Date of Award


Degree Name

Doctor of Philosophy


Health Education

First Advisor

Welshimer, Kathleen


This dissertation is about the factors that influence heat wave preparedness of Midwestern health departments, and the climate change perceptions of public health officials. Heat waves have historically impacted the Midwest and, due to the variable pattern of these events, are full of uncertainties. Climate change intensifies the threat of heat waves; therefore, it is important for public health officials to incorporate methods for addressing climate change into their short and long term plans and preparedness models. This study is unique, because it goes beyond previous work that has been done with heat wave preparedness by speaking with public health officials to understand the complexities of heat wave planning. Applying a comparative case study methodology to this study was important to see how three states, in varying stages of climate change preparedness, function regarding emergency planning, decision making, and collaboration. Further, interview discussions regarding climate change demonstrate the need to further assist public health with their mitigation and adaptation efforts. Topics within Chapter One describe the study framework, study significance, discuss the incorporated methodology, and the dissemination of results. In Chapter Two, I construct the scholarly framework for this study by examining climate change and public health impacts, how policy shapes program planning with regard to heat waves, the sociological implications of heat waves including communicative properties and community organizing, and heat wave preparedness plan evaluation. Chapter Three focuses on the methodology guiding this project as well as the research questions. Research questions focused on preparation for heat waves, communication among state and local health departments, climate change perceptions of health officials, and finally, the influence of grant funding on preparedness efforts. This study was constructed using an interpretive paradigm to guide a comparative case study framework for comparing heat wave preparedness of three Midwestern States. Using document analysis and semi-structured interviews, I was able to discuss the concept of preparedness with public health officials including emergency preparedness coordinators, environmental health directors, and emergency managers. In Chapters Four and Five, I developed the uniqueness of each case, and then built a broader story by examining findings across the cases. I met with 22 individuals representing fourteen local health departments, two state health departments, one city health department, two emergency management agencies, and one state climatologist office. Analysis was threaded into both Chapters Four and Five by exploring within (locality, misconception, and camaraderie) and cross (passive leadership, transitions, expectations, reputation, and strategies) case themes. In Chapter Six, I discuss the study findings by incorporating the social ecological model as well as cited literature. Finally, Chapter Seven revisits the study significance and implications for best possible practices in health and public health education. Climate change is one of the greatest threats to public health, and heat waves are only one anticipated threat from enhanced warming. This study sheds light on the importance of climate literacy and preparedness for all-hazards approaches in public health planning.




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