PROJECT SUMMARY The science is overwhelming that our planet is changing, and these climatic changes are exerting catastrophic pressures on local communities, with little time to reverse course. In the US, climatic variability and associated changes in weather patterns are creating new health risks and exacerbating existing health disparities in overburdened communities across the Nation. Local health departments and health care systems are front line defenders of the population’s health and play a key role in a community’s resilience to climate change. Yet climate-related health threats are not currently prioritized in local or regional community health assessment efforts, particularly in rural areas like Southern Appalachia. Partnerships between hospital, public health, community members, and environmental health scientists are often underutilized channels in examining the health impact of climate change as an environmental determinant that works independently and jointly with other social determinants to amplify local health risks. The overarching goal of this community-driven project is to integrate climate change impacts into a regional health assessment framework to enhance the capacity of local public health systems to protect the health of rural communities. We will achieve the following specific aims: Aim 1. Integrate climate change data into the regional community health assessment and examine climate sensitivities in priority health concerns; Aim 2. Engage regional hospitals, public health departments, and community members in the co-design of visual storytelling of local climate and health priorities; and Aim 3. Co-design targeted communication messaging to advance awareness on regional climate impacts on health. Our expected outcomes will include the: (1) integration of climate data into a regional community health assessment planning process; (2) identification intrinsic rural community health networks that will inspire commitment and foster capacity for community-wide participation in present and future climate resilience planning; and (3) targeted communication trainings and public health messaging to advance awareness on current and future climate impacts in the region. This work has the potential to be transformative to the field by providing a public health model for integrating climate change impacts in a regional community health assessment process for rural and historically marginalized communities. The long- term goal is to advance a national model that demonstrates the identification, prioritization, and implementation strategies to help communities address climate change impacts on health. This project will leverage WNC Health Impact, a partnership and coordinated process in existence for over a decade, to engage hospitals, public health agencies, and key regional partners in a 16-county region in rural Appalachia around a vision of improved community health. Results will address a well-cited research need from the NIH Cl...