finding 14.3 : key-message-14-3

Proactive adaptation policies and programs reduce the risks and impacts from climate-sensitive health outcomes and from disruptions in healthcare services (medium confidence). Additional benefits to health arise from explicitly accounting for climate change risks in infrastructure planning and urban design (low confidence).

This finding is from chapter 14 of Impacts, Risks, and Adaptation in the United States: The Fourth National Climate Assessment, Volume II.

Process for developing key messages:

The chapter evaluated the scientific evidence of the health risks of climate change, focusing primarily on the literature published since the cut off date (approximately fall 2015) of the U.S. Climate and Health Assessment.f1e633d5-070a-4a7d-935b-a2281a0c9cb6 A comprehensive literature search was performed by federal contractors in December 2016 for studies published since January 1, 2014, using PubMed, Scopus, and Web of Science. An Excel file containing 2,477 peer-reviewed studies was provided to the author team for it to consider in this assessment. In addition to the literature review, the authors considered recommended studies submitted in comments by the public, the National Academies of Sciences, Engineering, and Medicine, and federal agencies. The focus of the literature was on health risks in the United States, with limited citations from other countries providing insights into risks Americans are or will likely face with climate change. A full description of the search strategy can be found at The chapter authors were chosen based on their expertise in the health risks of climate change. Teleconferences were held with interested researchers and practitioners in climate change and health and with authors in other chapters of this Fourth National Climate Assessment (NCA4).

The U.S. Climate and Health Assessmentf1e633d5-070a-4a7d-935b-a2281a0c9cb6 did not consider adaptation or mitigation, including economic costs and benefits, so the literature cited includes research from earlier years where additional information was relevant to this assessment.

For NCA4, Air Quality was added as a report chapter. Therefore, while Key Messages in this Health chapter include consideration of threats to human health from worsened air quality, the assessment of these risks and impacts are covered in Chapter 13: Air Quality. Similarly, co-benefits of reducing greenhouse gas emissions are covered in the Air Quality chapter.

Description of evidence base:

Health adaptation is taking place from local to national scales.a6d2d472-b084-4805-9f08-cc5e1f95f668,2e9e29a1-e420-4d1f-b12b-53ccde149660,f82a2e76-95bb-4a33-8877-8c16ca217397 Because most of the health risks of climate change are also current public health problems, strengthening standard health system policies and programs, such as monitoring and surveillance, are expected to be effective in the short term in addressing the additional health risks of climate change. Modifications to explicitly incorporate climate change are important to ensure effectiveness as the climate continues to change. Incorporating environmentally friendly practices into healthcare and infrastructure can promote resilience.05ee299b-0f67-41b4-98c8-7f06718799fc

New information and remaining uncertainties:

Overall, while there is considerable evidence of the effectiveness of public health programs,289728b3-ae8b-417e-920e-96af1a5e64b3,a6d2d472-b084-4805-9f08-cc5e1f95f668,310a452b-67cd-458c-8a4d-056dba42ecef the effectiveness of policies and programs to reduce future burdens of climate-sensitive health outcomes in a changing climate can only be determined over coming decades. The relatively short time period of implementing health adaptation programs means uncertainties remain about how to best incorporate climate change into existing policies and programs to manage climate-sensitive health outcomes and about which interventions will likely be most effective as the climate continues to change.f82a2e76-95bb-4a33-8877-8c16ca217397,93b59cc9-ade0-45fe-9f08-79b0c00da931 For example, heat wave early warning and response systems save lives, but it is not clear which components most effectively contribute to morbidity and mortality reduction.

Assessment of confidence based on evidence:

There is medium confidence that with sufficient human and financial resources, adaptation policies and programs can reduce the current burden of climate-sensitive health outcomes.289728b3-ae8b-417e-920e-96af1a5e64b3,05ee299b-0f67-41b4-98c8-7f06718799fc,733c8418-ec60-42e0-b256-9800ba3816c4,46f2571e-7661-4163-9178-bee1d153a827 There is low confidence that the incorporation of health risks into infrastructure and urban planning and design will likely decrease climate-sensitive health impacts.

This finding was derived from scenario rcp_4_5
This finding was derived from scenario rcp_8_5

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