--- - chapter_identifier: populations-of-concern confidence: '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.' evidence: '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' href: https://data.globalchange.gov/report/usgcrp-climate-human-health-assessment-2016/chapter/populations-of-concern/finding/vulnerabilities-varies-over-time-place-specific.yaml identifier: vulnerabilities-varies-over-time-place-specific ordinal: 1 process: '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 2–3.

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.' report_identifier: usgcrp-climate-human-health-assessment-2016 statement: '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].' 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.' uri: /report/usgcrp-climate-human-health-assessment-2016/chapter/populations-of-concern/finding/vulnerabilities-varies-over-time-place-specific url: ~ - chapter_identifier: populations-of-concern confidence: 'Based on the evidence presented in the peer-reviewed literature, there is high confidence that a wide range of health effects exacerbated by climate change will be experienced by vulnerable age groups, especially young children and older adults. Both qualitative and quantitative studies have been published about the effects of age or life stage on vulnerability to health impacts, and that evidence is consistent and of good quality.' evidence: 'There is strong, consistent evidence from multiple studies that children have inherent sensitivities to climate-related health impacts. There are multiple, high-quality studies concerning the impact of changes in ground-level ozone, particulate matter, and aeroallergens on increases in childhood asthma episodes and other adverse respiratory effects in children.3dca835b-beb7-49f5-b9c1-54753dc54ddc,bc881478-a19f-48b7-af8e-40c36deaa679,0f20f4d5-6621-41f2-a728-827975453e2c,aa39f53c-b544-4f17-9bf9-59b1e4636b56 In addition, the literature supports a finding that children are vulnerable to waterborne pathogens in drinking water and through exposures while swimming. There is a positive and statistically significant association between heavy rain and emergency department visits for children with gastrointestinal illness, though evidence comes from regional studies and is not at the national scale.197b91b6-04d3-429a-9a6c-90c784d86c1f,603e74e7-cfae-45ff-bf78-4c38f32aa678 The science also supports a finding that children’s mental health is affected by exposures to traumatic weather events, which can undermine cognitive development and contribute to psychiatric disorders.bbd5cea5-84f0-4f77-95ed-45c80f636a8a,12483624-82b7-4221-9a35-5a247289e4fe

There is also strong, consistent evidence from multiple studies that older adults have inherent sensitivities to climate-related health impacts. In particular, exposure to extreme ambient temperature is an important determinant of health in older adultse4c07020-0c97-4a6c-ab4a-1859aaebd5ab,07b2dd38-4085-4184-a498-ec32526d710f and has been associated with increased hospital admissions for cardiovascular, respiratory, and metabolic disorders.4695344e-33e4-457d-a4e8-514481c7befe,7ed57375-4f4f-4157-9784-0d09fb2beae1 In addition, older adults are particularly affected by extreme weather events that compromise the availability and safety of food and water supplies; interrupt communications, utilities, and emergency services; and destroy or damage homes and the built environment.35e05ba9-a2e0-4178-a809-8c9bfe7be898,81e4da11-12ba-4f0e-8bdb-ca6a8dadd63d,a5db04e0-2a4f-4ddf-af07-a64797095d8e,65736c68-a5c9-44e8-acb7-879ef878a275 Some functional and mobility impairments make older adults less able to evacuate when necessary.b00a1349-fb5f-4e2d-b1bc-cfceb0863de2,1964a748-c888-46f9-aedc-dc2d27930f17' href: https://data.globalchange.gov/report/usgcrp-climate-human-health-assessment-2016/chapter/populations-of-concern/finding/health-impacts-vary-with-age-and-life-stage.yaml identifier: health-impacts-vary-with-age-and-life-stage ordinal: 2 process: '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 2–3.

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.' report_identifier: usgcrp-climate-human-health-assessment-2016 statement: 'People experience different inherent sensitivities to the impacts of climate change at different ages and life stages [High Confidence]. For example, the very young and the very old are particularly sensitive to climate-related health impacts.' uncertainties: 'There is less information with which to quantify climate-related impacts on children and older adults at a national level given limited data availability. Some studies of age-related vulnerability have limited geographic scope or focus on single events in particular locations. Nevertheless, multiple factors, all with some degree of uncertainty, converge to determine climate-related vulnerability across age groups.' uri: /report/usgcrp-climate-human-health-assessment-2016/chapter/populations-of-concern/finding/health-impacts-vary-with-age-and-life-stage url: ~ - chapter_identifier: populations-of-concern confidence: 'Based on the evidence presented in the peer-reviewed literature, there is high confidence that climate change threatens the health of people and communities by affecting exposure, sensitivity, and adaptive capacity. This conclusion takes into account the consistent evidence presented in multiple studies regarding the causes of vulnerability to climate-related health effects and the role of social determinants of health. There is high confidence based on many peer-reviewed studies that social determinants of health, such as those related to socioeconomic factors and health disparities, may amplify, moderate, or otherwise influence climate-related health effects across populations of concern, and the evidence presented is of good quality, consistent, and compelling.' evidence: 'The literature is consistent and the results are compelling that social determinants of health, such as those related to socioeconomic factors and health disparities, will contribute to the nature and extent of vulnerability and health effects due to climate change. The following factors illustrate the depth of the literature supporting the conclusions above regarding the relationship between climate change health threats, vulnerability (comprised of exposure, sensitivity, and adaptive capacity), and social determinants of health:


Health risks and vulnerability may increase in locations or instances where combinations of social determinants of health that amplify health threats occur simultaneously or close in time or space.a6491512-ba32-470d-934e-44c3b13d8b96,8ddfda37-f9e3-4848-aa97-6f5eb0704765 For example, people with limited economic resources living in areas with deteriorating infrastructure are more likely to experience disproportionate impacts and are less able to recover following extreme events,77ffab8c-05b9-42ab-bd76-22a19abfb429,fbc277e8-499f-4e93-9c33-1df56a674e71 increasing their vulnerability to climate-related health effects.' href: https://data.globalchange.gov/report/usgcrp-climate-human-health-assessment-2016/chapter/populations-of-concern/finding/social-determinants-health-interact-climate-factors-affect-health-risk.yaml identifier: social-determinants-health-interact-climate-factors-affect-health-risk ordinal: 3 process: '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 2–3.

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.' report_identifier: usgcrp-climate-human-health-assessment-2016 statement: 'Climate change threatens the health of people and communities by affecting exposure, sensitivity, and adaptive capacity [High Confidence]. Social determinants of health, such as those related to socioeconomic factors and health disparities, may amplify, moderate, or otherwise influence climate-related health effects, particularly when these factors occur simultaneously or close in time or space [High Confidence].' uncertainties: 'A wide range of non-climate factors are expected to interact with climate change health impacts to determine population vulnerability, all with some degree of uncertainty. The extent to which social determinants of health individually and collectively affect the different components of vulnerability is, in many cases, not well understood and not readily amenable to measurement or quantification. Assessing the extent and nature of non-climate impacts as compared to impacts related to climate change is limited by data availability. Many studies of climate change vulnerability have limited geographic scope or focus on single events in particular locations, which makes drawing national-level conclusions more challenging.' uri: /report/usgcrp-climate-human-health-assessment-2016/chapter/populations-of-concern/finding/social-determinants-health-interact-climate-factors-affect-health-risk url: ~ - chapter_identifier: populations-of-concern confidence: 'Based on the evidence presented in the peer-reviewed literature, there is high confidence that geographic data used in mapping tools and vulnerability indices can help to identify where and for whom climate health risks are greatest. A number of published studies provide consistent and good quality evidence to support a finding regarding the utility of mapping tools and vulnerability indices in a public health context, but methods are still emerging to support the application of these tools in the context of climate change. Overall, evidence is strong that mapping tools and vulnerability indices can help to identify at-risk locations and populations for whom climate health risks are greatest. As the state of the science continues to evolve, substantial improvements in mapping and spatial analytic tools and methodologies are expected that will allow researchers to predict, for a certain geographic area, the probability that human health impacts will occur across time.' evidence: 'Over the past decade, the literature on the use of GIS in a public health and vulnerability context has been steadily growing. Multiple studies provide strong, consistent evidence that spatial-analytic tools help facilitate analyses that link together spatially resolved representations of census data, data on the determinants of health (social, environmental, preexisting health conditions), measures of adaptive capacity (such as health care accessibility), and environmental data for the identification of at-risk populations.8dc8f888-18ac-4250-b07d-e744a46d70f2,399cfb21-5e6d-425a-98ec-55f42e32401a,e905bf75-5df5-4ca7-ab70-b4a35b1219f8,0cdb219f-c600-4fbf-b4c6-2d89f77d2868,96d81a21-9659-48f1-9149-35a4d10322ca,b6a2f8d3-a113-4e46-b62c-7fbaf90b4f59 Similarly, the more recent additions to the literature indicate that demographic and environmental data can be integrated to create an index that allows for analysis of the factors contributing to social vulnerability in a given geographic area.399cfb21-5e6d-425a-98ec-55f42e32401a,90ee72cf-ab21-486c-bb40-45780e31b45f Multiple studies conclude that spatial mapping that identifies factors associated with relative vulnerability is an important step in developing prevention strategies or determining where to focus or position health or emergency response resources.f48e92b8-1b15-46db-936f-249351f8c7a5,02028c63-7981-461c-8762-76105bc5ba36,a33f021d-b087-44d9-8fac-fb9507f789e8 Fewer studies explicitly focus on vulnerability mapping in a climate change context, with the notable exception of the case study of heat-related vulnerability in Georgia.399cfb21-5e6d-425a-98ec-55f42e32401a' href: https://data.globalchange.gov/report/usgcrp-climate-human-health-assessment-2016/chapter/populations-of-concern/finding/mapping-tools-vulnerability-indices-identify-climate-health-risks.yaml identifier: mapping-tools-vulnerability-indices-identify-climate-health-risks ordinal: 4 process: '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 2–3.

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.' report_identifier: usgcrp-climate-human-health-assessment-2016 statement: 'The use of geographic data and tools allows for more sophisticated mapping of risk factors and social vulnerabilities to identify and protect specific locations and groups of people [High Confidence].' uncertainties: 'Multiple factors, all with some degree of uncertainty, determine geographic vulnerability to the health impacts of climate change. Although the literature indicates that mapping tools and vulnerability indices are useful in characterizing geographically based exposures, geocoded health data (particularly those data relevant to an analysis of climate change vulnerability) are not always available in some locations of interest. In addition, the extent of uncertainty increases at smaller spatial scales, which is typically the scale most relevant for targeting vulnerable communities. For instance, mental health outcome data are particularly challenging to obtain and geocode, partly because the majority of cases are underdiagnosed or underreported (see Ch. 8: Mental Health).' uri: /report/usgcrp-climate-human-health-assessment-2016/chapter/populations-of-concern/finding/mapping-tools-vulnerability-indices-identify-climate-health-risks url: ~