Regional Assessments: Assessing Regional Vulnerability to Climate Change and Designing Regional Public Health Climate Adaptation Plans (VRAC-PARC)

The project, “Regional Assessments: Assessing Regional Vulnerability to Climate Change and Designing Regional Public Health Climate Adaptation Plans (VRAC-PARC),”was funded by Health Canada’s HealthADAPT program until March 2022.

This project is coordinated by the Institut national de santé publique du Québec (INSPQ) and includes 13 of the 18 public health departments in Québec to assess their regional vulnerabilities and develop a regional climate adaptation plan. The project took place in the following regions: Bas-Saint-Laurent, Québec City, Mauricie-et-Centre-du-Québec , Estrie, Montreal, Outaouais, Nord-du-Québec , Gaspésie–Îles-de-la-Madeleine, Chaudière-Appalaches, Laval, Lanaudière, Laurentians, and Terres-Cries-de-la-Baie-James.

More than fifteen hazards were considered, including extreme temperatures, coastal erosion, floods, extreme or atypical precipitation, allergens, air and water pollution and infectious diseases. The participating regions were characterized by a variety of different hazards, populations, resources, and capacities. For example, some populations reside in a coastal environment, while others are within a northern context. Generally, the regions included in the project were a diverse mix of urban, suburban, rural, and mixed environments. Due to the findings of the project, public health units were able to carry out a first round of prioritization of the risks present in their region according to the potential effects on the physical, mental and social health of the populations, and particularly focused on populations at greater risk, such as the elderly, people who are more isolated, homeless people, or low-income people. The project assessed the populations most at-risk at the scale of their territory, or according to different geographical units.

Understanding and Assessing Impacts


Many climate-related hazards have affected the health of the Québec population in recent years. For example, in the summer of 2020, massive heat waves resulted in 149 deaths and numerous hospitalizations, while floods in 2017 and 2019 caused significant psychological distress. Lyme disease cases have also continued to rise for more than a decade. These health effects, revealed by several studies, have generated a public health impetus to adapt to and address climate change. The “Assessing Regional Vulnerability to Climate Change and Designing Regional Public Health Climate Adaptation Plans” (VRAC-PARC) project thus aimed to integrate the health dimension of climate change adaptation more systematically at the regional level as well as to promote the capacity and importance of public health actors in adapting to climate change.

The VRAC-PARC project used the public health risk management method, while emphasizing the multi-risk aspect of climatic events, the effects of climate change on health, social determinants of health, and the accumulation of vulnerability. INSPQ provided a framework for participating public health departments to outline the foundations of an assessment, the methods, and the data sources available. The projected probabilities of occurrence for climatic hazards and their potential consequences on health were estimated based on the framework. The projections were then combined in a matrix to assess the overall public health risk. The data came from multiple pathways, including climate portals, censuses, surveys on health status and coping behaviors, and scientific literature and information collected in the field. Collaboration with regional actors was strongly encouraged within the scope of the project to take advantage of local expertise (e.g. adaptability).

As of the spring of 2022, more than 500 regional actors, particularly municipal or community actors, have participated in the efforts of the regional public health authority, DSPublique (Direction et Sante Publique), to carry out their assessment. The comparison of sectors, hazards, and populations according to their level of risk made it possible to better prioritize and target the adaptation measures that must be integrated into the regional plan to optimally reduce health consequences resulting from climate change and pre-existing social inequalities. Furthermore, INSPQ continues to periodically evaluate the project to improve the structure and methods.


With the support of the HealthADAPT program, the VRAC-PARC project called on public health departments in Québec, with the support of a number of public health teams, to carry out a pilot project to assess vulnerability and adaptation. While a dozen directorates expressed interest, eight were funded to prevent funding from being overstretched. This interest, however, made it possible to seek additional funds from the Government of Québec and fund other directorates. Currently, the project serves 75% of the population of Québec and more than half of the territory of the province. Due to the COVID-19 pandemic, the project was put on hold in 2020, as public health departments had to mobilize their resources to respond to COVID-19. Nevertheless, most public health departments are in the process of completing their regional vulnerability assessments, which are estimated to be published in fall 2022. INSPQ is also coordinating a community of practice with the working groups of the participating public health departments, which meet monthly and share their experiences and approaches to their assessments. In addition, several players, such as the Ministry of Health and Social Services, the Ministry of the Environment and the Fight against Climate Change, the Ministry of Municipal Affairs and Housing, and Espace MUNI (a community-focused non-profit organization), also form the monitoring committee and identify possible linkages within the assessments to avoid duplication of effort. Public health departments organize themselves differently according to their capacities, but the project promotes collaboration between several internal and external teams, which include environmental health, promotion, prevention, surveillance, and infectious disease teams.

Outcomes and Monitoring Progress

This project has been successful, not only for its evaluations, but for building the internal capacities of public health directorates while improving their external partnerships with stakeholders and other government departments. Prior to the launch of this pilot project, it was noted that many public health departments did not have adequate knowledge and capacity to integrate issues related to climate change and health adaptation into their current projects. To this end, the governance structure of this project has been a great asset – particularly towards the establishment of a community of practice and with its emphasis on knowledge sharing. As a capacity-building project, VRAC-PARC required public health teams to do the majority of their work in-house for assessments, despite the abundant supply of external services in this area. This has resulted in a better development of internal knowledge and skills, which will support the integration of issues related to climate change in current programs and operations of public health departments. Relations with various organizations, such as municipalities and university organizations, will also help to put in place future work, including priority adaptation measures that can be proposed by public health departments.

Next Steps

The VRAC-PARC project team and INSPQ greatly appreciated collaboration with Health Canada as part of the HealthADAPT program. Although the vast number of actors to support within the project may have presented a barrier, HealthADAPT funding was key in positioning the importance of public health work in climate adaptation. Most public health departments now have an assessment of their regional climate vulnerability and are moving towards developing an adaptation plan adapted to their regional reality. The results of this project made it possible to demonstrate the relevance of these evaluations, and to seek additional funding to integrate VRAC-PARC into the 2022-2027 Implementation Plan for the 2030 Plan for a Green Economy in Québec, which ensures the continuity of the project for the next few years.

Now funded by Québec ‘s 2030 Plan for a Green Economy, the project can begin its second phase. In particular, the project plans to include the remaining five public health departments, some of which already participate informally in VRAC-PARC activities as observers. The additional funding will expand the human and financial resources available for public health departments to refine their assessments, disseminate their results, and begin implementing their regional climate adaptation plan. Collaborative work with regional and governmental actors will continue and intensify in this second phase. INSPQ and its partners will continue to offer scientific services and tools to public health departments, including a framework for developing a regional public health climate adaptation plan, based on the needs raised by public health actors. During this second phase, VRAC-PARC will have to align itself with the government’s health prevention policy and the national public health program, which now includes climate change actions by the Québec government.