1. An Integrated Information System ……..Informs early warning to early action The systematic collection and analysis of relevant information about and coming from areas of impending risk that: (a)Inform the development of strategic responses to anticipate risks and opportunities and their evolution; and (b)Communicate options to critical actors for the purposes of decision- making and response US GEO Proposal for Integrated Information Systems for Health

2. An Integrated Information System Mutual priorities, resource dependencies and responsibilities Observations, Monitoring & Prediction: Interdisciplinary research, applications, and assessments: Communication and Outreach: Integrated Information Systems: Preparedness and Resilience Engaging Preparedness & Adaptation Communities:

3. Components of a Cholera Early Warning System Population Demographics, Transportation and Migration Epidemiological Surveillance Disease Watch Early Warning Risk Analysis, Vulnerability Assessment Response Strategy Communication and Action Evaluation and Feedback Ocean, Climate and Environmental Observation, Monitoring and Forecasts PredictiveModels Social and Behavioral Factors AdditionalSampling,Sensing Expert Assessment Trtanj, J., J Davis and T. Collier 2013

4. Extreme heat events will be more frequent and more intense in the future (IPCC) Collaboration among climate and public health communities defines demand and enables use of Heat Health forecasts and other information research, earth observations, prediction, and communication capabilities underpin NIHHIS – from weather to climate time scales In the US, NOAA CPO, NWS, NCEI- Partnering with Centers for Disease Control (NIH, USDA) Summit held in October 2014, International Workshop July 2015 Building Integrated Health Health Information Systems To provide a suite of decision support services that better serve public health needs to prepare and respond The US is starting to build the National Integrated Heat Health Information System—weaving together existing pieces, identifying gaps and filling them

5. Components of a National Integrated Heat Health Information System Impacts and Assessments Monitoring, Observation, and Forecasting Planning and PreparednessCommunication and Outreach INTEGRATED INFORMATION Integrated Information

6. NOAA sustains engagement between climate and public health communities to identify needs, develop solutions, and inform decisions. A National Integrated Heat Health Information System NOAA’s research programs and expertise help the nation understand, anticipate and respond to increased heat waves and heat-related events Define Demand RISA and Heat Health In New York City: www.CCRUN.orgwww.CCRUN.org In North Carolina: www.CISA.SC.eduwww.CISA.SC.edu In Arizona: www.CLIMAS.arizona.eduwww.CLIMAS.arizona.edu CDC Climate and Health Program: www.CDC.gov/climateandhealth www.CDC.gov/climateandhealth Crafting an integrated information system INTEGRATED INFORMATION Impacts and Assessments Monitoring, Observation, and Forecasting Planning and Preparedness Improve Forecasts NOAA works to improve current heat forecasts based on user need and to extend heat projections from weeks to months and beyond. Climate Variability & Predictability Program (CVP): bit.ly/AboutCVP bit.ly/AboutCVP Modeling, Analysis, Predictions, & Projections Program (MAPP): bit.ly/MAPPprojectsbit.ly/MAPPprojects Madden-Julian Oscillation: bit.ly/MJOandTempbit.ly/MJOandTemp Climate Prediction Center Temperature Outlooks: www.CPC.NCEP.NOAA.gov www.CPC.NCEP.NOAA.gov NOAA works to sustain observations that support improved understanding of the role of climate on extreme heat and enhance operational efforts. Observe & Monitor Climate Observations and Monitoring (COM): bit.ly/ClimateObs bit.ly/ClimateObs CDC National Environmental Public Health Tracking Program: bit.ly/CDC-NEHTP bit.ly/CDC-NEHTP Understand & Communicate U.S. Climate Resilience Toolkit and Human Health: toolkit.climate.gov/topics/human-health toolkit.climate.gov/topics/human-health Regional Integrated Sciences and Assessment (RISA): bit.ly/CPORISA bit.ly/CPORISA Coastal and Ocean Climate Applications Program (COCA): bit.ly/CPO-COCAbit.ly/CPO-COCA NOAA research enhances understanding and impact of extreme heat events across time scales, builds capacity across climate and public health communities, and develops timely and accessible communication tools to inform preparedness and adaptation. To make the best decisions, stakeholders need access to more than just one piece of the puzzle. Integrated Information Systems are designed to evolve over time, offer opportunities for diverse participation, and integrate what we learn through practice. Communication and Outreach

7. GFCS Approach: Core Pillars and Initial Priority Areas Food Security/Agriculture Disaster Risk Reduction Human Health Water Resources

8. Workshop on the Development of Climate Services for Heat Health Information Systems: Assessing Knowledge, Needs and the Path Forward July 28-30, 2015 Chicago, Illinois Goal: To explore lessons learned and best practices in order to develop a climate services pathway for Integrated Heat Health Information Systems –characterizing prediction parameters and effectiveness of existing heat health early warning systems; –understanding heat exposure outcomes across seasonal to decadal timescales; –identifying useful methodologies for producing, issuing and communicating warnings and alerts and their potential for use on climate time scales. Deutscher Wetterdienst (DWD), NOAA (NWS/CSD, CPC, NESDIS/NCEI, OAR/CPO), CDC, WMO, Global Framework on Climate Services (GFCS) Deutscher Wetterdienst (DWD), NOAA (NWS/CSD, CPC, NESDIS/NCEI, OAR/CPO), CDC, WMO, Global Framework on Climate Services (GFCS)

9. Other Ideas for Health Focus Area Stronger integration with Water team Malaria Model Intercomparison Links to Disaster community and be a resource for coordination for information during disasters—but not turning into Incident Command structure! Facilitating climate training for health professionals with GFCS Strengthen connections with SERVIR Leverage GEOSS Americas for health Reinvigorate CoP

10. NOAA-CDC Heat Health Summit Silver Spring, MD – October 28-30, 2014 Participants –NOAA, CDC, OSHA, EPA, and DOE; state and local health departments; and NOAA funded cooperative science centers, Health Canada, Environment Canada, and the International Association for Urban Climate Discussions –Understanding decision making contexts – health decisions on preparedness and response, and the Weather Forecast Office decision making process to issue a heat Watch, Warning or Advisory –Data availability and compatibility – need for better access to health data. –The need for consistency in—National application, local context Methodologies for issuing heat forecasts Common messaging and outreach efforts Statistical methodology to examine the association of extreme heat and a broad range of health outcomes Reporting of heat-related fatalities across federal, state and local agencies Weather, climate and health communities benefit from sharing data, tools, and expertise that support our shared interest and missions in protecting life.

11. NOAA-CDC Heat Health Summit Silver Spring, MD – October 28-30, 2014 Outcomes & Next Steps –Commitment to move forward with a focus on collaborations and partnerships between the weather forecast and public health communities. –Joint outreach and communications plans –Collaborative research efforts to investigate the utility of extended heat forecasts –Pilot Projects to identify appropriate heat parameter for exposure and health outcome, and test forecast methodologies –Meeting with international partners to compare methods and lessons learned and extend to climate time scales 11