Climate change poses health risks. But it’s hard to fight when state policy ignores it.

A Florida hospital prepares for a hurricane's landfall.
A Florida hospital prepares for a hurricane's landfall.

Mariners Hospital in the Florida Keys was evacuated to prepare for Hurricane Irma in September 2017. Experts say cities and counties are assuming a greater role in the state's response to climate change's cascading effects on public health. Marc Serota/Getty Images

ORLANDO, Fla. — Florida is the hottest state in the contiguous United States, and its residents suffer the most heat-related illness. Older people are most susceptible to the heat, and nearly 4.7 million Floridians — 1 in 5 residents — are older than 65.

The peninsula has 8,436 miles of coastline, and three-quarters of state residents live in coastal counties, imperiled by rising sea levels, extreme rainfall and more intense hurricanes.

Climate change is making Florida hotter and increasing the risk of flooding and severe storms. Increasingly, the state should expect “adverse public health outcomes, such as heat-related illness and mortality, especially among more vulnerable populations,” according to the state climatologist’s office at Florida State University.

But Republican Gov. Ron DeSantis has opposed many efforts to address the causes and public health effects of climate change. As a result, Florida cities, counties and nonprofits have had to assume a greater role in dealing with higher temperatures — without sufficient money and resources to do so, many argue.

Perhaps more than any other state, Florida illustrates how the politicization of climate change has thwarted efforts to deal with it.

Florida, unlike a growing number of other states, does not have a statewide plan designed specifically to help residents cope with extreme heat and other effects of climate change. Dr. Cheryl Holder, co-chair of Miami-Dade County’s Climate and Heat Health Task Force, said that in the absence of state leadership, Florida cities and counties have done what they can. In 2021, for example, Miami-Dade County named its first-ever chief heat officer, and last month Tampa released a “heat resilience playbook” that includes steps such as enhancing and protecting the city’s tree canopy.

But Holder said a statewide effort — akin to public health campaigns to curb smoking — would have a much greater impact.

“Systematic change is better, but we’re left with a piecemeal approach,” Holder told Stateline.

In Florida and around the country, state public health leadership is essential, said University of Washington professor Kristie Ebi, an epidemiologist and an expert on the health risks of climate change.

“The local health departments follow the lead of the state health department, and it’s difficult to contravene,” Ebi said. “It’s difficult when the state health department says, ‘This is the approach, this is the perspective, these are the parameters,’ for the local health department to do anything differently.”

DeSantis’ office, the Florida Department of Health and the Florida Department of Environmental Protection did not respond to Stateline requests for comment before publication.

A bipartisan concern in the past

As recently as 2008, climate change was a bipartisan concern in Florida. But DeSantis, who unsuccessfully sought the GOP presidential nomination this year, embodies his party’s current dismissive attitude toward climate change — a stance shared by his predecessor in the Florida governor’s office, current U.S. Sen. Rick Scott.

In May, for example, DeSantis signed legislation erasing references to climate change from the state’s energy policy and releasing state agencies from the obligation to consider climate change when executing it. “We’re restoring sanity in our approach to energy and rejecting the agenda of the radical green zealots,” DeSantis wrote on X.

In April, DeSantis signed a law barring Florida cities and counties from passing their own heat protections, such as mandated water breaks, for outdoor workers. As a result, Miami-Dade County had to withdraw its pending rule that would have required water breaks for outdoor workers and training on heat-related illness for employers.

We’re always ready and willing partners if and when the state decides that they’d like some more information along these lines.

– Chris Uejio, of Florida State University, who is leading a project with local health agencies on the health risks of climate change

Texas Republican Gov. Greg Abbott last year signed a similar law preempting cities from passing heat-break ordinances.

Meanwhile, many other states are moving in the opposite direction.

States such as Arizona, California, Connecticut, New York, North Carolina and Wisconsin have used federal money from the Centers for Disease Control and Prevention to craft statewide plans to address the effects of climate change on public health. All have Democratic governors.

In April, Democratic-led New Jersey released a draft Extreme Heat Resilience Action Plan that includes providing public cooling centers, planting more trees, and adopting workplace safety rules, among many other steps.

California launched and New Jersey plans to start statewide public information campaigns to raise awareness of the risks of extreme heat, especially among vulnerable populations such as older and homeless people.

Florida State University also received a CDC grant, but the team is focused on working with local health departments, said project lead Chris Uejio, a medical geographer and associate professor at FSU.

“We’re always ready and willing partners if and when the state decides that they’d like some more information along these lines,” Uejio said.

‘Falling behind the pack’

Despite downplaying climate change concerns, DeSantis in 2021 approved $640 million in new state spending to help communities deal with sea level rise, intensified storms and flooding. And in 2019, he appointed the state’s first chief resilience officer.

But DeSantis’ interest in such efforts waned as his presidential campaign ramped up. Florida was one of five states (Iowa, Kentucky, South Dakota and Wyoming were the others) that declined to apply for federal Climate Pollution Reduction Grants under President Joe Biden’s Inflation Reduction Act. The federal government allowed large metro areas to apply for their own climate planning grants. Five Florida areas applied for their own and received dollars for planning, but no grants for implementation.

A year ago, DeSantis rejected nearly $350 million in federal energy efficiency incentives and consumer rebates under the Inflation Reduction Act. But this year, after dropping out of the primary race, DeSantis accepted the money.

Susan Glickman, vice president of policy and partnerships at the CLEO Institute, a Florida-based nonprofit focused on climate education and advocacy, praised the state for addressing sea level rise and for assessing the vulnerabilities of coastal communities. But Glickman said Florida must address the root causes and cascading effects of climate change.

“We must adapt to the warming climate, but the decisions we make right now, not addressing the root cause of the problem, is really unacceptable,” Glickman said. “You cannot adapt your way out of climate change.”

Kim Ross, executive director of ReThink Energy Florida, a Tallahassee-based nonprofit that advocates for clean energy, said the DeSantis administration has been a roadblock.

“This could be a state that’s really focused in on the inventions that need to happen,” Ross said. “Instead, we’re just kind of falling behind the pack.”

Ross said that whenever she sees opportunities for federal climate change grants, her first question is whether it’s possible to get one without state support.

“I’m like, ‘Is there a non-state option?’ And I keep encouraging anybody I can talk to at the federal level to have there be a non-state option,” she said.

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