Mitigating Health Impacts from Climate Change through Managed Retreat

June, 2022

Sophie Geernaert, Student Researcher, Dalhousie University, Canada and Global Health Intern, Global Council for Science and the Environment
Mamta Mehra, Research Director, Global Council for Science and the Environment

There is no denying that climate change is one of the most potent drivers of human migration. The World Bank’s latest report projects that 216 million people across six world regions will move within their countries by 2050 (Clement et al., 2021). The big question is, are we prepared to manage these migrations and displacements? As these migrations are both internal and external, we need multilateral responses to address these issues. However, as of date there is no legal framework nor a multilateral strategy to account for climate change as a driver of migration (Podesta, J. 2019). 


Managed Retreat (MR), the strategic movement of people away from their home communities into new settlements, targeting the high-risk areas of adverse climate events, has emerged as a new field to address the issues of climate-induced migration and displacement systematically. These areas also host populations with a high vulnerability index. In addition, these communities are typically burdened with various social determinants of health such as low-income levels, lack of adequate education, occupations which may be hazardous or strenuous, high unemployment, and limited access to health services. Moreover, climate-induced migration also critically impacts the region's ecosystem and biodiversity, making it inhabitable for the communities to survive. These determinants interplay to affect many aspects of an individual and even a whole community's health and the ecosystem’s health. Therefore, MR needs to prioritize a systematic strategy that includes addressing health issues. MR needs to begin addressing current health issues in the community and mitigating any health issues that may arise from the migration. 


Innovative Strategies to Address Health Issues in Managed Retreat

Below are some of the strategies that have been successful in addressing health issues of the displaced communities based on our analysis of 25 case studies from different parts of the world.


  1. Follow-Up Analysis of Health Outcomes and Perceptions on Retreat 

This approach, called the HyperLocal or HyLo approach, was employed off the south coast of Florida in Little River and Homestead communities by using anthropological researchers to learn about people’s experiences and challenges and work with the community to create solutions (HyLo, 2021). After the MR, researchers revisited the community to measure social connectedness, community engagement, and perception of climate risk (HyLo, 2021). This example is one of the most comprehensive and holistic assessments  of mental and social health impacts confirmed to date in the strategic movement of people. 


  1. Community Participation in MR Strategy 

More MR planning has begun to include the community in the past five years (Lorenzo-Pérez, 2021). While this type of planning takes a proactive approach to potential mitigation of mental health issues, it is indirect in its attempts to address health. Additionally, this approach does not look to address any harms already present in the communities, such as the overcrowding in Kiribati (officially Republic of Kiribati, an island country in the central Pacific Ocean), leading to high cases of Tuberculosis (Huish, 2022). Some ways in which the community has been included in the process of the MR include assessing potential relocation areas and contributing to housing and infrastructure design. These techniques were employed in Cagayan de Oro in the Philippines (Carrasco et al., 2016), the Isle de Jean Charles in Louisiana, USA (Simms et al., 2021) and Yogyakarta, Indonesia (Kanako, 2019).


 In Yogyakarta, after the 2010 Volcanic eruption, the community was in charge of their MR and sought specialists when they needed them  (Kanako, 2019). As a result, they developed a sense of ownership for their new location and designed the community to be a unique representation of their culture. Likewise, in Alaska, the Kivalina community, consisting of 500 indigenous people, is planning to relocate inland to avoid flooding and erosion (Dannenburg et al., 2019). The community is currently administering their MR and is investing in a community center, school, and sanitation project inland to help improve the wellbeing and resilience of their residents post-movement. 


Communities may be hesitant to retreat due to place attachment, institutional reasons, such as a lack of government trust, or limited knowledge or belief in the perceived climate risk (Siders, 2019). In the Isle de Jean Charles, the state government led the MR but had consistent community involvement in choosing the location for the retreat and designing the houses (Simms et al., 2021). Although the implementation of this MR was postponed due to the COVID-19 Pandemic (Simms et al., 2021), extensive community involvement is likely to positively impact the community’s mental health. 


  1. Planning for Social and Community Services

This approach was taken a step further in Fiji when a community moved from Vunidogoloa, an area of high risk due to climate change-induced sea-level rise, to Keniani, a community at a higher elevation with a much lower risk of submersion. Again, broader health implications were considered, including accessible routes to revisit previous homes that aid in cultural connectivity (National Legislative Bodies, 2018). Additionally, women's empowerment increased by training women to make solar panels for the nearby hospital (National Legislative Bodies, 2018). Lastly, community schooling was improved to increase the education levels of the original Vunidogolain people (National Legislative Bodies, 2018). These efforts show a more significant consideration of community needs and indirectly assess some of the most critical social determinants of health. 


Limitations and Further Considerations in MR 

  • Communication with local communities has been led primarily by climate and geoscientists whose primary objective is to gain knowledge for predicting future climate-related land changes, not help assess community needs 
  • Most MR teams do not include sociologists or anthropologists to assess the cultural importance of the land in the movement leading to insufficient cultural and social services
  • Consideration for cultural and relational dynamics between migrating and receiving communities is minimal and impacts political representation, education, employment opportunities and social cohesion 
  • Receiving communities, on the other hand, are not fully prepared for population growth and lead to fewer educational opportunities, lower food security, and high homelessness. This sometimes creates conflict between migrating communities and receiving communities. 
  • New environments may pose greater or different risks to diseases such as malaria and yellow fever 
  • The lack of qualitative and quantitative assessment of health outcomes in remote areas leads strategists and policymakers to overlook health in their planning
  • Lack of a framework that include considerations for health have been standardized across MR 




Figure 1: Key Potential Areas Impacting Health Outcomes in Managed Retreat 


Figure 1 outlines some of the key potential areas that MR should anticipate when assessing health impacts and outcomes. GCSE’s Managed Retreat Learning Collaborative is working to create a team of scientists and decision makers to work together in sharing knowledge and experiences to expand and deepen the understanding of MR and further inform planning for anticipated MR by communities. This network of professionals aims to develop a comprehensive framework for health in MR and address many other dimensions of alleviating populations from the burdens of climate change. 



Source: Global Council for Science and the Environment




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  4. Huish, R. (2022). Structural Violence as the Greatest Determinant of All. Personal Collection of Huish, R. Dalhousie University, Halifax, Nova Scotia. 
  5. HyLo (2021). A Hyperlocal Approach to Climate Adaptation: Creating collaborative solutions to climate problems.
  6. Kanako, L. (2019, November 4-6).Exploring the potential of community co-design framework to address equitable community relocation. Columbia University. Climate Adaptation Initiative: Managed Retreat Conference. [Conference presentation].Virtual.
  7. Lorenzo-Pérez, M. & Contreras, S. (2021). Understanding the Impacts of Managed Retreat and Resettlement on Informal Communities. Natural Hazards Center Mitigation Matters Research Report. Retrieved from
  8. National Legislative Bodies (2018). Fiji: Planned Relocation Guidelines - A framework to undertake climate change related relocation. 
  9. Podesta, J. (2019). The climate crisis, migration, and refugees.…
  10. Simms, J.R.Z., Waller, H.L., Brunet, C. (2021). The long goodbye on a disappearing, ancestral island: a just retreat from Isle de Jean Charles. J Environ Stud Sci 11, 316–328.
  11. Siders, A. (October, 2019). Managed Retreat in the United States. One Earth. Volume 1. Issue 2, 216-225.


Opinions expressed in this essay are those of the authors. They do not purport to reflect the opinions or views of the GCSE or its members.