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Climate change impacts the public's health. People are at risk for extreme weather events in the 21st century. The purpose of this study was to assess Public Health agencies' awareness of climate change's impact on health, and what protective and preventive strategies the agencies have in place. Using mixed method research, a survey was designed to collect quantitative and qualitative data. Following IRB approval, surveys were sent to eight Public Health agencies in the USA's rural and urban Midwest, and rural Alaska. Quantitative data