Health, Wellbeing and the Changing Structure of Communities

Abstract

Climate-related illnesses, premature deaths, malnutrition in all its forms, and threats to mental health and well-being are increasing (very high confidence 1 ).Climate hazards are a growing driver of involuntary migration and displacement (high confidence) and are a contributing factor to violent conflict (high confidence).These impacts are often inter-connected, are unevenly distributed across and within societies, and will continue to be experienced inequitably due to differences in exposure and vulnerability (very high confidence).Cascading and compounding risks affecting health due to extreme weather events have been observed in all inhabited regions, and risks are expected to increase with further warming (very high confidence) {7.1.3,7.1.4;Cross-Chapter Box COVID in Chapter 7; 7.2.1, 7.2.2, 7.2.3,7.2.4,7.3.1,7.3.2,7.3.3,7.4.1,7.4.4;Cross-Chapter Box HEALTH in Chapter 7; Cross-Chapter Box ILLNESS in Chapter 2}. Since AR5, new evidence and awareness of current impacts and projected risks of climate change on health, well-being, migration and conflict have emerged, including greater evidence of the detrimental impacts of climate change on mental health (very high confidence).New international agreements were reached on climate change (Paris Agreement), disaster risk reduction (DRR) (Sendai Agreement), sustainable development (the Sustainable Development Goals (SDGs)), urbanisation (The New Urban Agenda), migration (Global Compact for Safe, Orderly and Regular Migration) and refugees (Global Compact on Refugees) that, if achieved, would reduce the impacts of climate change on health, well-being, migration and conflict (very high confidence).However, the challenges with implementing these agreements are highlighted by the coronavirus disease 2019 (COVID-19) pandemic, which exposed systemic weaknesses at community, national and international levels in the ability of societies to anticipate and respond to global risks (high confidence).Incremental changes in policies and strategies have proven insufficient to reduce climate-related risks to health, well-being, migration and conflict, highlighting the value of more integrated approaches and frameworks for solutions across systems and sectors that are embodied in these new international agreements (high confidence) {7.1.3,7.2.1, 7.4.1,7.4.2,7.4.3,7.4.6;Cross-Chapter Box COVID in Chapter 7}.With proactive, timely and effective adaptation, many risks for human health and well-being could be reduced and some potentially avoided (very high confidence).A significant adaptation gap exists for human health and well-being and for responses to disaster risks (very high confidence).Nationally Determined Contributions (NDCs) to the Paris Agreement from low-and middle-income countries identify health as a priority concern.National planning on health and climate change is advancing, but the comprehensiveness of strategies and plans need to be strengthened, and implementing action on key health and climate change priorities remains challenging (high confidence).Multi-sectoral collaboration on health and climate change policy is evident, with uneven progress, and financial support for healthIn this Report, the following summary terms are used to describe the available evidence: limited, medium, or robust; and for the degree of agreement: low, medium, or high.A level of confidence is expressed using five qualifiers: very low, low, medium, high, and very high, and typeset in italics, e.g., medium confidence.For a given evidence and agreement statement, different confidence levels can be assigned, but increasing levels of evidence and degrees of agreement are correlated with increasing confidence.adaptation is only 0.5% of dispersed multi-lateral climate finance projects (high confidence).This level of investment is insufficient to protect population health and health systems from most climatesensitive health risks (very high confidence) {7.4.1, 7.4.2,7.4.3}.1045 Health, Wellbeing and the Changing Structure of Communities Chapter 7 1046 Chapter 7 Health, Wellbeing and the Changing Structure of Communities Projected Risks and Vulnerabilities A significant increase in ill health and premature deaths from climate-sensitive diseases and conditions is projected due to climate change (high confidence).An excess of 250,000 deaths yr -1 by 2050 attributable to climate change is projected due to heat, undernutrition, malaria and diarrhoeal disease, with more than half of this excess mortality projected for Africa (compared to a 1961-1991 baseline period for a mid-range emissions scenario) (high confidence).Risks for heat-related morbidity and mortality, ozone-related mortality, malaria, diseases carried by Aedes sp.mosquitoes, Lyme disease and West Nile fever, as well as the temperatures at which risk transitions occur (i.e. from moderate to high to very high), are contingent on future development pathways (high confidence) {7.3.1}.Climate change is projected to significantly increase population exposure to heatwaves (very high confidence) and heat-related morbidity and mortality (high confidence).Models suggest exposure increases 16 times under Representative Concentration Pathway (RCP)4.5 and 36 times under RCP8.5, with the impact of warming amplified under development pathways that do not foster sustainable development.Globally, the impact of projected climate change on temperature-related mortality is expected to be a net increase under RCP4.5 to RCP8.5, even with adaptation (high confidence).Heat related cardiovascular disease mortality is projected to increase by the end of this century (high confidence).Strong geographical differences in heat-related mortality are projected to emerge later this century, mainly driven by population growth and aging in regions with tropical and subtropical climates (very high confidence) {7.3.1}. The burdens of several climate-sensitive food-borne, waterborne, and vector-borne diseases (VBDs) are projected to increase under climate change, assuming no additional adaptation (very high confidence).The distribution and intensity of transmission of malaria is expected to decrease in some areas and increase in others, with increases projected mainly along the current edges of its geographic distribution in endemic areas of sub-Saharan Africa, Asia and South America (high confidence).Dengue risk will increase, with a larger spatio-temporal distribution in Asia, Europe and sub-Saharan Africa under RCP6.0 and RCP8.5, potentially putting another 2.25 billion people at risk (high confidence).Higher incidence rates are projected for Lyme disease in the Northern Hemisphere (high confidence) and for transmission of Schistosoma mansoni in eastern Africa (high confidence) {7.3.1;Cross-Chapter Box ILLNESS in Chapter 2}.Increasing atmospheric concentrations of carbon dioxide and climate change are projected to increase diet-related risk factors and related non-communicable diseasess globally and increase undernutrition, stunting and related childhood mortality particularly in Africa and Asia, with outcomes depending on the extent of mitigation and adaptation (high confidence).These projected changes are expected to slow progress towards eradication of child undernutrition and malnutrition (high confidence).Higher atmospheric concentrations of carbon dioxide reduce the nutritional quality of wheat, rice and other major crops, potentially affecting millions of people at a doubling of carbon dioxide (very high confidence) {7.3.1}. Climate change is expected to have adverse impacts on well-being and to further threaten mental health (very high confidence).Children and adolescents, particularly girls, elderly people, and people with existing mental, physical and medical challenges are particularly at risk.Mental health impacts are expected to arise from exposure to high temperatures, extreme weather events, displacement, malnutrition, conflict, climate-related economic and social losses, and anxiety and distress associated with worry about climate change (very high confidence) {7.3.1.11}. 1047Health, Wellbeing and the Changing Structure of Communities Chapter 7 1048 Chapter 7 Health, Wellbeing and the Changing Structure of Communities Major Statements About Migration and Conflict in AR5Key statements made in AR5 Chapter 12 (Human Security) about the impacts of climate change on migration were that climate change will have significant impacts on forms of migration that compromise 2 In this Report, the following terms have been used to indicate the assessed likelihood of an outcome or a result: Virtually certain 99-100% probability, Very likely 90-100%, Likely 66-100%, About as likely as not 33-66%, Unlikely 0-33%, Very unlikely 0-10%, and Exceptionally unlikely 0-1%.Additional terms (Extremely likely: 95-100%, More likely than not > 50-100%, and Extremely unlikely 0-5%) may also be used when appropriate.Assessed likelihood is typeset in italics, e.g., very likely).This Report also uses the term 'likely range' to indicate that the assessed likelihood of an outcome lies within the 17

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