Effects of climate change on human health

The effects of climate change on human health are increasingly well studied and quantified.^[1][2] Rising temperatures and changes in weather patterns are increasing the frequency and severity of heat waves, wildfires, droughts, floods, landslides, hurricanes, and other causes of injury and illness. Heat waves and extreme weather events have a big impact on health both directly and indirectly. Direct effects of exposure to high and extended temperatures include illness, reduced labour capacity for outdoor workers, and heat-related mortality.^[3]

Heat stroke treatment at Baton Rouge during 2016 Louisiana floods. Climate change is making heat waves more common, potentially leading to a higher risk of heat stroke.

In addition to direct impacts, climate change and extreme weather events cause changes in the biosphere. Climate-sensitive pathogens and vector-borne diseases may increase in some regions. Changes in temperature are creating conditions favorable to mosquito-borne diseases such as dengue fever, and waterborne diseases including diarrhoeal disease.^[3][4] Climate change will impact where infectious diseases are able to spread in the future. Many infectious diseases will spread to new geographic areas where people have not previously been exposed or developed immunity.^[5][6]

Changes in climate can cause decreasing yields for some crops and regions, resulting in higher food costs, food insecurity, and undernutrition. Water insecurity is also a concern. Increases in poverty, displacement, migration, violent conflict, and negative effects on mental health are all occurring.^[7][8][3]

Climate change affects human health at all ages, from infancy through adolescence, adulthood and old age.^[7][3] Factors such as age, gender and socioeconomic status influence to what extent these effects become wide-spread risks to human health.^[8]: 1867 Extreme weather creates physical and economic risks for whole families, particularly those headed by women. Temperature and heatwaves affect the earning capacity and economic stability of individuals and households. Populations over 65 years of age are particularly vulnerable to heat and other health effects of climate change.^[7] Health risks are unevenly distributed across the world.^[8] Disadvantaged populations are especially vulnerable to climate change effects.^[3]: 15

The health effects of climate change are increasingly a matter of concern for the international public health policy community. Already in 2009, a publication in the general medical journal The Lancet stated: "Climate change is the biggest global health threat of the 21st century".^[9] The World Health Organization reiterated this in 2015.^[10] In 2019, the Australian Medical Association formally declared climate change a health emergency.^[11]

Research shows that health professionals around the world agree that climate change is real, is caused by humans, and is causing increased health problems in their communities. Studies also show that taking action to address climate change improves public health. Health professionals can act by informing people about health harms and ways to address them, by lobbying leaders to take action, and by taking steps to decarbonize their own homes and workplaces.^[12] Studies have found that communications on climate change that present it as a health concern rather than just an environmental matter are more likely to engage the public.^[13][14]

Root causes

Effects of climate change

This section is an excerpt from Effects of climate change.[edit]

Climate change affects the physical environment, ecosystems and human societies. Changes in the climate system include an overall warming trend, more extreme weather and rising sea levels. These in turn impact nature and wildlife, as well as human settlements and societies.^[15] The effects of human-caused climate change are broad and far-reaching. This is especially so if there is no significant climate action. Experts sometimes describe the projected and observed negative impacts of climate change as the climate crisis.

The changes in climate are not uniform across the Earth. In particular, most land areas have warmed faster than most ocean areas. The Arctic is warming faster than most other regions.^[16] There are many effects of climate change on oceans. These include an increase in ocean temperatures, a rise in sea level from ocean warming and ice sheet melting. They include increased ocean stratification. They also include changes to ocean currents including a weakening of the Atlantic meridional overturning circulation.^[17]: 10 Carbon dioxide from the atmosphere is acidifiying the ocean.^[18]

Recent warming has had a big effect on natural biological systems.^[19] It has degraded land by raising temperatures, drying soils and increasing wildfire risk.^[20]: 9 Species all over the world are migrating towards the poles to colder areas. On land, many species move to higher ground, whereas marine species seek colder water at greater depths.^[21] At 2 °C (3.6 °F) of warming, around 10% of species on land would become critically endangered.^[22]: 259

Climate change vulnerability

Further information: Climate change vulnerability

A 2021 report published in The Lancet found that climate change does not affect people's health in an equal way. The greatest impact tends to fall on the most vulnerable such as the poor, women, children, the elderly, people with pre-existing health concerns, other minorities and outdoor workers.^[3]: 13

There are certain predictors of health patterns that determine the social vulnerability of the individuals. These can be grouped into "demographic, socioeconomic, housing, health (such as pre-existing health conditions), neighbourhood, and geographical factors".^[23]

Overview of health effects

Types of pathways affecting health

The effects of climate change on human health can be grouped into direct and indirect effects.^[8]: 1867 Both types of effects interact with social dynamics. The combination of effects and social dynamics determines the eventual health outcomes. Mechanisms and social dynamics are explained further below:

• Direct mechanisms or risks: changes in extreme weather and resultant increased storms, floods, droughts, heat waves and wildfires^[3]
• Indirect mechanisms or risks: these are mediated through changes in the biosphere (e.g., the burden of disease and redistribution of disease vectors, or food availability, water quality, air pollution, land use change, ecological change)
• Social dynamics (age and gender, health status, socioeconomic status, social capital, public health infrastructure, mobility and conflict status)

These health risks vary across the world and between different groups of people. For example, differences in health service provision or economic development will result in different health risks for people in different regions, with less developed countries facing greater health risks. In many places, the combination of lower socioeconomic status and cultural gender roles result in increased health risks to women and girls as a result of climate change, compared to those faced by men and boys (although the converse may apply in other instances).^[8]

Impact on general health and wellbeing

The direct, indirect and social dynamic effects of climate change on health and wellbeing produce the following health effects: cardiovascular diseases, respiratory diseases, infectious diseases, undernutrition, mental illness, allergies, injuries and poisoning.^{[8]: Figure 2}

Health and health care provision can also be impacted by the collapse of health systems and damage to infrastructure due to climate-induced events such as flooding. Therefore, building health systems that are climate resilient is a priority.^{[24][3]: 15}

Impact on mental health

This section is an excerpt from Effects of climate change on mental health.[edit]

 

Smoke in Sydney (Australia) from large bushfires (in 2019), affected some people's mental health in a direct way. The likelihood of wildfires is increased by climate change.

The effects of climate change on mental health and wellbeing are documented. This is especially the case for vulnerable populations and those with pre-existing serious mental illness.^[25] There are three broad pathways by which these effects can take place: directly, indirectly or via awareness.^[26] The direct pathway includes stress-related conditions caused by exposure to extreme weather events. These include post-traumatic stress disorder (PTSD). Scientific studies have linked mental health to several climate-related exposures. These include heat, humidity, rainfall, drought, wildfires and floods.^[27] The indirect pathway can be disruption to economic and social activities. An example is when an area of farmland is less able to produce food.^[27] The third pathway can be of mere awareness of the climate change threat, even by individuals who are not otherwise affected by it.^[26]

An additional aspect to consider is the detrimental impact climate change can have on green or blue natural spaces, which in themselves have been proven to have beneficial impact on mental health.^[28][29] Impacts of anthropogenic climate change, such as freshwater pollution or deforestation, degrade these landscapes and reduce public access.^[30] Even when the green and blue spaces are intact, access to them is not equal across society, which is an issue of environmental justice and economic inequality.^[31]

Mental health outcomes have been measured in several studies. These use indicators such as psychiatric hospital admissions, mortality, self-harm and suicide rates. People with pre-existing mental illness, Indigenous peoples, migrants and refugees, and children and adolescents are all vulnerable. The emotional responses to the threat of climate change can include eco-anxiety, ecological grief and eco-anger.^[32][33] Such emotions can be rational responses to the degradation of the natural world and lead to adaptive action.^[34]

Assessing the exact mental health effects of climate change is difficult; increases in heat extremes pose risks to mental health which can manifest themselves in increased mental health-related hospital admissions and suicidality.^[35]: 9

Impact caused by heat

Further information: Instrumental temperature record

Impact of higher global temperatures will have ramifications for the following aspects: vulnerability to extremes of heat, exposure of vulnerable populations to heatwaves, heat and physical activity, change in labor capacity, heat and sentiment (mental health), heat-related mortality.^[3]

The global average and combined land and ocean surface temperature show a warming of 1.09 °C (range: 0.95 to 1.20 °C) from 1850–1900 to 2011–2020, based on multiple independently produced datasets.^[36] The trend is faster since the 1970s than in any other 50-year period over at least the last 2000 years.^[36]

A 2023 study estimated that climate change since 1960–1990 has put over 600 million people (9% of the global population) outside the "temperature niche" - the average temperature range at which humans flourish.^[37]

A 2020 study projects that regions inhabited by a third of the human population could become as hot as the hottest parts of the Sahara within 50 years without a change in patterns of population growth and without migration, unless greenhouse gas emissions are reduced. The projected annual average temperature of above 29 °C for these regions would be outside the "human temperature niche" – a suggested range for climate biologically suitable for humans based on historical data of mean annual temperatures (MAT) – and the most affected regions have little adaptive capacity as of 2020.^[38][39] The UK Met Office came to similar conclusions, reporting that the "numbers of people in regions across the world affected by extreme heat stress – a potentially fatal combination of heat and humidity – could increase" "from 68 million today to around one billion" if the world's temperature rise reaches 2°C,^[40] albeit it is unclear if that limit or the 1.5 °C goal of the Paris Agreement is achieved.

Heat-related health effects for vulnerable people

Further information: Effects of climate change § Heatwaves, and Heat illness

 

Overlap between future population distribution and extreme heat^[41]

Vulnerable people with regard to heat illnesses include people with low incomes, minority groups, women (in particular pregnant women), children, older adults (over 65 years old), people with chronic diseases, disabilities and co-morbidities.^[3]: 13 Other people at risk include those in urban environments (due to the urban heat island effect), outdoor workers and people who take certain prescription drugs.^[3] Exposure to extreme heat poses an acute health hazard for many of the people deemed as vulnerable.^[3][42]

Climate change increases the frequency and severity of heatwaves and thus heat stress for people. Human responses to heat stress can include heat stroke and hyperthermia. Extreme heat is also linked to low quality sleep, acute kidney injury and complications with pregnancy. Furthermore, it may cause the deterioration of pre-existing cardiovascular and respiratory disease.^[2]: 1624 Adverse pregnancy outcomes due to high ambient temperatures include for example low birth weight and pre-term birth.^[2]: 1051Heat waves have also resulted in epidemics of chronic kidney disease (CKD).^[43][44] Prolonged heat exposure, physical exertion, and dehydration are sufficient factors for the development of CKD.^[43][44]

The human body requires evaporative cooling to prevent overheating, even with a low activity level. With excessive ambient heat and humidity during heatwaves, adequate evaporative cooling might be compromised.

A wet-bulb temperature that is too high means that human bodies would no longer be able to adequately cool the skin.^[45][46] A wet bulb temperature of 35 °C is regarded as the limit for humans (called the "physiological threshold for human adaptability" to heat and humidity).^[47]: 1498 As of 2020, only two weather stations had recorded 35 °C wet-bulb temperatures, and only very briefly, but the frequency and duration of these events is expected to rise with ongoing climate change.^[48][49][50] Global warming above 1.5 degrees risks making parts of the tropics uninhabitable because the threshold for the wet bulb temperature may be passed.^[45]

Further study found that even a wet bulb temperature of 31 degrees is dangerous, even for young and healthy people. This threshold is not uniform for all and depend on many factors including environmental factors, activity and age. If the global temperature will rise by 3 degrees (the most likely scenario if things will not change), temperatures will exceed this limit at large areas in Pakistan, India, China, Sub Saharan Africa, United States, Australia, South America.^[51]

People with cognitive health issues (e.g. depression, dementia, Parkinson's disease) are more at risk when faced with high temperatures and ought to be extra careful^[52] as cognitive performance has been shown to be differentially affected by heat.^[53] People with diabetes and those who are overweight, have sleep deprivation, or have cardiovascular/cerebrovascular conditions should avoid too much heat exposure.^[52][54]

The risk of dying from chronic lung disease during a heat wave has been estimated at 1.8-8.2% higher compared to average summer temperatures.^[55] An 8% increase in hospitalization rate for people with Chronic Obstructive Pulmunary Disease has been estimated for every 1 °C increase in temperatures above 29 °C.^[42]

In urban areas

Further information: Urban heat island

 

Increasing heat waves are one effect of climate change that affect human health: Illustration of urban heat exposure via a temperature distribution map: red shows warm areas, white shows hot areas.

The effects of heatwaves tend to be more pronounced in urban areas because they are typically warmer than surrounding rural areas due to the urban heat island effect.^{[56][57]: 2926} This is caused from the way many cities are built. For example, they often have extensive areas of asphalt, reduced greenery along with many large heat-retaining buildings that physically block cooling breezes and ventilation.^[42] Lack of water features are another cause.^[57]: 2926

Extreme heat exposure in cities with a wet bulb globe temperature above 30 °C tripled between 1983 and 2016.^[56] It increased by about 50% when the population growth in these cities is not taken into account.^[56]

Cities are often on the front-line of climate change due to their densely concentrated populations, the urban heat island effect, their frequent proximity to coasts and waterways, and reliance on ageing physical infrastructure networks.^[58]

Heat-related mortality

Health experts warn that "exposure to extreme heat increases the risk of death from cardiovascular, cerebrovascular, and respiratory conditions and all-cause mortality. Heat-related deaths in people older than 65 years reached a record high of an estimated 345 000 deaths in 2019".^[3]: 9 More than 70,000 Europeans died as a result of the 2003 European heat wave.^[59] Also more than 2,000 people died in Karachi, Pakistan in June 2015 due to a severe heat wave with temperatures as high as 49 °C (120 °F).^[60][61]

Increasing access to indoor cooling (air conditioning) will help prevent heat-related mortality but current air conditioning technology is generally unsustainable as it contributes to greenhouse gas emissions, air pollution, peak electricity demand, and urban heat islands.^[3]: 17

Mortality due to heat waves could be reduced if buildings were better designed to modify the internal climate, or if the occupants were better educated about the issues, so they can take action on time.^[62][63] Heatwave early warning and response systems are important elements of heat action plans.

Reduced labour capacity

Heat exposure can affect people's ability to work.^[3]: 8 The annual Countdown Report by The Lancet investigated change in labour capacity as an indicator. It found that during 2021, high temperature reduced global potential labour hours by 470 billion - a 37% increase compared to the average annual loss that occurred during the 1990s. Occupational heat exposure especially affects laborers in the agricultural sector of developing countries. In those countries, the vast majority of these labour hour losses (87%) were in the agricultural sector.^[2]: 1625

Working in extreme heat can lead to labor force productivity decreases as well as participation because employees' health may be weaker due to heat related health problems, such as dehydration, fatigue, dizziness, and confusion.^{[64][1]: 1073–1074}

Sports and outdoor exercise

With regards to sporting activities it has been observed that "hot weather reduces the likelihood of engaging in exercise".^[2]: 1625 Furthermore, participating in sports during excessive heat can lead to injury or even death.^{[1]: 1073–1074} It is also well established that regular physical activity is beneficial for human health, including mental health.^[2]: 1625 Therefore, an increase in hot days due to climate change could indirectly affect health due to people exercising less.

Effects caused by weather and climate events other than heat

Further information: Effects of climate change § Extreme weather events, and Extreme weather

Climate change is increasing the periodicity and intensity of some extreme weather events.^[65] Confidence in the attribution of extreme weather to anthropogenic climate change is highest in changes in frequency or magnitude of extreme heat and cold events with some confidence in increases in heavy precipitation and increases in the intensity of droughts.^[66]

Extreme weather events, such as floods, hurricanes, droughts and wildfires can result in injuries, death and the spread of infectious diseases. For example, local epidemics can occur due to loss of infrastructure, such as hospitals and sanitation services, but also because of changes in local ecology and environment.

Floods

Further information: Effects of climate change § Floods, and Flood § Health effects

Due to an increase in heavy rainfall events, floods are expected to become more severe in future when they do occur.^[67]: 1155 However, the interactions between rainfall and flooding are complex. In some regions, flooding is expected to become rarer. This depends on several factors, such as changes in rain and snowmelt, but also soil moisture.^[67]: 1156 Floods have short and long-term negative implications to people's health and well-being. Short term implications include mortalities, injuries and diseases, while long term implications include non-communicable diseases and psychosocial health aspects.^[68]

For example, the 2022 Pakistan Floods (which were likely more severe because of climate change^[69][70]) affected people's health directly and indirectly. There were outbreaks of diseases like malaria, dengue, and other skin diseases.^[71][72] Flood runoff can wash soil contaminants like fertilisers and toxins into estuaries, lakes and seas, posing a threat to human health by reducing water quality.^[73]

Hurricanes and thunderstorms

Further information: Effects of climate change § Tropical cyclones and hurricanes, and Tropical cyclones and climate change

Stronger hurricanes create more opportunities for vectors to breed and infectious diseases to flourish.^[74][75] Extreme weather also means stronger winds. These winds can carry vectors tens of thousands of kilometers, resulting in an introduction of new infectious agents to regions that have never seen them before, making the humans in these regions even more susceptible.^[74]

Another result of hurricanes is increased rainwater, which promotes flooding. Hurricanes result in ruptured pollen grains, which releases respirable aeroallergens. Thunderstorms cause a concentration of pollen grains at the ground level, which result in an increase in the release of allergenic particles in the atmosphere due to rupture by osmotic shock. Around 20–30 minutes after a thunderstorm, there is an increased risk for people with pollen allergies to experience severe asthmatic exacerbations, due to high concentration inhalation of allergenic peptides.^[42]

Droughts

Further information: Effects of climate change § Droughts

Climate change affects multiple factors associated with droughts, such as how much rain falls and how fast the rain evaporates again. Warming over land increases the severity and frequency of droughts around much of the world.^{[76][67]: 1057} Many of the consequences of droughts have effects on human health. This can be through destruction of food supply (loss of crop yields), malnutrition and with this, dozens of associated diseases and health problems.

Wildfires

 

Air pollution from a surface fire in the western desert of Utah. Wildfires become more frequent and intense due to climate change.

Further information: Wildfire § Climate change effects, and Wildfire § Health effects

Climate change increases wildfire potential and activity.^[77] Climate change leads to a warmer ground temperature and its effects include earlier snowmelt dates, drier than expected vegetation, increased number of potential fire days, increased occurrence of summer droughts, and a prolonged dry season.^[78]

Wood smoke from wildfires produces particulate matter that has damaging effects to human health.^[79] The primary pollutants in wood smoke are carbon monoxide and nitric oxide.^[78] Through the destruction of forests and human-designed infrastructure, wildfire smoke releases other toxic and carcinogenic compounds, such as formaldehyde and hydrocarbons.^[80] These pollutants damage human health by evading the mucociliary clearance system and depositing in the upper respiratory tract, where they have toxic effects.^[78]

The health effects of wildfire smoke exposure include exacerbation and development of respiratory illness such as asthma and chronic obstructive pulmonary disorder; increased risk of lung cancer, mesothelioma and tuberculosis; increased airway hyper-responsiveness; changes in levels of inflammatory mediators and coagulation factors; and respiratory tract infection.^[79]

Health risks due to climate-sensitive infectious diseases

This section is an excerpt from Climate change and infectious diseases.[edit]

 

Climate change is altering the geographic range and seasonality of some insects that can carry diseases, for example Aedes aegypti, the mosquito that is the vector for dengue transmission.

Global climate change has increased the occurrence of some infectious diseases. Infectious diseases whose transmission is impacted by climate change include, for example, vector-borne diseases like dengue fever, malaria, tick-borne diseases, leishmaniasis, zika fever, chikungunya and Ebola. One mechanism contributing to increased disease transmission is that climate change is altering the geographic range and seasonality of the insects (or disease vectors) that can carry the diseases. Scientists stated a clear observation in 2022: "the occurrence of climate-related food-borne and waterborne diseases has increased (very high confidence)."^[81]: 11

Infectious diseases that are sensitive to climate can be grouped into: vector-borne diseases (transmitted via mosquitos, ticks etc.), waterborne diseases (transmitted via viruses or bacteria through water), and food-borne diseases.^[82]: 1107 Climate change is affecting the distribution of these diseases due to the expanding geographic range and seasonality of these diseases and their vectors.^[83]: 9 Like other ways in which climate change affects on human health, climate change exacerbates existing inequalities and challenges in managing infectious disease.

Mosquito-borne diseases that are sensitive to climate include malaria, lymphatic filariasis, Rift Valley fever, yellow fever, dengue fever, Zika virus, and chikungunya.^[84][85][86] Scientists found in 2022 that rising temperatures are increasing the areas where dengue fever, malaria and other mosquito-carried diseases are able to spread.^[82]: 1062 Warmer temperatures are also advancing to higher elevations, allowing mosquitoes to survive in places that were previously inhospitable to them.^[82]: 1045 This risks malaria making a return to areas where it was previously eradicated.^[87]

Ticks are changing their geographic range because of rising temperatures, and this puts new populations at risk. Ticks can spread lyme disease and tick-borne encephalitis. It is expected that climate change will increase the incidence of these diseases in the Northern Hemisphere.^[82]: 1094 For example, a review of the literature found that "In the USA, a 2°C warming could increase the number of lyme disease cases by over 20% over the coming decades and lead to an earlier onset and longer length of the annual Lyme disease season".^[82]: 1094

Waterborne diseases are caused by a pathogen transmitted through water. The symptoms of waterborne diseases typically include diarrhea, fever and other flu-like symptoms, neurological disorders, and liver damage.^[88] Changes in climate have a large effect on the distribution of microbial species. These communities are very complex and can be extremely sensitive to external climate stimuli.^[89] There are a range of waterborne diseases and parasites that will pose greater health risks in future. This will vary by region. For example, in Africa Cryptosporidium spp. and Giardia duodenalis (protozoan parasites) will increase. This is due to increasing temperatures and drought.^[82]: 1095

Scientist also expect that disease outbreaks caused by vibrio (in particular the bacterium that causes cholera, called vibrio cholerae) are increasing in occurrence and intensity.^[82]: 1107 One reason is that the area of coastline with suitable conditions for vibrio bacteria has increased due to changes in sea surface temperature and sea surface salinity caused by climate change.^[83]: 12 These pathogens can cause gastroenteritis, cholera, wound infections, and sepsis. The increasing occurrence of higher temperature days, heavy rainfall events and flooding due to climate change could lead to an increase in cholera risks.^[82]: 1045

Health risks from food and water insecurity

Further information: Effects of climate change on agriculture, Effects of climate change on oceans, and Effects of climate change on livestock

Climate change affects many aspects of food security through "multiple and interconnected pathways".^[2]: 1619 Many of these are related to the effects of climate change on agriculture, for example failed crops due to more extreme weather events. This comes on top of other coexisting crises that reduce food security in many regions. Less food security means more undernutrition with all its associated health problems. Food insecurity is increasing at the global level (some of the underlying causes are related to climate change, others are not) and about 720–811 million people suffered from hunger in 2020.^[2]: 1629

The number of deaths resulting from climate change-induced changes to food availability are difficult to estimate. The 2022 IPCC Sixth Assessment Report does not quantify this number in its chapter on food security.^[90] A modelling study from 2016 found "a climate change–associated net increase of 529,000 adult deaths worldwide [...] from expected reductions in food availability (particularly fruit and vegetables) by 2050, as compared with a reference scenario without climate change."^[91][92]

Reduced nutritional value of crops

This section is an excerpt from Effects of climate change on agriculture § Reduced nutritional value of crops.[edit]

 

Average decrease of micronutrient density across a range of crops at elevated CO₂ concentrations, reconstructed from multiple studies through a meta-analysis.^[93] The elevated concentration in this figure, 689 ppm, is over 50% greater than the current levels, yet it is expected to be approached under the "mid-range" climate change scenarios, and will be surpassed in the high-emission one.^[94]

Changes in atmospheric carbon dioxide may reduce the nutritional quality of some crops, with for instance wheat having less protein and less of some minerals.^{[95]: 439 [96]} The nutritional quality of C3 plants (e.g. wheat, oats, rice) is especially at risk: lower levels of protein as well as minerals (for example zinc and iron) are expected.^[97]: 1379 Food crops could see a reduction of protein, iron and zinc content in common food crops of 3 to 17%.^[98] This is the projected result of food grown under the expected atmospheric carbon-dioxide levels of 2050. Using data from the UN Food and Agriculture Organization as well as other public sources, the authors analyzed 225 different staple foods, such as wheat, rice, maize, vegetables, roots and fruits.^[99]

Food production from the oceans

Further information: Effects of climate change on oceans and Climate change and fisheries

A headline finding in 2021 regarding marine food security stated that: "In 2018–20, nearly 70% of countries showed increases in average sea surface temperature in their territorial waters compared within 2003–05, reflecting an increasing threat to their marine food productivity and marine food security".^[3]: 14

Water insecurity

Further information: Water security § Climate change

 

Aggregated global water security index, calculated using the aggregation of water availability, accessibility, safety and quality, and management indices. The value '0–1' (with the continuous color 'red to blue') represents 'low to high' security.^[100]

Access to clean drinking water and sanitation is important for healthy living and well-being.^[101]

This section is an excerpt from Effects of climate change § Water security.[edit]

Water resources can be affected by climate change in various ways. The total amount of freshwater available can change, for instance due to dry spells or droughts. Heavy rainfall and flooding can have an impact on water quality. They can transport pollutants into water bodies through increased surface runoff. In coastal regions, more salt may find its way into water resources due to higher sea levels and more intense storms. Higher temperatures also directly degrade water quality. This is because warm water contains less oxygen.^[102] Changes in the water cycle threaten existing and future water infrastructure. It will be harder to plan investments for water infrastructure. This is because there are significant uncertainties about future variability of the water cycle.^[103]

Other health risks influenced by climate change

Pollen allergies

 

Depiction of a person suffering from Allergic Rhinitis

A warming climate can lead to increases of pollen season lengths and concentrations in some regions of the world. For example, in northern mid-latitudes regions, the spring pollen season is now starting earlier.^[1]: 1049 This can affect people with pollen allergies (hay fever).^[104] The rise in pollen also comes from rising CO₂ concentrations in the atmosphere and resulting CO₂ fertilisation effects.^[1]: 1096

Violence and conflicts

See also: Climate security

Climate change may increase the risk of violent conflict, which can lead to injuries, such as battle injuries, and death. Conflict can result from the increased propensity towards violence after people become more irritable due to excessive heat.^[105] There can also be follow-on effects on health from resource scarcity or human migrations that climate change can cause or aggravate in already conflict prone areas.^[106][107]

However, the observed contribution of climate change to conflict risk is small in comparison with cultural, socioeconomic, and political causes. There is some evidence that rural-to-urban migration within countries worsens the conflict risk in violence prone regions. But there is no evidence that migration between countries would increase the risk of violence.^{[1]: 1008, 1128}

Ozone-related health burden

Further information: Ozone § Ozone air pollution, Ozone § Low level ozone in urban areas, and Ground-level ozone § Ozone and the climate

 

Signboard in Gulfton, Houston indicating an ozone watch

The relationship between surface ozone (also called ground-level ozone) and ambient temperature is complex. Changes in air temperature and water content affect the air's chemistry and the rates of chemical reactions that create and remove ozone. Many chemical reaction rates increase with temperature and lead to increased ozone production. Climate change projections show that rising temperatures and water vapour in the atmosphere will likely increase surface ozone in polluted areas like the eastern United States.^[108]

On the other hand, ozone concentrations could decrease in a warming climate if anthropogenic ozone-precursor emissions (e.g., nitrogen oxides) continue to decrease through implementation of policies and practices.^[109] Therefore, future surface ozone concentrations depend on the climate change mitigation steps taken (more or less methane emissions) as well as air pollution control steps taken.^[110]: 884

High surface ozone concentrations often occur during heat waves in the United States.^[109] Throughout much of the eastern United States, ozone concentrations during heat waves are at least 20% higher than the summer average.^[109] Broadly speaking, surface ozone levels are higher in cities with high levels of air pollution.^[110]: 876 Ozone pollution in urban areas affects denser populations, and is worsened by high populations of vehicles, which emit pollutants NO₂ and VOCs, the main contributors to problematic ozone levels.^[111]

There is a great deal of evidence to show that surface ozone can harm lung function and irritate the respiratory system.^[112][113] Exposure to ozone (and the pollutants that produce it) is linked to premature death, asthma, bronchitis, heart attack, and other cardiopulmonary problems.^[114][115] High ozone concentrations irritate the lungs and thus affect respiratory function, especially among people with asthma.^[109] People who are most at risk from breathing in ozone air pollution are those with respiratory issues, children, older adults and those who typically spend long periods of time outside such as construction workers.^[116]

Harmful algal blooms in oceans and lakes

See also: Harmful algal bloom

 

Cyanobacteria (blue-green algae) bloom on Lake Erie (United States) in 2009. These kinds of algae can cause harmful algal blooms.

The warming oceans and lakes are leading to more frequent harmful algal blooms.^{[74][117][118]} Also, during droughts, surface waters are even more susceptible to harmful algal blooms and microorganisms.^[119] Algal blooms increase water turbidity, suffocating aquatic plants, and can deplete oxygen, killing fish. Some kinds of blue-green algae (cyanobacteria) create neurotoxins, hepatoxins, cytotoxins or endotoxins that can cause serious and sometimes fatal neurological, liver and digestive diseases in humans. Cyanobacteria grow best in warmer temperatures (especially above 25 degrees Celsius), and so areas of the world that are experiencing general warming as a result of climate change are also experiencing harmful algal blooms more frequently and for longer periods of time.^[120]

One of these toxin producing algae is Pseudo-nitzschia fraudulenta. This species produces a substance called domoic acid which is responsible for amnesic shellfish poisoning.^[121][122] The toxicity of this species has been shown to increase with greater CO₂ concentrations associated with ocean acidification.^[121] Some of the more common illnesses reported from harmful algal blooms include; Ciguatera fish poisoning, paralytic shellfish poisoning, azaspiracid shellfish poisoning, diarrhetic shellfish poisoning, neurotoxic shellfish poisoning and the above-mentioned amnesic shellfish poisoning.^[121]

Carbon dioxide levels and human cognition

Higher levels of indoor and outdoor CO₂ levels may impair human cognition.^{[123][124][125]}

Accidents

Researchers found that there is a strong correlation between higher winter temperatures and drowning accidents in large lakes, because the ice gets thinner and weaker.^[126]

Available evidence on the effect of climate change on the epidemiology of snakebite is limited but it is expected that there will be a geographic shift in risk of snakebite: northwards in North America and southwards in South America and in Mozambique, and increase in incidence of bite in Sri Lanka.^[127]

Potential health benefits

Benefits from climate change response

See also: Co-benefits of climate change mitigation

The potential health benefits (also called "co-benefits") from climate change mitigation and adaptation measures are significant, having been described as "the greatest global health opportunity" of the 21st century. ^[8]: 1861 Measures can not only mitigate future health effects from climate change but also improve health directly.^[128] Climate change mitigation is interconnected with various co-benefits (such as reduced air pollution and associated health benefits)^[129] and how it is carried out (in terms of e.g. policymaking) could also determine its effect on living standards (whether and how inequality and poverty are reduced).^[130]

There are many health co-benefits associated with climate action. These include those of cleaner air, healthier diets (e.g. less red meat), more active lifestyles, and increased exposure to green urban spaces.^[3]: 26 Access to urban green spaces provides benefits to mental health as well.^[3]: 18

Compared with the current pathways scenario (with regards to greenhouse gas emissions and mitigation efforts), the "sustainable pathways scenario" will likely result in an annual reduction of 1.18 million air pollution-related deaths, 5.86 million diet-related deaths, and 1.15 million deaths due to physical inactivity, across the nine countries, by 2040. These benefits were attributable to the mitigation of direct greenhouse gas emissions and the commensurate actions that reduce exposure to harmful pollutants, as well as improved diets and safe physical activity.^[131] Air pollution generated by fossil fuel combustion is both a major driver of global warming and the cause of a large number of annual deaths with some estimates as high as 8.7 million excess deaths during 2018.^[132][133]

Placing health as a key focus of the Nationally Determined Contributions could present an opportunity to increase ambition and realize health co-benefits.^[131]

Potential health benefits from global warming

It is possible that a potential health benefit from global warming could result from fewer cold days in winter:^[1]: 1099 This could lead to some mental health benefits. However, the evidence on this correlation is regarded as inconsistent in 2022.^[1]: 1099

Global estimates

 

Simplified conceptual causal loop diagram of cascading global climate failure, related to the concept of One Health^[134]

Estimating deaths (mortality) or DALYs (morbidity) from the effects of climate change at the global level is very difficult. A 2014 study by the World Health Organization estimated the effect of climate change on human health, but not all of the effects of climate change were included.^[135] For example, the effects of more frequent and extreme storms were excluded. The study assessed deaths from heat exposure in elderly people, increases in diarrhea, malaria, dengue, coastal flooding, and childhood undernutrition. The authors estimated that climate change was projected to cause an additional 250,000 deaths per year between 2030 and 2050 but also stated that "these numbers do not represent a prediction of the overall impacts of climate change on health, since we could not quantify several important causal pathways".^[135]

Climate change was responsible for 3% of diarrhoea, 3% of malaria, and 3.8% of dengue fever deaths worldwide in 2004.^[136] Total attributable mortality was about 0.2% of deaths in 2004; of these, 85% were child deaths. The effects of more frequent and extreme storms were excluded from this study.

The health effects of climate change are expected to rise in line with projected ongoing global warming for different climate change scenarios.^[137][138] A review^[139] found if warming reaches or exceeds 2 °C this century, roughly 1 billion premature deaths would be caused by anthropogenic global warming.^[140]

Society and culture

Climate justice and climate migrants

Further information: Climate justice and Climate migrant

Much of the health burden associated with climate change falls on vulnerable people (e.g. indigenous peoples and economically disadvantaged communities). As a result, people of disadvantaged sociodemographic groups experience unequal risks.^[141] Often these people will have made a disproportionately low contribution toward man-made global warming, thus leading to concerns over climate justice.^{[142][143][138]}

Climate change has diverse effects on migration activities, and can lead to decreases or increases in the number of people who migrate.^[1]: 1079 Migration activities can have an effect on health and well-being, in particular for mental health. Migration in the context of climate change can be grouped into four types: adaptive migration (see also climate change adaptation), involuntary migration, organised relocation of populations, and immobility (which is when people are unable or unwilling to move even though it is recommended).^[1]: 1079

Communication strategies

Further information: Individual action on climate change

Studies have found that when communicating climate change with the public, it can help encourage engagement if it is framed as a health concern, rather than as an environmental issue. This is especially the case when comparing a health related framing to one that emphasised environmental doom, as was common in the media at least up until 2017.^[144][145] Communicating the co-benefits to health helps underpin greenhouse gas reduction strategies.^[58] Safeguarding health—particularly of the most vulnerable—is a frontline local climate change adaptation goal.^[58]

Policy responses

 

Degrees of concern about the effects of climate change vary with political affiliation.^[146]

Due to its significant impact on human health,^[147][148] climate change has become a major concern for public health policy. The United States Environmental Protection Agency had issued a 100-page report on global warming and human health back in 1989.^[138][149] By the early years of the 21st century, climate change was increasingly addressed as a public health concern at a global level, for example in 2006 at Nairobi by UN secretary general Kofi Annan. Since 2018, factors such as the 2018 heat wave, the Greta effect and the IPCC's 2018 Special Report on Global Warming of 1.5 °C further increased the urgency for responding to climate change as a global health issue.^{[138][58][143]}

The World Bank has suggested a framework that can strengthen health systems to make them more resilient and climate-sensitive.^[150]

See also

• Health policy
• Health system
• Health law
• Environmental health
• Global health
• Universal health care

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149. Dean Russell; Elisabeth Gawthrop; Veronica Penney; Ali Raj; Bridget Hickey (16 June 2020). "Deadly heat is killing Americans: A decade of inaction on climate puts lives at risk". The Guardian. Retrieved 1 March 2021.
150. Operational framework for building climate resilient health systems. WHO. 2015. ISBN 978-92-4-156507-3.^{[page needed]}

External links

• Public health and climate change (Lancet)
• Climate change and health (World Health Organization)