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Peer-reviewedCC BY 4.0BMC Public Health

How are local authorities responding to climate change and health impacts? a policy document analysis of four England regions

  • Turner GA1,2
  • O’Connor L1
  • O’Connell E2
  • Coleman PC1,3
  • Sharma-Waddington H1,4
  • Hajat S1,2
  • Kovats RS1,2
4 affiliations
  1. 1NIHR Health Protection Research Unit in Climate Change and Health Security, 15-17 Tavistock Place, St Pancras, London, WC1H 9SH UK
  2. 2Department of Public Health, Environment and Society, London School of Hygiene and Tropical Medicine, London, UK
  3. 3Extreme Events and Health Protection, UK Health Security Agency, London, UK
  4. 4Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
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Abstract

Background: Climate change poses growing risks to population health. In England, local authorities can influence key determinants of climate-related health outcomes through responsibilities for housing, transport, environmental protection and public health. However, climate mitigation and adaptation are not statutory duties, and there is limited evidence on how climate and public health objectives are integrated across local policy frameworks.

Aim: This study reviews local authority policy documents across English local governments, examining how they incorporate public health objectives within climate-related strategies, align policies across multiple policy domains and address health inequalities.

Methods: We conducted a qualitative content analysis of 129 publicly available policy documents from 12 local authorities across four regions of England. Documents were identified through structured web searches and analysed using an a priori conceptual framework covering mitigation, adaptation, population health, environmental exposures and sectoral policy domains, vulnerability and inequality, and interventions.

Results: Policy documents included a wide range of interventions, particularly in transport, housing energy efficiency and urban greenspace. Public health was rarely articulated as a primary objective and was more commonly framed as a co-benefit. Cross-sectoral alignment varied between policy domains, with stronger integration observed in active travel, housing retrofit, greenspace access and quality as well as flood resilience strategies. Air quality and transport strategies most clearly linked climate and health objectives, while food, greenspace and health and wellbeing strategies often did so implicitly. No authority had a standalone heat strategy, although heat-related actions appeared across multiple policy documents.

Conclusion: Local authorities are implementing many interventions with potential public health benefits, but explicit integration of public health objectives within local climate policy frameworks remains variable. Stronger cross-sectoral coordination, clearer public health framing, and improved monitoring may help maximise health co-benefits and reduce climate-related health inequalities.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12889-026-28752-9.

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Cite

BibTeXRIS
BibTeX
@article{turner2026local,
  title = {{How are local authorities responding to climate change and health impacts? a policy document analysis of four England regions}},
  author = {Turner GA and O’Connor L and O’Connell E and Coleman PC and Sharma-Waddington H and Hajat S and Kovats RS},
  journal = {BMC Public Health},
  year = {2026},
  month = jul,
  doi = {10.1186/s12889-026-28752-9},
  url = {https://doi.org/10.1186/s12889-026-28752-9},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - How are local authorities responding to climate change and health impacts? a policy document analysis of four England regions
AU  - Turner GA
AU  - O’Connor L
AU  - O’Connell E
AU  - Coleman PC
AU  - Sharma-Waddington H
AU  - Hajat S
AU  - Kovats RS
PY  - 2026
DA  - 2026/07/01
JO  - BMC Public Health
DO  - 10.1186/s12889-026-28752-9
UR  - https://doi.org/10.1186/s12889-026-28752-9
AB  - Background: Climate change poses growing risks to population health. In England, local authorities can influence key determinants of climate-related health outcomes through responsibilities for housing, transport, environmental protection and public health. However, climate mitigation and adaptation are not statutory duties, and there is limited evidence on how climate and public health objectives are integrated across local policy frameworks.  Aim: This study reviews local authority policy documents across English local governments, examining how they incorporate public health objectives within climate-related strategies, align policies across multiple policy domains and address health inequalities.  Methods: We conducted a qualitative content analysis of 129 publicly available policy documents from 12 local authorities across four regions of England. Documents were identified through structured web searches and analysed using an a priori conceptual framework covering mitigation, adaptation, population health, environmental exposures and sectoral policy domains, vulnerability and inequality, and interventions.  Results: Policy documents included a wide range of interventions, particularly in transport, housing energy efficiency and urban greenspace. Public health was rarely articulated as a primary objective and was more commonly framed as a co-benefit. Cross-sectoral alignment varied between policy domains, with stronger integration observed in active travel, housing retrofit, greenspace access and quality as well as flood resilience strategies. Air quality and transport strategies most clearly linked climate and health objectives, while food, greenspace and health and wellbeing strategies often did so implicitly. No authority had a standalone heat strategy, although heat-related actions appeared across multiple policy documents.  Conclusion: Local authorities are implementing many interventions with potential public health benefits, but explicit integration of public health objectives within local climate policy frameworks remains variable. Stronger cross-sectoral coordination, clearer public health framing, and improved monitoring may help maximise health co-benefits and reduce climate-related health inequalities.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12889-026-28752-9.
SN  - 1471-2458
ER  -