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Climate change is changing the world’s ocean in three important ways. First, the ocean is warming. Second, sea levels are rising. Finally, ice is melting. All of these changes have important implications for human disease risk, ranging from a fairly prosaic increase in harmful algal blooms to the science-fictionish re-release of deadly microbes from long ago.

In the United States, coastal adaptation efforts to date have been sluggish. Many uncertainties attend climate change’s effects on the ocean, particularly with regard to sea-level rise and ice melting. In addition, the time scales involved are generally long, outside of the planning ken of most governmental agencies.

Turning from physical risk to disease risk, however, can provide a more effective focus for immediate coastal adaptation efforts. Public health threats are politically salient in ways that climate change itself, or even sea-level rise, often are not. Moreover, a public health adaptation focus both addresses real human needs and can help to identify practical “no regrets” first steps that can advance more general adaptation efforts.