Climate migration and health system preparedness in the United States

Every country will have to prepare for climate change. Despite obvious risks to national security in terms of safety, food, and infrastructure as well as impending economic losses, countries like the United States (US) have declined to pursue meaningful federal action. The human impact of climate change – specifically climate migration and its health implications – has been largely neglected at a policy level. Yet climate migration is predicted to have tremendous consequences for people in the next 30 years and beyond, and with it comes a host of difficulties – political, cultural, economic, and structural. Preparedness will be of great importance to potential migrants and how they adapt to their receiving (host) locations. Health systems are one of the most significant institutions impacting long-term migration and these systems’ strengths and weaknesses will determine the integration and well-being of migrants for years to come. A critical analysis of existing literature exposes that there is little current research on health system preparedness as it relates to climate migration, especially in the US. To help address this gap, this paper focuses on how the American health system, already fraught with limitations, can prepare for the expected increase in mostly internal migrants in the face of climate change.Key policy insights Climate migration in the US will pose huge challenges for health systems because of the American health system’s unique, pre-existing weaknesses.To prepare for climate migration, federal, state, local, tribal, and territorial governments should focus on adopting a universal healthcare policy, shifting primary care tasks away from physicians and towards other qualified and more ubiquitous professionals, and investing in telemedicine, retail clinics, and a national electronic health record system.A ‘health in all policies’ approach, which applies a health lens to legislation, needs to be applied in the context of health system strengthening for climate migration since countless environmental determinants of health and infrastructural decisions shape the vulnerability of communities.