Managing the Health Effects of Temperature in Response to Climate Change: Challenges Ahead

By Huang, Cunrui; Barnett, Adrian G. et al. | Environmental Health Perspectives, April 2013 | Go to article overview

Managing the Health Effects of Temperature in Response to Climate Change: Challenges Ahead


Huang, Cunrui, Barnett, Adrian G., Xu, Zhiwei, Chu, Cordia, Wang, Xiaoming, Turner, Lyle R., Tong, Shilu, Environmental Health Perspectives


BACKGROUND: Although many studies have shown that high temperatures are associated with an increased risk of mortality and morbidity, there has been little research on managing the process of planned adaptation to alleviate the health effects of heat events and climate change. In particular, economic evaluation of public health adaptation strategies has been largely absent from both the scientific literature and public policy discussion.

OBJECTIVES: We examined how public health organizations should implement adaptation strategies and, second, how to improve the evidence base required to make an economic case for policies that will protect the public's health from heat events and climate change.

DISCUSSION: Public health adaptation strategies to cope with heat events and climate change fall into two categories: reducing the heat exposure and managing the health risks. Strategies require a range of actions, including timely public health and medical advice, improvements to housing and urban planning, early warning systems, and assurance that health care and social systems are ready to act. Some of these actions are costly, and given scarce financial resources the implementation should be based on the cost-effectiveness analysis. Therefore, research is required not only on the temperature-related health costs, but also on the costs and benefits of adaptation options. The scientific community must ensure that the health co-benefits of climate change policies are recognized, understood, and quantified.

CONCLUSIONS: The integration of climate change adaptation into current public health practice is needed to ensure the adaptation strategies increase future resilience. The economic evaluation of temperature-related health costs and public health adaptation strategies are particularly important for policy decisions.

KEY WORDS: adaptation, climate change, economic analysis, heat event, public health. Environ Health Perspect 121:415-419 (2013). http://dx.doi.org/10.1289/ehp.1206025 [Online 12 February 2013]

Many studies have found that extreme temperatures are associated with an increased risk of illness and death (Basu 2009; Kovats and Hajat 2008; O'Neill and Ebi 2009). The associations between daily temperature and mortality are generally U-shaped, with lower mortality rates in a "comfort zone" of temperatures, and mortality rates rising progressively as temperatures become hotter or colder (Analitis et al. 2008; McMichael et al. 2008). The comfort zone varies between cities and is generally higher in warmer climates, suggesting adaptation to local climatic conditions.

Heat-related mortality is a growing public health concern because of climate change, population aging, and increasing urbanization (Luber and McGeehin 2008). Climate change is projected to increase global mean surface temperatures by 2-4.5 [degrees]C with 76% probability, and over 4.5 [degrees]C with 14% probability, by 2100 (Rogelj et al. 2012) and will increase the frequency and intensity of heat waves. These changes are likely to have a greater impact on persons living in old or poorly constructed houses, which offer less protection from the outside heat (Chapman et al. 2009) and those living without air conditioners (Kovats and Hajat 2008). Population aging may further amplify vulnerability: the elderly and those with preexisting disease are often more susceptible to heat (Basu 2009). A larger number of people living in cities may also contribute to additional heat-related health problems because of urban heat islands, an interaction between air pollution and heat, and higher concentrations of heat-susceptible people (Harlan and Ruddell 2011).

Managing the health effects of temperature in response to climate change is a global public health challenge (Hajat et al. 2010). Until now, most studies have focused on quantifying temperature-health relationships, characterizing vulnerable subgroups, identifying effect modifiers (e. …

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