Lyndon Johnson's attitude toward polluted water was that the United States has a "moral imperative" to clean and restore its rivers. The Johnson Administration created America's first national water quality standards in 1965; enforced them without having to go to court; sought and spent funds to help cities build sewers and wastewater treatment plants to prevent, remove, and treat pollution; and helped the states develop water planning and water quality management programs. His administration supported training of new water quality professionals and research on difficult water quality problems, such as combined storm-sanitary sewerage and nonpoint pollution sources. The national water quality program the Johnson Administration put in place has thrived over the past 50 years and has improved surface water quality. Although President Johnson's successors have modified his program they also have kept its key elements in place, such as the relationships among the federal agencies, states, and local governments.

Many cities have integrated health co-benefits into their climate plans to address cost concerns and build multi-stakeholder support for resilient, net-zero transitions. While some studies have demonstrated that cities vary in how much they link health and climate, few have examined why this is the case. This study fills this gap by using 16 negative binomial regression models to test whether three sets of independent variables—(1) plan attributes, (2) politics, and (3) demographics—are correlated with two different measures of climate–health integration for 50 large cities in the United States. The modeling suggests that plan age is consistently associated with deeper forms of integration (links between key sectoral actions and related health–environmental and social benefits), while plan type (adaptation/mitigation-focused versus integrated) is related to shallower health references. Associations between climate–health integration and the liberal leanings of a city’s population find support in more than half the models; other political and demographic variables lack discernible or predicted relationships with health integration for most models. The study concludes that linking mitigation–adaptation actions can bring more attention to health, but regularly updating urban climate plans is the key to deepening the integration required for a sustainable future.