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Climate change was responsible for 3% of [[diarrhoea]], 3% of [[malaria]], and 3.8% of [[dengue fever]] deaths worldwide in 2004.<ref>{{cite book |author=WHO |url=https://www.who.int/healthinfo/global_burden_disease/global_health_risks/en/index.html |title=Global health risks: mortality and burden of disease attributable to selected major risks |publisher=WHO Press |year=2009 |isbn=978-92-4-156387-1 |location=Geneva, Switzerland |page=24 |chapter=Ch. 2, Results: 2.6 Environmental risks |format=PDF |access-date=4 October 2020 |chapter-url=https://www.who.int/entity/healthinfo/global_burden_disease/GlobalHealthRisks_report_part2.pdf |archive-url=https://web.archive.org/web/20131210002548/http://www.who.int/healthinfo/global_burden_disease/global_health_risks/en/index.html |archive-date=10 December 2013 }}</ref> 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.
Climate change was responsible for 3% of [[diarrhoea]], 3% of [[malaria]], and 3.8% of [[dengue fever]] deaths worldwide in 2004.<ref>{{cite book |author=WHO |url=https://www.who.int/healthinfo/global_burden_disease/global_health_risks/en/index.html |title=Global health risks: mortality and burden of disease attributable to selected major risks |publisher=WHO Press |year=2009 |isbn=978-92-4-156387-1 |location=Geneva, Switzerland |page=24 |chapter=Ch. 2, Results: 2.6 Environmental risks |format=PDF |access-date=4 October 2020 |chapter-url=https://www.who.int/entity/healthinfo/global_burden_disease/GlobalHealthRisks_report_part2.pdf |archive-url=https://web.archive.org/web/20131210002548/http://www.who.int/healthinfo/global_burden_disease/global_health_risks/en/index.html |archive-date=10 December 2013 }}</ref> 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 impacts of climate change are expected to rise in line with projected ongoing global warming for different [[climate change scenario]]s.<ref>{{cite book |last1=Crimmins |first1=A. |url=https://digital.library.unt.edu/ark:/67531/metadc950291/ |title=The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment |last2=Balbus |first2=J. |last3=Gamble |first3=J.L. |last4=Beard |first4=C.B. |last5=Bell |first5=J.E. |last6=Dodgen |first6=D. |last7=Eisen |first7=R.J. |last8=Fann |first8=N. |last9=Hawkins |first9=M.D. |year=2016 |isbn=978-0-16-093241-0 |doi=10.7930/J0R49NQX |last10=Herring |first10=S.C. |last11=Jantarasami |first11=L. |last12=Mills |first12=D.M. |last13=Saha |first13=S. |last14=Sarofim |first14=M.C. |last15=Trtanj |first15=J. |last16=Ziska |first16=L.}}</ref><ref name="GPH2021" />
The health impacts of climate change are expected to rise in line with projected ongoing global warming for different [[climate change scenario]]s.<ref>{{cite book |last1=Crimmins |first1=A. |url=https://digital.library.unt.edu/ark:/67531/metadc950291/ |title=The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment |last2=Balbus |first2=J. |last3=Gamble |first3=J.L. |last4=Beard |first4=C.B. |last5=Bell |first5=J.E. |last6=Dodgen |first6=D. |last7=Eisen |first7=R.J. |last8=Fann |first8=N. |last9=Hawkins |first9=M.D. |year=2016 |isbn=978-0-16-093241-0 |doi=10.7930/J0R49NQX |last10=Herring |first10=S.C. |last11=Jantarasami |first11=L. |last12=Mills |first12=D.M. |last13=Saha |first13=S. |last14=Sarofim |first14=M.C. |last15=Trtanj |first15=J. |last16=Ziska |first16=L.}}</ref><ref name="GPH2021" /> A review<ref>{{Cite journal |last=Pearce |first=Joshua M. |last2=Parncutt |first2=Richard |date=2023-01 |title=Quantifying Global Greenhouse Gas Emissions in Human Deaths to Guide Energy Policy |url=https://www.mdpi.com/1996-1073/16/16/6074 |journal=Energies |language=en |volume=16 |issue=16 |pages=6074 |doi=10.3390/en16166074 |issn=1996-1073}}</ref> found if warming reaches or exceeds 2 °C this century, roughly 1 billion premature deaths would be caused by anthropogenic global warming.<ref>{{Cite news |date=2023-08-29 |title=Human-caused climate change may lead to 1 billion premature deaths over next century: Study |work=The Times of India |url=https://timesofindia.indiatimes.com/home/environment/global-warming/human-caused-climate-change-may-lead-to-1-billion-premature-deaths-over-next-century-study/articleshow/103164287.cms?from=mdr |access-date=2023-09-18 |issn=0971-8257}}</ref>


== Society and culture ==
== Society and culture ==

Revision as of 11:18, 18 September 2023

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.

The effects of climate change on human health are increasingly well studied and quantified.[1][2] Direct effects include heat waves and extreme weather events. Indirect effects take place through changes in the biosphere. Examples are changes in water and air quality, food security and displacement. Factors such as age, gender or socioeconomic status influence to what extent these effects become wide-spread risks to human health.[3]: 1867  Health risks are unevenly distributed across the world.[3] Disadvantaged populations are especially vulnerable to climate change impacts.[4]: 15  For example, young children and older people are the most vulnerable to extreme heat.[5]

The relationship between health and heat includes several aspects.[4] One is the exposure of vulnerable populations to heatwaves. Another is heat-related mortality. Reduced labour capacity for outdoor workers and impacts on mental health are others. Extreme weather events have a big impact on health. These include floods, hurricanes, droughts and wildfires. They cause injuries, diseases, and air pollution in the case of wildfires. Other indirect health impacts from climate change may be rising food insecurity, undernutrition and water insecurity.[4]

A range of climate-sensitive infectious diseases may increase in some regions. These include mosquito-borne diseases, zoonoses, cholera and some waterborne diseases.[4] Climate change will also impact where infectious diseases are likely to be able to spread in the future. Many infectious diseases will spread to new geographic areas where people do not yet have suitable immune systems.

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".[6] The World Health Organisation reiterated this in 2015.[7] In 2019, the Australian Medical Association formally declared climate change a health emergency.[8]

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.[9][10]

Root causes

Effects of climate change

Effects of climate change are well documented and growing for Earth's natural environment and human societies. Changes to the climate system include an overall warming trend, changes to precipitation patterns, and more extreme weather. As the climate changes it impacts the natural environment with effects such as more intense forest fires, thawing permafrost, and desertification. These changes impact ecosystems and societies, and can become irreversible once tipping points are crossed.

The effects of climate change vary in timing and location. Up until now the Arctic has warmed faster than most other regions due to climate change feedbacks.[11] Surface air temperatures over land have also increased at about twice the rate they do over the ocean, causing intense heat waves. These temperatures would stabilize if greenhouse gas emissions were brought under control. Ice sheets and oceans absorb the vast majority of excess heat in the atmosphere, delaying effects there but causing them to accelerate and then continue after surface temperatures stabilize. Sea level rise is a particular long term concern as a result. The effects of ocean warming also include marine heatwaves, ocean stratification, deoxygenation, and changes to ocean currents.[12]: 10  The ocean is also acidifying as it absorbs carbon dioxide from the atmosphere.[13]

The ecosystems most immediately threatened by climate change are in the mountains, coral reefs, and the Arctic. Excess heat is causing environmental changes in those locations that exceed the ability of animals to adapt.[14] Species are escaping heat by migrating towards the poles and to higher ground when they can.[15] Sea level rise threatens coastal wetlands with flooding. Decreases in soil moisture in certain locations can cause desertification and damage ecosystems like the Amazon Rainforest.[16]: 9  At 2 °C (3.6 °F) of warming, around 10% of species on land would become critically endangered.[17]: 259 

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.[4]: 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".[18]

Overview of health impacts

Types of pathways affecting health

The effects of climate change on human health can be grouped into direct and indirect effects.[3]: 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[4]
  • 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).[3]

Impacts on general health and wellbeing

The direct, indirect and social dynamic effects of climate change on health and wellbeing produce the following health impacts: cardiovascular diseases, respiratory diseases, infectious diseases, undernutrition, mental illness, allergies, injuries and poisoning.[3]: 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.[19][4]: 15 

Impacts on mental health

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.[20] There are three broad pathways by which these effects can take place: directly, indirectly or via awareness.[21] 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.[22] 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.[22] The third pathway can be of mere awareness of the climate change threat, even by individuals who are not otherwise affected by it.[21]

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.[23][24] Impacts of anthropogenic climate change, such as freshwater pollution or deforestation, degrade these landscapes and reduce public access.[25] 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.[26]

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.[27][28] Such emotions can be rational responses to the degradation of the natural world and lead to adaptive action.[29]

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.[30]: 9 

Impacts caused by heat

Impacts 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.[4]

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.[31] The trend is faster since the 1970s than in any other 50-year period over at least the last 2000 years.[31]

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.[32]

Heat-related health impacts for vulnerable people

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.[4]: 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.[4] Exposure to extreme heat poses an acute health hazard for many of the people deemed as vulnerable.[4][33]

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]: 1051 Heat waves have also resulted in epidemics of chronic kidney disease (CKD).[34][35] Prolonged heat exposure, physical exertion, and dehydration are sufficient factors for the development of CKD.[34][35]

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.[36][37] 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).[38]: 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.[39][40][41] Global warming above 1.5 degrees risks making parts of the tropics uninhabitable because the threshold for the wet bulb temperature may be passed.[36]

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[42] as cognitive performance has been shown to be differentially affected by heat.[43] People with diabetes and those who are overweight, have sleep deprivation, or have cardiovascular/cerebrovascular conditions should avoid too much heat exposure.[42][44]

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.[45] 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.[33]

In urban areas

Increasing heat waves are one effect of climate change that impacts 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.[46][47]: 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.[33] Lack of water features are another cause.[47]: 2926 

Extreme heat exposure in cities with a wet bulb globe temperature above 30 °C tripled between 1983 and 2016.[46] It increased by about 50% when the population growth in these cities is not taken into account.[46]

Cities are often on the front-line of climate impacts 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.[48]

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".[4]: 9 

More than 70,000 Europeans died as a result of the 2003 European heat wave.[49] 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).[50][51]

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.[4]: 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.[52][53] 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.[4]: 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.[54][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.

Impacts caused by weather and climate events other than heat

A schematic showing the regions where more disasters will occur due to climate change

Climate change is increasing the periodicity and intensity of some extreme weather events.[55] 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.[56]

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

Due to an increase in heavy rainfall events, floods are expected to become more severe in future when they do occur.[57]: 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.[57]: 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.[58]

For example, the 2022 Pakistan Floods (which were likely more severe because of climate change[59][60]) affected people's health directly and indirectly. There were outbreaks of diseases like malaria, dengue, and other skin diseases.[61][62] 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.[63]

Hurricanes and thunderstorms

Stronger hurricanes create more opportunities for vectors to breed and infectious diseases to flourish.[64][65] 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.[64]

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.[33]

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.[66][57]: 1057  Many of the consequences of droughts have impacts 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

Flat expanse of brown grasses and some green trees with black and some gray smoke and visible flames in the distance.
Air pollution from a surface fire in the western desert of Utah. Wildfires become more frequent and intense due to climate change.

Climate change increases wildfire potential and activity.[67] 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.[68]

Wood smoke from wildfires produces particulate matter that has damaging effects to human health.[69] The primary pollutants in wood smoke are carbon monoxide and nitric oxide.[68] Through the destruction of forests and human-designed infrastructure, wildfire smoke releases other toxic and carcinogenic compounds, such as formaldehyde and hydrocarbons.[70] These pollutants damage human health by evading the mucociliary clearance system and depositing in the upper respiratory tract, where they have toxic effects.[68]

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.[69]

Health risks due to climate-sensitive infectious diseases

Infectious diseases that are sensitive to climate can be grouped into: vector-borne diseases (transmitted via mosquitos, ticks etc.), water-borne diseases (transmitted via viruses or bacteria, e.g.: E. Coli) and food-borne diseases (e.g.: Salmonella).[1]: 1107  Climate change is affecting the distribution of these diseases due to the expanding geographic range and seasonality of these diseases and their vectors.[4]: 9 

Climate change may also lead to new infectious diseases due to changes in microbial and vector geographic range. Microbes that are harmful to humans can adapt to higher temperatures, which will allow them to build better tolerance against human endothermy defences.[71]

Vector-borne diseases

Aedes aegypti, the mosquito that is the vector for dengue transmission.
An Anopheles stephensi mosquito shortly after obtaining blood from a human (the droplet of blood is expelled as a surplus). This mosquito is a vector of malaria, and mosquito control is an effective way of reducing its incidence.

Mosquito-borne diseases

Mosquito-borne diseases that are sensitive to climate include malaria, elephantiasis, Rift Valley fever, yellow fever, dengue fever, Zika virus, and chikungunya.[72][73][74] Scientists found in 2022 that rising temperatures are increasing the areas where dengue fever, malaria and other mosquito-carried diseases are able to spread.[1]: 1062  Warmer temperatures are also advancing to higher elevations, allowing mosquitoes to survive in places that were previously inhospitable to them.[1]: 1045  This risks malaria making a return to areas where it was previously eradicated.[64]

Diseases from ticks

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.[1]: 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".[1]: 1094 

Waterborne diseases

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 (two protozoan parasites) will increase. This is due to increasing temperatures and drought.[1]: 1095 

Scientist expect that disease outbreaks caused by vibrio (in particular the bacterium that causes cholera, called vibrio cholerae) are increasing in occurrence and intensity.[1]: 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.[4]: 12  These pathogens can cause gastroenteritis, cholera, wound infections, and sepsis. It has been observed that in the period of 2011–21, the "area of coastline suitable for Vibrio bacterial transmission has increased by 35% in the Baltics, 25% in the Atlantic Northeast, and 4% in the Pacific Northwest.[4]: 12  Furthermore, the increasing occurrence of higher temperature days, heavy rainfall events and flooding due to climate change could lead to an increase in cholera risks.[1]: 1045 

Health risks from food and water insecurity

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.[75] 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."[76][77]

Reduced nutritional value of crops

Average decrease of micronutrient density across a range of crops at elevated CO2 concentrations, reconstructed from multiple studies through a meta-analysis.[78] 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.[79]
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.[80]: 439 [81] 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.[82]: 1379  Food crops could see a reduction of protein, iron and zinc content in common food crops of 3 to 17%.[83] 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.[84]

Food production from the oceans

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".[4]: 14 

Water insecurity

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.[85]

Access to clean drinking water and sanitation is important for healthy living and well-being.[86]

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.[87] 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.[88]

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).[89] The rise in pollen also comes from rising CO2 concentrations in the atmosphere and resulting CO2 fertilisation effects.[1]: 1096 

Violence and conflicts

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.[90] 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.[91][92]

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

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.[93]

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.[94] 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.[95]: 884 

High surface ozone concentrations often occur during heat waves in the United States.[94] Throughout much of the eastern United States, ozone concentrations during heat waves are at least 20% higher than the summer average.[94] Broadly speaking, surface ozone levels are higher in cities with high levels of air pollution.[95]: 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.[96]

There is a great deal of evidence to show that surface ozone can harm lung function and irritate the respiratory system.[97][98] Exposure to ozone (and the pollutants that produce it) is linked to premature death, asthma, bronchitis, heart attack, and other cardiopulmonary problems.[99][100] High ozone concentrations irritate the lungs and thus affect respiratory function, especially among people with asthma.[94] 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.[101]

Harmful algal blooms in oceans and lakes

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.[64][74][102] Also, during droughts, surface waters are even more susceptible to harmful algal blooms and microorganisms.[103] 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.[104]

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.[105][106] The toxicity of this species has been shown to increase with greater CO2 concentrations associated with ocean acidification.[105] 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.[105]

Carbon dioxide levels and human cognition

Higher levels of indoor and outdoor CO2 levels may impair human cognition.[107][108][109]

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.[110]

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.[111]

Potential health benefits

Health co-benefits from mitigation

The health benefits (also called "co-benefits") from climate change mitigation measures are significant: potential measures can not only mitigate future health impacts from climate change but also improve health directly.[112] Climate change mitigation is interconnected with various co-benefits (such as reduced air pollution and associated health benefits)[113] and how it is carried out (in terms of e.g. policymaking) could also determine its impacts on living standards (whether and how inequality and poverty are reduced).[114]

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.[4]: 26  Access to urban green spaces provides benefits to mental health as well.[4]: 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.[115] 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.[116][117]

Placing health as a key focus of the Nationally Determined Contributions could present an opportunity to increase ambition and realize health co-benefits.[115]

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[118]

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.[119] 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".[119]

Climate change was responsible for 3% of diarrhoea, 3% of malaria, and 3.8% of dengue fever deaths worldwide in 2004.[120] 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 impacts of climate change are expected to rise in line with projected ongoing global warming for different climate change scenarios.[121][122] A review[123] found if warming reaches or exceeds 2 °C this century, roughly 1 billion premature deaths would be caused by anthropogenic global warming.[124]

Society and culture

Climate justice and climate migrants

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.[125] Often these people will have made a disproportionately low contribution toward man-made global warming, thus leading to concerns over climate justice.[126][127][122]

Climate change has diverse impacts on migration activities, and can lead to decreases or increases in the number of people who migrate.[1]: 1079  Migration activities can have impacts 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

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.[128][129] Communicating the co-benefits to health helps underpin greenhouse gas reduction strategies.[48] Safeguarding health—particularly of the most vulnerable—is a frontline local climate change adaptation goal.[48]

Policy responses

Degrees of concern about the effects of climate change vary with political affiliation.[130]

Due to its significant impact on human health,[131][132] 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.[122][133] 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.[122][48][127]

The World Bank has suggested a framework that can strengthen health systems to make them more resilient and climate-sensitive.[134]

See also

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