finding 9.1 : vulnerabilities-varies-over-time-place-specific

Across the United States, people and communities differ in their exposures, their inherent sensitivity, and their adaptive capacity to respond to and cope with climate change related health threats [Very High Confidence]. Vulnerability to climate change varies across time and location, across communities, and among individuals within communities [Very High Confidence].

This finding is from chapter 9 of The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment.

Process for developing key messages: The chapter was developed through technical discussions of relevant evidence and expert deliberation by the report authors at several workshops, teleconferences, and email exchanges. The authors considered inputs and comments submitted by the public, the National Academies of Sciences, and Federal agencies. For additional information on the overall report process, see Appendices 23.

The author team identified a number of populations affected by climate change health impacts, including communities of color and low-income, immigrant, and limited English proficiency groups; Indigenous populations; children and pregnant women; older adults; certain occupational groups; persons with disabilities; and persons with chronic medical conditions. This list of populations was identified to reflect current understandings related to how the health of particular groups of people or particular places are affected by climate change in the United States. While not exhaustive, these populations of concern are those most commonly identified and discussed in reviews of climate change health impacts on vulnerable populations. In this chapter, the order of these populations is not prioritized. While there are other populations that may be threatened disproportionately by climate change, the authors focused the sections of this chapter on populations for which there is substantive literature. In addition to this chapter’s summary of vulnerable populations, each of the health outcome chapters in the report includes discussion of populations of concern. Some populations may be covered more extensively in these other chapters; for instance, homeless populations are discussed in Chapter 8: Mental Health, as the literature on this population focuses primarily on mental health.

Description of evidence base: There is strong evidence from multiple current epidemiological studies on climate-sensitive health outcomes in the United States that health impacts will differ by location, pathways of exposure, underlying susceptibility, and adaptive capacity. The literature consistently finds that these disparities in health impacts will largely result from differences in the distribution of individual attributes in a population that confers vulnerability (such as age, socioeconomic status, and race), attributes of place that reduce or amplify exposure (such as floodplain, coastal zone, and urban heat island), and the resilience of public health infrastructure.

Across multiple studies, the following factors are consistently identified that contribute to exposure: occupation,e3439854-edb7-4acd-9e4f-b6ae0477f688 time spent in risk-prone locations,de5b6f9d-388d-4f67-8115-ad5fca6a95d5 1aca1900-c64c-4624-a696-3aab59ba6673 b79c1dff-2558-4eae-9357-054e54a67366 displacement by weather extremes,31d2b0b2-0570-48fc-8605-30e9c1922dad economic status,5f587662-8664-420f-8045-196e2bb7ec0d 218cc72e-737b-470e-89d7-6ef0ebce12c3 condition of infrastructure,60c1199f-692f-4e77-bd9b-15ae136141e7 b0818c9e-b245-44be-9851-213def5d25da and compromised mobility, cognitive function, and other mental or behavioral factors.8dcca72f-cc82-4b1c-a828-fc0d6c02ca7a

There is consensus within the scientific literature that biologic sensitivity and adaptive capacity are tied to many of the same factors that contribute to exposures, and that all of these factors can change across time and life stage.de5b6f9d-388d-4f67-8115-ad5fca6a95d5 3bd47363-8f13-4c90-b52d-26e7ff47f216 c681c3c2-48a8-4fe6-8e91-86db5bff7fa3 There is also strong evidence from multiple studies that social and economic factors affect disparities in the prevalence of chronic medical conditions that aggravate biological sensitivity.3f2402c5-22aa-4f75-861e-f6aca127cd1f 27dc34c7-af90-41db-9e6d-7cc5bf34e6cf

New information and remaining uncertainties: Understanding how exposure, sensitivity, and adaptive capacity change over time and location for specific populations of concern is challenging, particularly when attempting to project impacts of climate change on health across long time frames (such as in the year 2100, a year for which climate projections often estimate impacts) or vast geographic areas. Uncertainties remain with respect to the underlying social determinants of health, public health interventions or outreach, adaptation options, and climate impacts at fine local scales.

Assessment of confidence based on evidence: Based on the evidence presented in the peer-reviewed literature, there is very high confidence that climate change impacts on health will vary across place and time, as demonstrated by the complex factors driving vulnerability. Many qualitative and quantitative studies have been published with consistent findings and strong consensus that the impacts of climate change on human health will vary according to differential exposure, sensitivity, and adaptive capacity, which change over time and across places. These conclusions are well-documented and supported by high-quality evidence from multiple sources.

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