects climate change will cause an additional 250,000 deaths a year from 2030 to 2050. The families most affected by climate change often have the fewest resources and the least ability to adapt in times of crisis.

Working Together to Build Climate Resilience

Thousands of community health centers and free clinics across the U.S. care for millions of our nation’s uninsured or underinsured patients. Yet, more intense hurricanes, historic floods, unprecedented wildfires, increasing heatwaves, and other extreme weather events from climate change threaten their ability to provide care and keep their patients healthy.

The Center for Climate, Health, and the Global Environment at Harvard T.H. Chan School of Public Health (Harvard Chan C-CHANGE) and Americares have collaborated to help protect people on the frontlines of the climate crisis with the Climate Resilience for Frontline Clinics project. Biogen is a founding donor of the project. The three-year effort began with a groundbreaking survey of over 450 clinic staff from 47 U.S. states and territories to identify knowledge gaps and real-world challenges of caring for patients during and after climate shocks. The knowledge gained from that survey helped us create the Climate Resilience for Frontline Clinics Toolkit which provides useful resources for health care providers, patients and administrators at free clinics and community health centers to meet the challenges for health care from climate change.

Diana Ross walks over pieces of ceiling that have fallen to the floor.
A Perry County yellow school bus sits in flood waters and surrounded by flood debris
Fire outside of a home with firefighters combatting the blaze. Photo by David Royal

The Climate Resilience
for Frontline Clinics Toolkit

The following resources can be downloaded for your use by clicking on Heat, Wildfires, Hurricanes, Floods or General Guidance and then selecting each document (information or checklist) that you wish to download. Please help us learn more in this project by first filling in the simple form below with the name of your clinic/health center and its location. If you wish, you can also share your name and email so we can alert you to new resources and training opportunities. Then download as many of the PDFs that you wish. The documents are organized for Health Care Providers, Patients and Administrators.


Extreme heat is a particularly deadly form of extreme weather. 

The World Health Organization tells us that heat waves are considered among the most dangerous of natural hazards but rarely receive adequate attention because their death tolls and destruction are not always accurately assessed and reported. These documents contain critical information you need and actions you and your patients can take to prepare for the challenge of extreme heat. You can view and download English or Spanish versions of the documents by clicking on the links.


Fire Icon

Wildfires have many effects on health, especially for individuals with chronic medical conditions.

The changing climate leads to greater periods of drought and extreme heat which increase the likelihood of wildfires. These resources contain critical information you need and actions you and your patients can take to help minimize the impacts of wildfires on health. You can view and download English or Spanish versions of the documents by clicking on the links.


Hurricane Icon

Hurricanes can cause long-term damage to communities

The changing climate can increase the frequency and severity of hurricanes and other storms leading to greater illness, injury and death. The impacts of these storms can last for years due to infrastructure damage and evacuation of communities. These resources contain critical information you need to help you and your patients minimize the impacts of hurricanes. You can view and download English or Spanish versions of the documents by clicking on the links.



Floods are a health hazard, especially for individuals with chronic medical conditions.

Flood risk is increasing as a result of climate change, thanks to warmer temperatures and more intense storms. Flood waters can cause injuries and drowning, while damage to homes and difficulty accessing medical care can affect long-term health. These resources contain actions you and your patients can take to help minimize the impacts of floods on human health. You can view and download English or Spanish versions of the documents by clicking on the links.

General Guidance

Global Icon

Climate change-related hazards are harming human health and increasing demand for healthcare services.

The following documents are applicable to all hazards and support clinics in developing the operational capabilities critical for them to stay open and continue to care for their patients during an emergency. You can view and download English or Spanish versions of the documents by clicking on the links.

Click on the arrow and watch the video on the Climate Resilience for Frontline Clinics Project.

“We aim to find new ways to protect people most at risk from the climate crisis and advance health equity.”

Dr. Aaron Bernstein, interim director of Harvard Chan C-CHANGE

The Project Story

The project launched with a nationwide survey as well as focus groups with nine pilot clinics in four states: California, Massachusetts, North Carolina and Texas. All of the focus group clinics have experienced recurring emergencies due to the climate crisis. Participating clinics provided information on knowledge gaps, real-world challenges, and opportunities for interventions for their patient populations. They also reviewed the toolkit content and provided valuable feedback that helps us ensure the utility of these resources.

From the data collected from the nationwide survey, we learned that:

  • 81% of clinic staff said their clinic experienced some kind of disruption due to extreme weather within the past three years;
  • Fewer than 20% of clinic staff feel their clinic is “very resilient” in the face of extreme weather;
  • 77% of clinic staff say they do not have the knowledge or tools to implement climate change preparedness at their clinic; and
  • More than 80% want education and training to protect their patients from climate-related events.

The team is using this information to create tailored resources for health care providers, staff, and patients on extreme heat, wildfires, hurricanes and floods and working with clinics to put these materials into practice.

“This project is about resilience – not just protecting buildings but protecting people and communities. It is the first of its kind to focus on developing resources for frontline clinics – clinics that serve people disproportionately impacted by the climate crisis,” said Kristin Stevens, Director, Climate and Disaster Resilience

The project will expand across the U.S. to ensure that more clinics providing free or low-cost health care to uninsured or underinsured patients – such as primary, behavioral, emergency, maternity, and specialty care – are ​​better equipped to manage care and protect patients from climate risks.

“It is essential that we work to meet science-based targets that limit global warming to 1.5C, while also addressing the impacts that the climate crisis is having on human health. This pioneering initiative is aimed at protecting patients from the climate health effects happening now, with a focus on those most at risk.”

Biogen Chief Medical Officer Maha Radhakrishnan, M.D.

Participating Clinics and Organizations

California | Massachussetts | North Carolina | Texas


Free Clinic of Simi Valley

The Free Clinic of Simi Valley

The Free Clinic of Simi Valley in Southern California provides critical medical care to low-income families. Its patients live with the intensifying effects of climate change, including heat and drought.

Two CalFire crew digging a fire line with orange flames near by.

Lestonnac Free Clinic

Lestonnac Free Clinic, based in Orange County, California, has 13 clinic sites throughout Southern California. In 2020, due to the numerous wildfires, they saw a significant increase in patients coming into the clinic for upper respiratory issues and breathing problems due to the fires.


Flood photo of cars underwater

Cambridge Health Alliance

Cambridge Health Alliance works in two safety net community hospitals and multiple primary care centers that serve several diverse communities north of Boston. Its patients are at high risk of heat-related illnesses due to urban heat-island effects, and their neighborhoods are at high risk of flooding due to rising sea levels and worsening storms.

North Carolina

Community Care Clinic of Dare

The Community Care Clinic of Dare

The Community Care Clinic of Dare in the Outer Banks of North Carolina. In addition to the frequent and intensifying hurricanes that have been occurring, the clinic and patients face challenges from ongoing flooding caused by rising sea levels and increasing temperatures that have a disproportionate effect on their patients who often work outdoors.

Kintegra Health clinic

Kintegra Health

Kintegra Health, a community health center in North Carolina with over 30 sites. The sites and patients face significant issues from frequent flooding washing out roads and access to healthcare, as well as deteriorating infrastructure, particularly in the rural areas.

Poster showing NCAFCC

The North Carolina Association of Free and Charitable Clinics

The North Carolina Association of Free and Charitable Clinics (NCAFCC) supports 70 free and charitable clinics and pharmacies in the state by coordinating disaster response activities and supporting clinics as they provide healthcare for medically underserved North Carolinians. NCAFCC is feeling the effects of climate change and staff are called on to assist member clinics as climate change has acute and long-term effects on patient care and clinic operations.


Matagorda health workers in front of a COVID Workers sign

Matagorda Episcopal Health Outreach Program (MEHOP)

Matagorda Episcopal Health Outreach Program (MEHOP) provides critical health and behavioral health services for Matagorda County on the east coast of Texas. The facility was evacuated during Hurricane Harvey in 2017 and had many patients and staff members affected by the recent deep freeze. MEHOP is in a rural, underserved area with significant and growing challenges around access to healthcare, degrading infrastructure, and insufficient funds to rebuild after disasters.

Medicines being preserved in cooler

San José Clinic

San José Clinic, a charity clinic in Houston, Texas, serves patients directly impacted by Hurricane Harvey and the recent winter storm and related power outages.

Photo of a flooded road in Beaumont Texas

Ubi Caritas

Ubi Caritas, a free clinic in Beaumont, Texas, serves communities impacted by multiple hurricanes.