A Research Agenda to Protect Human Health and Build Resilience in the Face of a Changing Climate (2025)
Chapter: FOREWORD
FOREWORD
Less than a year after I joined Kaiser Permanente, our Santa Rosa Medical Center in California was evacuated in the face of catastrophic wildfires. Two years later, it happened again. In a city of 200,000 residents, 22 people were killed in the fires, 3,000 homes were lost, and more than $10 billion in property was destroyed. What once seemed like an outlier has become the new normal. Not a single location where we work—from Hawaii to Georgia—has been immune to extreme weather conditions. Climate-driven events, ranging from wildfires and heatwaves to drought and flooding, have devastated our communities and made it harder for people to be healthy.
Beyond the immediate threats these events pose, as health care providers we see the lingering effects on people’s health and well-being through displacement, respiratory diseases, stress, anxiety, and economic burden.
Health systems have an important role to play in addressing the mounting climate-related health needs communities face. As the demand for treatment swells, the supply chains, facilities, and human resources that fuel health care will struggle to keep pace. In the face of these risks to our sector and to the people who rely on it, we must ready our operations and re-imagine how, when, and where people get care.
We cannot do that effectively or efficiently without research.
When we have the right information, we can anticipate who will be affected the most and plan for ways to help them. We can also understand the immediate and long-term effects on the people we treat in our clinics and hospitals.
Kaiser Permanente is grateful to the National Academy of Medicine for building and expanding the evidence base of effective solutions to prevent and adapt to the health threats posed by climate change and to inform future investments in research, strategies, and policies. As we look ahead and navigate uncertainty, our commitment to understanding our evolving environment must remain constant.
We have already seen the value the types of preparation research can inform. Communities in Denver have responded to poor air quality caused by pollution and wildfire smoke with monitoring tools deployed at health clinics and schools that allow residents to make decisions based on hyperlocal conditions (City and County of Denver 2025). Kaiser Permanente has developed online resources about how to protect health before, during, and after major climate events, and proactively provides to at-risk populations. These interventions were informed by existing research, and their results will contribute to future efforts.
The right research can show us not only that this is possible but also narrow in on what strategies to pursue. Research in Europe estimates that heat-related deaths last year were 80% lower than they would have been because of adaptations implemented in the last two decades (Gallo et al. 2024). We have an opportunity to set the same pace of progress in the next 20 years.
The most successful health care systems are the ones that put patient outcomes first. The ones that invest wisely in communities and prevention so that their patients do not need emergency treatment. The ones that look beyond what is happening within the hospital walls to understand where health problems truly begin. And they are the ones that have the research needed to guide their actions.
Bechara Choucair, MD
Executive Vice President and Chief Health Officer
Kaiser Permanente
