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

The project, “Regional climate change vulnerability assessment and design of 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 (DSPubliques) in Quebec to assess their regional vulnerabilities and develop a regional climate adaptation plan. The project took place in the following regions: Bas-Saint-Laurent, Quebec, 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 risks were considered, including extreme temperatures, coastal erosion, flooding, extreme and/or atypical rainfall, allergens, air and water pollution and infectious diseases. A variety of different risks, populations, resources and capacities characterize the participating regions. For example, some populations reside in a coastal environment, while others are found in a northern context.

In general, a diverse mix of urban, suburban, rural and mixed environments cover the affected regions. Due to the results of the project, the DSPubliques were able to carry out an initial prioritization of the risks present in the region according to the potential effects on the physical, mental, and social health of the population. The project focused, in particular, on the effects affecting the populations most at-risk, such as the elderly, the isolated people, people experiencing homelessness, and people on low incomes. The project assessed risks at the scale of the health region, but also at finer geographic scales in most cases.

Understanding and Assessing Impacts

Many climatic hazards have affected the health of the Quebec population in recent years. For example, during the summer of 2020, severe heat waves led to 149 deaths and numerous hospitalizations, while the floods of 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 sparked public health momentum to adapt to and respond to climate change. The project, “Regional climate change vulnerability assessment and design of regional public health climate adaptation plans (VRAC-PARC),” therefore aimed to integrate the health dimension of climate change adaptation more systematically at the regional level, as well as promote the capacity and importance of public health actors in adapting to climate change.

VRAC-PARC used the public health risk management method, emphasizing the multi-risk aspect of climatic phenomena, the effects of climate change on health, the social determinants of health, and the accumulation of vulnerability. The INSPQ has provided a framework for participating DSPubliques to describe the foundations of their assessments, the methods, and the data sources available. The probabilities of occurrence of climate-related risks and their potential health consequences were estimated based on this framework. The projections were then combined into a risk matrix to assess the overall public health risk. The data comes from multiple sources, including climate portals, censuses, health status and coping behavior surveys, as well as scientific literature and information collected in the field.

Collaboration with regional actors was strongly encouraged as part of the project in order to take advantage of local expertise (eg, adaptive capacity) and complement existing adaptation efforts. By the end of 2022, more than 800 regional players, particularly from municipal and community circles, had taken part in the efforts of the DSPublique to carry out their assessment. The comparison of sectors, hazards, and populations according to their level of risk will make it possible to better target the adaptation measures that must be integrated at the regional level to optimally reduce the consequences of climate change on health. In addition, the INSPQ continues to periodically evaluate the project in order to improve its structure and methods.


As part of the HealthADAPT program, eight DSPubliques had been financed from the start of the project. Interest from the DSPubliques made it possible to seek additional funds from the Government of Quebec and to finance five other DSPubliques. By the end of 2022, the project served 75% of the population of Quebec and more than half of the territory of the province. DSPubliques are organized differently depending on their capacities, but the project encourages collaboration between several internal and external teams, which include teams in environmental health, promotion and prevention, surveillance, and infectious diseases. 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. Nevertheless, DSPubliques managed to submit a preliminary assessment of their regional vulnerability to climate change by December 2022.

The INSPQ also coordinates a community of practice with the working groups of the participating public health departments, which meet monthly and share their experiences. A group of partners, made up of several government actors 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 determine linkages with other climate adaptation projects to avoid duplication of effort.

Outcomes and Monitoring Progress

VRAC-PARC has served to build the internal capacities of the DSPubliques and to create external partnerships with more than 800 regional and governmental actors. Many public health departments did not initially have adequate knowledge and capacity to integrate climate change and health adaptation issues into their work. To this end, the governance structure of this project has been a great asset, particularly in terms of establishing a community of practice and the emphasis on knowledge sharing. VRAC-PARC has also required public health teams to do the majority of their work internally, and not externally, so that they can develop their expertise and better use the results.

DSPubliques now integrate climate change more systematically into all of their work. Relations with various organizations, such as municipalities and university organizations, will also make it possible to implement future work, in particular the priority adaptation measures proposed by the public health departments in collaboration with them.

Several other levers and obstacles also influenced the progress and results of the project, including limited funding, scientific support from the INSPQ and access to data. An overall evaluation of the process was carried out in 2022 and will be published on the project site in 2023 (see “Resources”).

Next Steps

The VRAC-PARC team and the INSPQ greatly appreciated the collaboration with Health Canada within the framework of the HealthADAPT program. Although the large number of actors to be supported within the framework of the project could have been an obstacle, the funding from HealthADAPT helped to highlight the importance of public health work in climate adaptation. The 13 participating DSPubliques now have an assessment of their regional vulnerability to climate change and are moving towards developing an adaptation plan that is adapted to their regional reality. The results of this project made it possible to demonstrate the relevance of these evaluations and to request additional funding from the 2022-2027 Implementation Plan within the Government of Quebec’s Plan for a Green Economy 2030 to continue phase 2 of the VRAC-PARC project.

This second phase aims to include the five other DSPubliques du Québec, some of whom already informally participate in VRAC-PARC activities as observers. This additional funding will increase the human and financial resources available to the DSPubliques to refine their assessments, disseminate their results and develop their regional climate adaptation plans. Collaborative work with regional and governmental actors will continue and intensify during this second phase. The INSPQ and its partners will continue to offer services and scientific tools to public health professionals based on the needs raised by public health actors. During this second phase, VRAC-PARC will have to harmonize with the Government Health Prevention Policy (PGPS) and the National Public Health Program (PNSP) of the Quebec government, which now includes climate change measures.