Climate Change and Child Health Inequality: A Review of Reviews.

Emmanuelle Arpin,Anders Hjern,Imti Choonara,Angela Mashford-Pringle,Meghan Kerr,Karl Gauffin,Luis Rajmil,Aluisio Barros,Nicholas Spencer

doi:10.3390/ijerph182010896

Abstract

There is growing evidence on the observed and expected consequences of climate change on population health worldwide. There is limited understanding of its consequences for child health inequalities, between and within countries. To examine these consequences and categorize the state of knowledge in this area, we conducted a review of reviews indexed in five databases (Medline, Embase, Web of Science, PsycInfo, Sociological s). Reviews that reported the effect of climate change on child health inequalities between low- and high-income children, within or between countries (high- vs low–middle-income countries; HICs and LMICs), were included. Twenty-three reviews, published between 2007 and January 2021, were included for full-text analyses. Using thematic synthesis, we identified strong descriptive, but limited quantitative, evidence that climate change exacerbates child health inequalities. Explanatory mechanisms relating climate change to child health inequalities were proposed in some reviews; for example, children in LMICs are more susceptible to the consequences of climate change than children in HICs due to limited structural and economic resources. Geographic and intergenerational inequalities emerged as additional themes from the review. Further research with an equity focus should address the effects of climate change on adolescents/youth, mental health and inequalities within countries.

Highlights

Many children in low- and middle-income countries (LMICs) live in circumstances in which they are deprived of essential determinants of health such as clean air, adequate shelter, nutrition, safe water and sanitation [3], all of which contribute to the higher risk of adverse child health outcomes such as stunting secondary to malnutrition [4], acute respiratory illness [5], diarrheal disease [6] and vector-borne diseases such as malaria [7]
All reviews and reports were published in international peer-reviewed journals with the exception of the Assembly of First Nations Report which was included as the challenges faced by indigenous children and their families are under-represented in the literature
We found descriptive evidence of the differential impact of climate change on children in social groups by relative advantage versus disadvantage within countries and in LMICs compared with high-income countries (HICs); quantitative evidence comparing advantaged and disadvantaged children was limited

Summary

Introduction

The uneven distribution of social and environmental factors on birth and early life give rise to avoidable child health inequalities [1]. Differences in child survival, health, development and well-being are stark between low- and middle-income countries (LMICs) and high-income countries (HICs) [2]. Many children in LMICs live in circumstances in which they are deprived of essential determinants of health such as clean air, adequate shelter, nutrition, safe water and sanitation [3], all of which contribute to the higher risk of adverse child health outcomes such as stunting secondary to malnutrition [4], acute respiratory illness [5], diarrheal disease [6] and vector-borne diseases such as malaria [7]. Despite improvement in child survival rates within these countries, children from poorer

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