Managed Retreat as a Strategy for Climate Change Adaptation in Small Communities: Public Health Implications

As sea levels rise due to climate change, some communities will eventually become unlivable. One proactive solution is “managed retreat.” This is the planned relocation of people before a crisis forces them to move.

But moving an entire community is not simple. Managed retreat can disrupt people’s health, their social connections, and their way of life. These health impacts are wide-ranging, touching on mental health, food security, clean water, sanitation, infectious disease risk, injury, and access to healthcare.

Researchers searched through both peer-reviewed studies and gray literature for reports on small island and coastal communities that were in the process of relocating or had already — done so — primarily because of sea level rise. They wanted to understand the public health effects and the barriers communities face. The search turned up eight relevant communities: three in the United States (Alaska, Louisiana, and Washington) and one each in Panama, Fiji, Papua New Guinea, the Solomon Islands, and Vanuatu. The affected populations ranged from just 60 to about 2,700 people, most of whom are Indigenous and rely on subsistence fishing and farming.

Few of the reports directly addressed public health. Some relocations went well, but others hit serious roadblocks. Common barriers included deep attachment to place, fear of losing livelihoods, lack of funding, shortage of suitable land, community consensus, and governance procedures.

The researchers conclude that more work is needed, especially studies that track health indicators before and after communities relocate due to sea level rise, drought, or other environmental hazards. The lessons learned from these small communities could help guide the relocation of both small and large populations in a warming world.

Abstract

In coming decades, sea level rise associated with climate change will make some communities uninhabitable. Managed retreat, or planned relocation, is a proactive response prior to catastrophic necessity. Managed retreat has disruptive health, sociocultural, and economic impacts on communities that relocate. Health impacts include mental health, social capital, food security, water supply, sanitation, infectious diseases, injury, and health care access. We searched peer-reviewed and gray literature for reports on small island or coastal communities at various stages of relocation primarily due to sea level rise. We reviewed these reports to identify public health impacts and barriers to relocation. We identified eight relevant small communities in the USA (Alaska, Louisiana, and Washington), Panama, Fiji, Papua New Guinea, Solomon Islands, and Vanuatu. Affected populations range from 60 to 2700 persons and are predominantly indigenous people who rely on subsistence fishing and agriculture. Few reports directly addressed public health issues. While some relocations were successful, barriers to relocation in other communities include place attachment, potential loss of livelihoods, and lack of funding, suitable land, community consensus, and governance procedures. Further research is needed on the health impacts of managed retreat and how to facilitate population resilience. Studies could include surveillance of health indicators before and after communities relocate due to sea level rise, drought, or other environmental hazards. Lessons learned may inform relocation of both small and large communities affected by climate change.