Extreme Events and Gaps in Health Emergency Preparedness in New Jersey

The frequency and severity of extreme weather events are accelerating across the United States, producing compounding public health consequences that current institutional frameworks are not designed or prepared to address. Nationally, heat is the leading cause of weather-related death, with extreme heat driving almost 120,000 emergency department visits annually and worsening chronic medical conditions among those most at risk. Beyond heat, climate change degrades air quality through increased ground-level ozone and wildfire smoke exposure, exacerbating respiratory disease in the state’s dense urban corridors. Flooding poses catastrophic risks and billions in damages, overwhelming local response systems and exposing coordination failures between health, emergency management, local governments, and environmental agencies. Despite these escalating threats, health systems, hazard planning efforts, and emergency management agencies remain insufficiently prepared for the population health impacts of compound climate disasters. A key obstacle is the fragmentation of authority and responsibility across these sectors. Public health agencies, hospital systems, hazard planning, and emergency management departments operate under different statutory mandates, planning cycles, and risk assessment frameworks, creating governance gaps where coordinated action is most needed.

Led by Rutgers researchers, Dr. Kasia Klasa (Department of Human Ecology) and Dr. James Shope (Department of Environmental Science), this project seeks to understand how New Jersey’s county-level Emergency Operations Plans, Hazard Mitigation Plans, and hospital Community Health Needs Assessments account for and operationalize the population health impacts of extreme weather events and to what extent the hazards mentioned in these plans align with each county’s hazard vulnerability profile through systematic document analysis and key informant interviews. The outputs will include a gap analysis comparing these plans across New Jersey’s 21 counties, as well as policy recommendations for New Jersey in how to better address the health consequences of extreme climate vulnerability.