From Siloed Interventions to Structural Solutions: Climate Change as a Test Case for a New Public Health Paradigm.

Public health practice has traditionally addressed discrete problems with targeted interventions: surveillance, risk mitigation, program implementation, and evaluation. This approach has yielded enormous gains, yet it is increasingly inadequate in the face of complex, interdependent crises such as climate change. The climate crisis exposes the limitations of siloed, problem-specific solutions and requires a more fundamental reconceptualization of public health approaches, one that treats health as an emergent property of social, economic, and environmental systems. In this perspective, we argue that climate change is not merely another public health threat, but a paradigmatic challenge that requires upstream, structural interventions capable of addressing multiple health outcomes simultaneously. Drawing on examples from the fields of mental health, political economy, and environmental justice, we contend that public health policy must reorient toward root cause solutions that prioritize people over profit and reassert collective responsibility for managing shared risks. (Am J Public Health. Published online ahead of print August 6, 2026:e1-e6. https://doi.org/10.2105/AJPH.2026.308615).