Project Abstract - Overall The burden of climate change is of particular concern to American Indian, rural, and agricultural populations. While a considerable amount of research has evaluated climate effects in urban and coastal populations, largely due to more abundant data, less is available for rural populations, where there are persistent healthcare inequities and deficient health infrastructure. Additionally, the lack of comprehensive health outcomes data at a population level has limited the evaluation of climate factors such as extreme weather, air pollution, and drought in specific vulnerable groups that are difficult to identify. The burden of climate change is of particular concern to American Indian persons. The historical systematic destruction of their communities and cultural connection to natural systems creating a condition of ecological grief, i.e., grief due to loss or deterioration of land, is believed to be linked to mental health conditions, substance use, obesity, and chronic health conditions. This project will establish the Mni Sota Center for Climate Change and Health (M3CH). Mni Sota is the Dakota word for ‘where the waters reflect the sky’, which well describes the Upper Midwest. The long-term objective of the Mni Sota Center for Climate Change and Health is to be a leading research enterprise to characterize health impacts related to climate change and translate findings to create practical and actionable measures for climate change adaptation with a specific focus on American Indian and rural communities. The objective of this proposal is to develop regional climate and health research capacity through the M3CH by leveraging the multidisciplinary assets of the University of Minnesota, partner institutions, and communities to create actionable knowledge for addressing the health impacts of a changing climate in the Upper Midwest. The primary focus of the proposed center is to develop capacity to address the impacts of climate change experienced by American Indian persons and people living in rural areas with an emphasis on populations in the Mni Sota region. The Specific Aims of the proposed center are to; 1) Leverage multidisciplinary expertise and partnerships to build regional capacity for research on climate change and health that aligns with the priorities of target communities. 2)Establish a Community Engagement Core to co-develop a research agenda with American Indian and rural communities that will guide future research using novel and existing data while following culturally safe research practices. 3)Support a research project that will develop climate change and health research capacity using a novel data resource based on a multi-system electronic health records consortium to evaluate the effects of extreme weather events in at risk communities and specifically American Indian and rural populations. 4)Establish a Pilot Project and Emerging Issues program that identifies and responds to stakeholder prioritie...