While California leads the nation's charge against global warming pollution, local health officials lag on preparedness for the expected fallout of more frequent and more severe heat waves, bad air days and disease epidemics.Sacramento County is an example."We are starting to gather the data on what to expect and how to respond," said Val Siebal, Sacramento County environmental management director.Siebal convened the first meeting last week with county heads of public health, mosquito control and human assistance. They raised daunting questions:Will Sacramento become like Phoenix or Tucson? Should homes and roads be designed to reflect rather than absorb the sun's radiation?Should mental health specialists be enlisted to help residents cope with longer heat spells and a warmer Delta breeze? Will the region see a resurgence of malaria -- the scourge of early Sacramento -- or the emergence of such tropical diseases as dengue fever?"I'm not sure I know all the implications of climate change," said Dr. Glennah Trochet, county public health officer. "We need to educate the decision-makers and the public, but first we need to educate ourselves."Department of Health and Human Services officials say they do not have the means to add climate-related crises to their broad responsibilities, from tracking sexually transmitted diseases to regulating day-care facilities and offering pregnancy counseling."We don't have the staff that could spend time thinking only about this," Trochet said.Sacramento County is hardly alone. More than 80 percent of the 133 local health officials nationwide who responded to a survey said they lacked the expertise to craft climate-adaptation plans."There has been much discussion on (shrinking) the carbon footprint, but the dialogue on health implications of climate change has been given short shrift," said Dr. Dennis McBride, of the National Association of County and City Health Officials.The survey results show "serious gaps in the U.S. public health system's ability to meet that need," said Dr. John Balbus, chief health scientist for the Environmental Defense Fund advocacy group and lead author of the survey report, which was released Thursday and sent to U.S. Health and Human Services Secretary Mike Leavitt.Trochet said she agreed wholeheartedly with the survey's findings and counted herself among the 60 percent of local health directors who believed their communities would experience at least one "serious" public health problem in the next 20 years.A warmer Central Valley also makes for worse air quality as higher temperatures speed the formation of ozone, the corrosive gas in smog that inflames airways and triggers heart and asthma attacks.Despite the sense of being ill prepared, most local health agencies in California have programs in place to help minimize climate-related threats, according to a survey of local health officers earlier this year by the Public Policy Institute of California. These include heat emergency plans, programs to control disease-carrying insects and rodents and disease tracking and surveillance."Our efforts at the state and local level will be an enhancement of what we already do," said Dr. Bonnie Sorensen, chief deputy director of policy and programs for the state Department of Public Health.The department is building a statewide reportable disease system to better communicate with local health officials about unusual infections or signs of an outbreak.Although federally funded to bolster the public's defense against bioterrorism attacks, Sorensen said the computerized network also should enhance the state's ability to catch climate-related infections early, before they turn epidemic.The state also improved its emergency response strategy for heat waves after the unprecedented July 2006 episode of 11 days and nights that caused the 140 deaths statewide, including 13 in Sacramento County, officials said.Reach Sacramento Bee reporter Chris Bowman at cbowman(at)sacbee.com(Distributed by Scripps Howard News Service, www.scrippsnews.com.)