Climate Communication, Public Health, and Social Media: Examining the Role of Health Agencies in Addressing the Impacts of Climate Change on Human Health

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Abstract

The impacts of climate change on human health are a critical public health concern, with previous studies highlighting its clear effects on well-being. Understanding how state and territorial health agencies (STHAs) are addressing these emerging risks is important. This study conducted 26 in-depth interviews across the U.S. to explore the perceptions and communication strategies of STHA officials regarding climate change’s impact on human health. Additionally, the study sought to identify the primary challenges faced by these officials to effectively communicate the impacts. Thematic analysis of the data revealed three major themes: community building and coalitions, climate denialism on social media, and misinformation about climate change and its effects on human health. These findings offer valuable insights for climate change and public health communication. The importance of the STHAs’ development of technical and informational capacity to effectively communicate climate-related risks and threats is emphasized.

Climate scientists have established the existence of climate change, marked by increasing surface temperatures, melting glaciers, rising sea levels, and heightened climate variability. These drastic variations in global climate patterns have also had an adverse direct and indirect impacts on human health (Frumkin, Hess, Luber, Malilay, & McGeehin, 2008). Under these circumstances, potential consequences of climate change on human health have been extensively studied (Ebi, Mills, Smith, & Grambsch, 2006; Longstreth, 1999). Furthermore, scholars have investigated the role of communication in addressing climate change and its associated health effects (Chadwick, 2016). Communication plays a crucial role in enhancing the preparedness of state and local health systems to effectively respond to the climate disasters (Maibach et al., 2008). Moreover, these same agencies have improved the public’s understanding of climate change associated risks and threats to human health (Villagran, Weathers, Keefe, & Sparks, 2010). Previous research has indicated wide-ranging consequences of climate change including increased illnesses and deaths linked to poor air quality, polluted water, foodborne contamination, and the occurrence of extreme weather patterns which produce high temperatures or heatwaves (Abbasi et al., 2023). How the state and territorial health agencies (STHAs) in the U.S. communicate about this global health threat is, therefore, important.

With over 302 million people in the U.S. using social media every day, it is important to investigate the use of social media by STHAs in measuring and navigating communications to inform the public about the relationship between climate change and human health. Prior research suggests that public health officials recognized the lack of knowledge about these topics within their constituency (Maibach et al., 2008), with almost 80% of SHDs now using social media (Chen & Wang, 2021), it becomes crucial to investigate how they communicate about the health implications of climate change. For this, we conducted 26 interviews with STHA officials responsible for disseminating information, addressing climate misinformation on social media, and informing their local communities about this growing issue. By doing so, this study hopes to make contributions to the fields of climate change communication, health communication, climate misinformation, and social media.

Literature Review

Climate Change Consequences on Human Health

The climate crisis poses a significant threat to human health, manifesting both directly and indirectly through various global repercussions such as frequent heat stress, deteriorating air quality, rising sea levels, and extreme weather events like floods, droughts, earthquakes, volcano eruptions, hurricanes, tornadoes, and tsunamis (Kim, Kabir, & Ara Jahan, 2014). These conditions contribute to the spread of diseases, including diarrhea, vector-borne illnesses, infectious diseases, cardiovascular and respiratory problems, and malnutrition. For instance, Coalson et al. (2021) found an increase in malaria and dengue after extreme floods, highlighting the link between climate events and disease outbreaks. Consequently, extreme weather related diseases will be burned on the healthcare systems, causing potential disruptions and delays in timely care and reduced access to public health services (Muro et al., 2024).

The consequences of the climate crisis are devastating across various age groups, genders, races, and among the elderly. For example, Longstreth (1999) asserts that the elderly face heightened vulnerability to the impacts of the climate crisis due to increased exposure to heatwaves. They are also more vulnerable to extreme storms and floods because of their inability to quickly evacuate and respond to climate stressors or emergencies (Astone & Vaalavuo, 2023). Similarly, lower socio-economic individuals will be disproportionately affected because of low access to healthcare and medical insurance. Individuals with preexisting conditions will especially face heightened sensitivity to heat stress, cerebrovascular, cardiovascular, and respiratory diseases.

Moreover, the variations of pollutant concentration and distribution in the atmosphere poses a significant public health risk. The frequency, for example, of heatwaves mixed with pollution will contribute more to illnesses including heart attacks, dehydration, respiratory diseases, and strokes. Heat stress can exacerbate chronic medical conditions like vascular disease, obesity, skin diseases, hyperthyroidism, respiratory problems, and diabetes, and other associated illnesses. Change in dietary habits and air pollution due to climate change will also increase the risk for cardiovascular disease (Costello et al., 2009). According to Kim et al., (2014), vector-borne diseases such as schistosomiasis, malaria, onchocerciasis, leishmaniasis, filariasis, and plague, as well as diarrheal diseases and cholera, may start to appear more throughout the planet and become more frequent and severe due to climate change. In addition, bad air quality is associated with higher air pollutant levels which may elevate the risk of lung cancer. With the facts and warnings in front of us to the damage of human health if climate change effects are not addressed, comprehensive communication strategies are needed to integrate both environmental and public health considerations. Mishandling the ongoing climate crisis could lead to a dark age for environmental health. To that end, addressing this crisis requires immediate, interdisciplinary, and substantial actions at international, national, and local levels. Health should be at the forefront of communication strategies aimed at mitigating and adapting to the effects of the climate crisis (Maipas & Kavantzas, 2024). The STHAs play a critical role in communicating risks, educating the public, informing diverse audiences (Ittefaq, 2023a, 2023b), and ultimately planning and managing the health impacts of climate change.

Health Agencies, Climate Change, and Health Communication

The adverse impact of climate change on morbidity and mortality have been extensively documented within local communities in the U.S. This has sparked a renewed interest in adaptive measures seriously supported by funding from the Centers for Disease Control and Prevention (CDC) through its Climate-Ready States and Cities Initiative (Errett, Dolan, Hartwell, Vickery, & Hess, 2022). Through this initiative, the CDC is actively providing guidance to state and local health departments to develop, implement, and promote activities geared toward building resilience against the effects of climate change. In response, the STHAs have established climate and health programs covering critical areas including surveillance, interagency coordination, mitigation policies, internal and external education, technical assistance, adaptation implementation, and evaluation (Errett, Dolan, Hartwell, Vickery, & Hess, 2022). Even though the CDC’s initiative has been available for funding purposes, many STHAs engaged in seeking funding and information without the dependency of formal federal dedicated funding (Errett et al., 2023).

Health agencies are adapting to the challenges posed by climate change (see Buse, 2018; Errett et al., 2023; Marinucci, Luber, Uejio, Saha, & Hess, 2014). Previous research emphasized the preparedness of health agencies to implement climate health programming and capacity-building initiatives or just to keep an agency growing. Furthermore, it suggests the necessity for additional training in areas such as vulnerability assessment, health impact assessment, risk assessment, adaptation planning, communication, and the integration of equity (Errett et al., 2023). The STHAs are uniquely positioned to navigate their existing evidence and data to anticipate any climate change impact because it is in their own communities and can be more strategic about prioritizing the immediate needs. However, a study by Bedsworth (2012) suggests that despite 56% of local health officials acknowledging climate change as a serious threat to public health, they face challenges due to insufficient funding and resources to mitigate the risks associated with climate change. These challenges reflect a critical gap on the local level for climate-related health interventions which needs to be addressed effectively.

With global climate change significantly increasing the probability of extreme weather events, it becomes essential for health agencies not only to adapt to these changes but also expertly communicate with the local public (Keim, 2008; Peters et al., 2022). This communication is critical for conveying risks associated with climate change and, more importantly, countering climate-related misinformation on social media. Homophily, polarization, and echo chambers create fertile ground for the spread of misinformation on social media. Moreover, misinformation has been identified as a contributor to climate denial (Treen, Williams, & O’Neill, 2020). Therefore, it is essential that public communication and engagement remain critical to build trust within communities and allow health agencies to play a pivotal role in that messaging. The STHAs have recognized the significance of using social media to disseminate information about climate change. Yet, Albright, Shah, Santodomingo, and Scandlyn (2020) analyzed the types of climate-related content on health agencies’ websites and found while 40% of state health departments provide a clear path to navigate to climate change information, 3.9% of city websites, and only 1.6% of the county offer similar resources. Interestingly, about 48% do not provide any information about the causes of climate change. The study concluded that “these departments must be better supported to facilitate the dissemination of reliable, scientific information about climate change and its effects on health” (Albright et al., 2020, p. 1184). Public health officials acknowledge the impact of climate change on health and express the willingness to be advocates to inform the public on the consequences of climate change on well-being (Hathaway & Maibach, 2018; Kotcher et al., 2021; Luong et al., 2021; Maibach et al., 2008; McKinnon et al., 2022). However, there is insufficient knowledge about the communication and information related challenges they face in their respective jurisdictions. This present study aims to fill these research voids and asks the following research questions:

Research Question 1: How do STHA officials perceive and communicate the impact of climate change on human health?

Research Question 2: What are the key challenges that STHAs face when communicating the impact of climate change on human health?

Method

The study used semi-structured interviews with STHA officials, employing a purposive sampling strategy. The selected participants are involved in developing the climate change initiatives, working with other departments such as the department of environment, partnering with environmental protection agencies, communicating with local populations, and designing programs such as environmental justice, climate adaptation, public engagement, climate change impacts on health, and environmental health. In addition, the author also contacted those who are responsible for managing, posting, and moderating content on social media. The author sent e-mails to various STHAs outlining the project’s objectives, the types of questions that would be asked, and the potential risks associated with the interview process. The author obtained the e-mail addresses from the official websites of the respective STHAs. Initially, the author contacted 32 people in STHAs. However, six declined interview request, citing various reasons such as it not being a priority, being too new to the job to share details, or being occupied with current projects and lacking availability. For the final sample, the author interviewed 26 participants from various states in the U.S.

Interviewees hold diverse roles in their respective STHAs. Table 1 presents participants characteristics. Interviews were conducted via Zoom by the author between August 2023 and November 2023. The interviews ranged from 30 minutes to 55 minutes. The sample included 12 females and 14 males. Instead of participants real names, participant code numbers were used to ensure their anonymity (e.g., P1, P2).

Table 1. Characteristics of sample population

Participant	Age	Gender	Title	State
P1	35	M	Director digital media	Maine
P2	28	F	Community engagement coordinator	Massachusetts
P3	29	F	Director communication office	New Jersey
P4	34	F	Assistant director climate action initiative	New York
P5	40	M	Environmental justice coordinator	Illinois
P6	31	M	Director environmental health program	Indiana
P7	39	M	Media relations manager	California
P8	34	M	Public information officer	Arizona
P9	34	F	Community education officer	Oklahoma
P10	42	M	Director communications	Kansas
P11	37	F	Public relations officer	Colorado
P12	43	M	Environmental epidemiologist	Missouri
P13	32	F	Sustainability program officer	Utah
P14	45	M	Crisis and emergency communicator	Washington
P15	38	M	Environmental health coordinator	Oregon
P16	29	M	Social media manager	Iowa
P17	33	M	Public information officer	Alabama
P18	40	M	Director digital communication	California
P19	39	F	Climate justice coordinator	New Mexico
P20	45	M	Director clean energy	West Virginia
P21	44	M	Online content manager	Texas
P22	41	F	Director environmental health	Montana
P23	38	F	Social media coordinator	Michigan
P24	37	F	Disaster communication officer	Nevada
P25	40	F	Climate action program assistant	Ohio
P26	43	F	Director climate communication	Wisconsin

Analysis Strategy

The author used the constant comparison technique for qualitative data analysis based on grounded theory (Charmaz, 2014; Charmaz & Thornberg, 2021) to develop codes and organize themes related to the perception of STHA officials, their communication on social media related to climate change impact on human health, and the challenges faced by them in sharing information related to climate threats and risks. The constant comparison technique involves six phases: (1) data familiarization, (2) initial coding, (3) comparison, (4) development of categories, (5) refinement, and (6) saturation (Charmaz & Thornberg, 2021). In the first phase, the author familiarizes himself with the data during the interview process and transcriptions and takes notes on how participants expressed their views. During the second phase, initial coding was generated using NVivo 12 with the author coding various participants’ responses to the same question. These codes were shared with the participants to verify their accuracy and to ensure the author captured the essence of their responses effectively. About 15 participants replied to an e-mail requesting them to review the results at this stage. In the third phase, the author compared participants’ responses to identify similarities and differences, while at the same time supervised by one qualitative researcher from the author’s institution. This supervision functioned as secondary coding to review all codes and verify patterns and themes. The comparison process was applied to each participant’s response. During the fourth phase, broad categories were created and illustrative names were given to those categories such as building communities and coalitions. During the fifth refinement stage, the author collaborated with the qualitative researcher, who was well acquainted with the project, to ensure the quality of coding. Finally, in the sixth stage, saturation of themes was achieved after coding responses from the 26 participants. This process was helpful in generating more focused and comprehensive themes. The iterative process of coding and constant comparison allowed for the construction of tightly fitting, focused themes that aligned well with the data (Braun & Clarke, 2021). Data coding was initially done in chronological order during data collection, using NVivo version 12. Below the author discusses each of these three themes.

Results

Building Communities and Coalitions

In this theme, participants noted the proactive efforts of STHAs in building communities and coalitions to address the impacts of climate change on human health. They highlighted the importance of coalition-building in their respective communities. Additionally, they emphasized the need for these coalitions to have a meaningful change in their local communities. For example, an environmental epidemiologist working in the Midwest expressed his perspective as follows:

The nature of my work demands extensive information sharing and collaboration across various departments, communities, and individuals. I collaborate closely with the energy and water departments, major employers in the state, diverse communities, as well as universities and think tanks. Given the urgency of the climate crisis, I know that it is not a challenge that my department alone can address. (P24)

A participant working in the sustainability program in the health department, emphasized the undeniable nature of the impact of climate change on human health, stating that people have witnessed these effects firsthand. She stressed the importance of collaboration with stakeholders as the key to addressing these challenges effectively. She shared her thoughts:

My [department] prioritizes fostering collaboration and uniting people and institutions to address this multifaceted issue [climate change] collectively. Over the past five years [2019–2024], my department has acknowledged the necessity of partnering with others to enact substantial change in our community. Without the cooperation of all stakeholders, establishing meaningful relationships becomes increasingly challenging. People have seen the consequences of the climate crisis; most of them if not all. (P13)

During an interview, a communication official from the Northeast noted the importance of stakeholder engagement in following words:

Stakeholder engagement is crucial, considering the abundance of non-profit organizations (NGOs), businesses, and advocacy groups dedicated to the cause. In our area [Maine], we have a vibrant community deeply concerned about how climate change is impacting water quality and aquatic life. I mean people harbor various concerns and are eager to contribute to society. Therefore, building coalitions is imperative, as these stakeholders have a wealth of resources and expertise to offer. (P21)

One participant who is involved with the climate justice program in the Department of Environmental Quality in the Southeast, highlighted their department’s recent initiative on climate justice. They emphasized active collaboration with a local NGO that has been dedicated to this issue for over a decade.

We have recently established a coalition called “equity approach to climate change” thanks to a grant from the state. This initiative has strengthened our relationship with the community significantly. Our aim is to develop an equitable approach to environmental health, leveraging expertise from climate scientists, social activists, local media, and NGOs to effectively communicate the consequences of climate change on well-being. While we are relatively new to this program, our focus is on fostering long-term relationships as we continue to grow and evolve. (P10)

An interviewee who manages social media communication about an environmental health program highlighted the barriers inherent in constructing online communities and fostering collaborations, and further emphasized:

You know, as a government institution, we encounter distinctive challenges regarding public perception. There’s a prevailing sentiment of distrust toward us, fueled in part by the proliferation of misinformation, particularly about climate change and its societal implications, on various social media platforms. Consequently, this skepticism significantly impedes our efforts to cultivate online communities and engage with the public effectively through social media. (P19)

Similar sentiments were echoed by a program coordinator, who has dedicated the last decade to environmental health initiatives in the West. Despite the challenges, she holds a somewhat more optimistic view about the evolving public perception of climate change impact on human health. She contributed:

I would say that since I took on this position, there has been a significant shift, at least in my state. Previously, those who held this role expressed hesitancy about using the term “climate change” in social media posts to avoid potential conflicts. I understand their caution. However, now we actively use this term and encounter less resistance. I attribute this change to the fact that residents in impoverished neighborhoods have directly witnessed the consequences of climate change. While the situation is still far from ideal, there has been some improvement since I assumed this role. I mean, engaging in conversations on social media remains challenging, primarily due to climate denial and polarization. (P2)

Overall, participants reveal their proactive approach in seeking ways to build communities and coalitions to effectively communicate climate risks to local populations. Participants perceive these collaborations significant and are actively engaged in developing and implementing climate change programs in their health agencies. While they recognize the resources available in their jurisdictions, STHAs are adapting to these changes and are relatively new to this domain. Indeed, as indicated by several participants, forming online communities poses its own challenges. Participants emphasized the significance of building coalitions and communities. However, they did not elaborate on the specific strategies they use to form these coalitions.

Addressing Climate Denialism on Social Media

Many interviewees pointed to the importance of social media in climate conversations. However, three major categories were revealed during the interviews with participants: personal attacks, abstract nature of science, and engagement with climate deniers. For example, a participant noted:

In my view, many fail to grasp the essence of our work. Our department frequently faces attacks on social media, with users alleging that we are part of a broader leftist agenda and vehemently denying the reality of climate change. It’s disheartening to witness the stark division between our shared humanity and the polarizing discourse prevalent on social platforms. For instance, our Facebook comment section is inundated with climate deniers, persistently sharing links in response to our posts addressing the health risks associated with climate change. (P25)

A social media manager from the Midwest who manages a social media page for an environmental health division said:

Recently, someone on social media accused our director of receiving funds from climate advocacy groups in exchange for speaking out against oil and gas companies. Despite our efforts to clarify our mission, funding sources, and program details, our explanations were met with denial. It’s understandable to an extent; we operate as a small department in a rural community, where the complexities of climate science and its impacts on human health may not be fully comprehended. However, the level of hostility directed toward our team, including allegations of corruption, is demoralizing. (P4)

Local health and environmental departments play a critical role during crises and emergencies. In this regard, a participant from the emergency preparedness and response team from the West observed that despite their efforts in planning and executing emergency responses during hurricanes and floods, there has been increase in the community’s vulnerability to climate change impacts over the past decade. She emphasized that the abstract nature of science, along with obstructionist actors, contributes to spreading skepticism about climate change. She commented:

I think climate skepticism and denial often stem from obstructive actors. However, nowadays, explaining scientific concepts to laypeople who may not fully comprehend the complexities of the science presents a significant challenge. I am not blaming them; rather, I understand why laypeople may struggle to grasp how the science works. In rural Southern America, distrust in government departments, limited connectivity, and a lack of literacy in climate and health exacerbate these difficulties. Consequently, social media has become a platform where individuals can freely express their opinions, regardless of their accuracy or authenticity. (P1)

Some participants highlighted the problems in addressing the climate denialism on social media. For instance, an information officer from a state health department located in Southeast shared the challenges of his department. He noted:

We are committed to addressing climate denial and educating people on climate change and its consequences on human health. However, we are constrained by social, political, cultural, legal, and financial limitations. While I can dedicate some time each day to addressing climate change and health issues, the challenge lies in being the sole member of the department. I often feel reluctant in engaging with social media users due to my perceived lack of expertise. Honestly, handling these conversations effectively remains a puzzle as I’ve never received formal training on social media communication. I’m wary of inadvertently exacerbating the issue rather than resolving it. (P17)

To engage with climate deniers on social media, the director of communications from the West shared his strategies. He noted:

I tend to avoid direct engagement with individuals who share links to websites containing anti-science content. Instead, I use social media listening to gauge the traction of such posts. If they don’t gain much attention, I refrain from intervening immediately. Instead, I wait and post a debunking response with evidence about a week later. This approach allows me to address denial while also educating others. I find it more effective than engaging directly with deniers. (P7)

Misinformation Related to Climate Change and Its Effects on Health

All participants have seen misinformation about climate change on social media, particularly regarding its impact on human health. They have identified various contributing factors for the prevalence of misinformation on social media. Furthermore, they have collectively shared their experiences in addressing and correcting misinformation related to climate risks. For instance, a participant noted:

It’s unfortunate, but I think much of the misinformation stems from a lack of experience or a resistance to change. People often hold onto their beliefs, even when they are wrong, and sometimes spread lies to justify them. I have been trying to correct misinformation on social media, but it is overwhelming. (P15)

Another participant presented a unique approach to addressing misinformation on social media, emphasizing the importance of “social media listening.” This method entails actively monitoring conversations and trends on social media platforms to gain a deeper understanding of the misinformation circulating and to efficiently counter it with accurate information. She noted:

I lead a three-member team; my assistant monitors social media conversations about climate change and its impact on human health. When we notice recurring topics, we create infographics or host live conversations with experts on Facebook. Due to our government affiliation, we refrain from directly engaging with such posts. (P14)

Some participants shared their challenges in engaging with people who share misinformation on social media. They mentioned “lack of capacity” and noted that correcting misinformation is not a “priority” for many STHAs. This has resulted in fewer staff members working in communication in general, and social media in particular. For example, a participant working on a clean energy transition program highlighted these issues:

I think many STHAs recognize the importance of social media communication. However, they often face resource scarcity or lack the capacity to develop comprehensive communication programs for educating people about clean energy or correcting misinformation. In my five years’ experience, I think officials in environment, health, and energy departments tend to prioritize building offline communities over online presence, leading to a lack of resources allocated to social media communication. (P26)

Another participant, a director of content management, shared similar sentiments.

For us, social media is a lifeline because it’s how we communicate our message to local communities. We use relevant hashtags to promote our posts but are cautious about using tax money for sponsored content. Our legal and financial team advises against paying for social media promotion related to climate, health, or other issues or delete content which contain falsehoods. However, we prioritize making connections and engaging in dialogue, especially in posts containing misinformation, although it’s not our highest priority. (P16)

During COVID-19, it became evident that misinformation spreads rapidly on social media, where people consume information and engage with each other. While STHAs are trusted sources of information, many people turn to less reliable sources. This was illustrated by a director of an environmental health division. She noted:

I believe there are many individuals who trust social media more than they trust official sources, which is problematic. Platforms like Facebook contain a lot of misinformation about topics such as climate, health, and politics. Our strategy is to provide accurate and timely information to counter this trend. I think this is one way we can combat misinformation effectively on social media.

The participants shared strategies, challenges, reasons, and motivations for addressing misinformation on social media regarding climate change and its impact on human health. Their insights highlighted the need for substantial resources, coordinated efforts, and thoughtful approaches to effectively address this issue within local communities. Additionally, they acknowledged that misinformation is a significant challenge, and STHAs are actively working to educate people about climate risks.

Discussion

This study explored the perspectives of officials in STHAs regarding their use of social media to share information about climate change and its impact on human health. It also sought to understand the challenges they encounter in this context and how they address misinformation online. While the importance of social media in disseminating information about climate change has increasingly grown, there is limited research on how STHAs leverage social media to foster community engagement.

This study found that STHA officials are seeking collaborations and coalitions between them and other local entities which presents both challenges and opportunities. The collaboration harnessed the symbolic capital of the STHAs, along with the social capital and networks of local NGOs, media, advocacy groups, businesses, and individuals to actively engage communities offline. Through coalitions and collaborations, numerous opportunities abound when viewed through Bourdieu’s conceptualization of social capital (Watkins et al., 2023). Bourdieu defines social capital as “the sum of the resources, whether tangible or intangible, that accrue to individuals or groups by virtue of possessing a durable network of more or less institutionalized relationships of mutual acquaintance and recognition” (Bourdieu, 2018, p. 119). This capital encompasses various forms, including social, economic, and symbolic. The STHAs stand as recognized authorities, embodying symbolic capital, which is the manifestation of legitimacy in various forms of capital (Bourdieu, 1987). Therefore, by collaborating, STHAs contribute symbolic capital, while other local groups and entities bring social capital to the table. Indeed, building online networks and communities is a challenge. This study showed STHAs efforts and unique challenges in their constituencies not only in advocating for climate change but also for climate skepticism on social media.

These findings are consistent with previous research, such as Maibach et al. (2008), which reported that 70% of local health officials perceive their jurisdictions to have experienced climate change in the last 20 years. Almost all participants not only acknowledged the existence of climate change but also recognized its impact on human health. Other studies have highlighted that STHAs are concerned about non–vector-borne and vector-borne infectious diseases, extreme heat events, and natural hazards (Errett et al., 2023).

Many participants noted the challenge of building online communities due to climate denial and skepticism. Engaging with social media users on polarized issues such as climate change has become increasingly difficult, with an abundance of misinformation and climate denial prevalent on these platforms. Therefore, designing messages around the health impacts of climate change to build public support is essential (Campbell, Uppalapati, Kotcher, & Maibach, 2023), STHA officials find this task nearly impossible given the prevalence of misinformation and climate denial.

The STHAs are viewed as credible sources of information and are interested in engaging the public in climate discourse through social media. However, barriers such as time constraints, limited human resources, and legal issues related to correcting misinformation hinder their efforts. In these endeavors, the trusted messenger hypothesis (Ittefaq, 2023b) can be helpful as it suggests the potential of health professionals in engaging to address climate change as a public health problem (Campbell et al., 2023).

Building coalitions and partnerships to enhance the capacity of STHAs requires several key actions, as highlighted by participants. These include conducting training sessions, enhancing knowledge, increasing staffing levels, and providing informational support. These aspects are crucial for their job and are essential for improving their engagement with people and making their systems more resilient. The STHAs require substantial support to enhance their engagement with communities and improve their resilience to climate disasters. This support should include programs to enhance their technical and informational capacities, investment in new initiatives such as climate justice, and the identification of opportunities for their well-being (Errett et al., 2023). Currently, only a few STHAs have comprehensive information about climate change (Errett et al., 2023). The adaptation is challenging, and they sometimes hesitate to respond to inquiries on social media because they lack the expertise to address complex questions about the consequences of climate change on human health. Addressing these gaps in expertise and capacity is essential for STHAs to effectively respond to the challenges posed by climate change.

The complex nature of human-caused climate change and the uncertainties regarding its risks pose challenges for laypersons in understanding its causes, impacts, and potential solutions, which can hinder their ability to act. Organized disinformation campaigns on social media have contributed to increased skepticism and denial of climate change (Dunlap, 2013). Participants in this study expressed concerns that climate denialism is hindering their efforts, and they feel ill-equipped to address it. Climate deniers have targeted STHA officials, blaming and attacking them on social media, leading to increased hostility and challenges in countering misinformation. While climate deniers previously influenced public discourse through alternative media (Vowles & Hultman, 2021), they have now shifted to using social media to attack organizations and individuals. Many individuals on social media distribute messages that align with the interests of corporations, including asserting that fossil fuels are beneficial for society, often using questionable data to support their claims. Climate obstruction actors employ tactics such as science denial and climate skepticism to promote their agenda (Holder, Mirza, Ngo-Lee, Carbone, & McKie, 2023). Participants refrain from directly engaging with social media users to avoid hostility, and some feel they lack the expertise and formal training needed to effectively address misinformation and climate denial. Climate discourses on social media are often highly politicized, calling for action, criticizing administrations, highlighting negative future scenarios, and engaging in controversial debates over the reality of climate change (Meyer, Peach, Guenther, Kedar, & Bruggemann, 2023).

When communicating about the risks of climate change, it is crucial to craft messages that inspire constructive engagement on social media and encourage wise policy choices (Frumkin et al., 2008). However, there is a growing recognition that social media presents opportunities for STHAs to engage with the public in innovative ways, requiring them to adopt a more social approach. While social media is often seen as a platform for spreading misinformation, there is evidence to suggest that it can also serve as a valuable tool for promoting health literacy (Watkins et al., 2023). Participants expressed concerns about the spread of misinformation, conspiracy theories, and climate denialism on social media. They emphasized the significance of social media in educating the public about the health risks associated with climate change. While some participants mentioned strategies like “social media listening” to address misinformation, they also expressed uncertainty about the most effective practices for combating it. Additionally, many noted a lack of resources available to address misinformation related to climate change. These findings are significant as research suggest effective communication is the key when informing and educating people on climate change and its effects on human health (Frumkin et al., 2008). Risk communication frameworks should be applied, especially in high-stress, high-concern, and controversial situations, such as discussions about the consequences of climate change on public health. Effective risk communication is characterized by two-way interaction that aims to establish credibility, trust, knowledge, and cooperation in addressing the issue. Participants in this study emphasized the importance of seeking the cooperation of community partners to establish credibility.

Climate change has evolved into a political battleground, necessitating political initiatives to tackle the climate crisis through negotiations and policy implementation. Achieving climate cooperation has become increasingly challenging (Bernauer, 2013). In this study, participants hailed from diverse states across the US, each embedded within its unique political landscape. For example, states governed by Republicans may espouse different climate-related policies compared to those led by Democrats. Similarly, the reception of trolling or climate denial on social media may vary across states due to their distinct political climates. While participants in this study did not explicitly highlight how the political environment disrupts their day-to-day work, there were passive mentions, particularly from participants in the Midwest. They indicated that their communities perceive climate change and its impacts differently compared to many other parts of the US. This suggests that the political climate indirectly influences their work dynamics, potentially shaping attitudes and responses toward climate-related issues in their respective regions.

Limitations and Future Research

This study has several limitations. First, many STHAs are at the nascent stage of implementing initiatives related to climate change and health. Consequently, they exhibited some hesitancy in providing expert insights during interviews, as their departments are still navigating this new terrain. Second, a majority of the participants are based in the Northeast region and primarily handle external communications for their departments. While they demonstrate active engagement with audiences, they may possess limited technical knowledge regarding climate change and its implications for human health. Nonetheless, it’s worth acknowledging their efforts amidst the prevalent polarization about this issue. Lastly, certain interview questions may have lacked clarity, potentially hindering participants from providing comprehensive responses. Consequently, this may have led to the loss of meaning or unequal representation of voices within the data.

Conclusion

This study has documented the perspectives of STHA officials regarding the impact of climate change on human health. The responses from participants indicate that STHAs are currently adapting to new changes in their respective regions. However, they are facing challenges such as limited capacity, misinformation, and climate denial. The positive news is that STHA officials are eager to overcome these challenges and are strong advocates for more sustainable futures. To fully implement their programs, they are seeking effective collaborative approaches to build online communities.

Acknowledgements

The author extend his sincere appreciation to Dr. Leigh Nelson for providing insightful feedback on a previous version of this manuscript.

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.