To learn more about the project, explore this story map.

Strengthening Weather Hazard Resilience in North Carolina's Safety Net Clinics

In response to the increasing threats posed by extreme weather events, safety net clinics across North Carolina are stepping up to protect their communities. These clinics, including Community Health Centers (CHCs) and Free and Charitable Clinics, serve as critical lifelines for populations facing significant barriers to healthcare. Recognizing their unique position to integrate extreme weather resilience into care models, the Carolinas Climate Adaptation Partnership (CAP) and the Carolina Advocates for Climate, Health, and Equity (CACHE), in partnership with Harvard Chan C-CHANGE and Americares, have launched an ambitious initiative aimed at strengthening local health care systems. 

This collaborative effort, involving the NC Community Health Center Association and the NC Association of Free and Charitable Clinics, began with listening sessions to shape the project based on clinic needs. A subsequent survey assessed perceptions of extreme weather risks, barriers, and progress in resilience practices. The results have been compiled into a resource guide to highlight emerging needs, map exposure, and connect clinics to relevant funding and training resources.

Do Health Clinics See Climate Change as a Major Threat to Their Patients? 

North Carolina's safety net clinics are acutely aware of the impacts of extreme weather, and a majority expressed concern about the health risks posed to their patients. Despite this awareness, preparedness remains limited—only 45% of staff reported having the necessary resources to address extreme weather challenges and less than 10% report screening for weather hazard-related health factors.

What Challenges Do Clinics Face in Addressing Extreme Weather?

Safety net clinics face significant barriers to addressing extreme weather in their health care practice, including time constraints, lack of training, lack of funding, and insufficient institutional prioritization. A lack of expertise in hazard exposure, further restricts clinics' ability to conduct risk assessments, staff training, and resilience planning. Only 20% of clinics have conducted hazard exposure assessments, 13% provide staff training on the health impacts of extreme weather, and fewer than 10% participate in regional weather hazard collaborations. These challenges highlight the urgent need for tailored resources, additional funding, and increased institutional support to enhance extreme weather readiness, clinic resilience, and patient protection.

How Confident Are Clinicians in Protecting Their Patients from Weather Hazards?

Limited educational materials and evidence-based anticipatory guidance hinder clinicians' confidence in discussing extreme weather impacts and implementing preparedness strategies. This lack of preparedness is reflected in their low confidence in guiding patients during extreme weather events, particularly for the most exposed groups. Only 37% of clinicians felt confident advising pregnant individuals, 40% felt confident supporting children, and 43% felt prepared to assist non-English speaking patients or workers in at-risk occupations. The highest confidence was reported in supporting older adults (55%). Further, when asked about the health concerns that extreme weather will impact for their patients, respondents expressed the least concern about pregnancy and newborn complications, sexually transmitted infections, and vector borne diseases, despite evidence-based linkages between these health concerns and extreme weather. These gaps highlight the need for more targeted training and resources to empower clinicians to protect their patients during extreme weather-related events.