• Paul B English, Amber H Sinclair, Zev Ross, Henry Anderson, Vicki Boothe, Christine Davis, Kristie Ebi, Betsy Kagey, Kristen Malecki, Rebecca Shultz, and Erin Simms.
• Center for Chronic Disease Prevention and Health Promotion, California Department of Public Health, Richmond, California 94804, USA. penglish@dhs.ca.gov.
• Environ. Health Perspect. 2009 Nov 1; 117 (11): 1673-81.

ObjectiveTo develop public health adaptation strategies and to project the impacts of climate change on human health, indicators of vulnerability and preparedness along with accurate surveillance data on climate-sensitive health outcomes are needed. We researched and developed environmental health indicators for inputs into human health vulnerability assessments for climate change and to propose public health preventative actions.Data SourcesWe conducted a review of the scientific literature to identify outcomes and actions that were related to climate change. Data sources included governmental and nongovernmental agencies and the published literature.Data ExtractionSources were identified and assessed for completeness, usability, and accuracy. Priority was then given to identifying longitudinal data sets that were applicable at the state and community level.Data SynthesisWe present a list of surveillance indicators for practitioners and policy makers that include climate-sensitive health outcomes and environmental and vulnerability indicators, as well as mitigation, adaptation, and policy indicators of climate change.ConclusionsA review of environmental health indicators for climate change shows that data exist for many of these measures, but more evaluation of their sensitivity and usefulness is needed. Further attention is necessary to increase data quality and availability and to develop new surveillance databases, especially for climate-sensitive morbidity.

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