Heat and health prevention in European Region under a changing climate: the urgent need for a faster roll-out of Heat-Health Action Plans (HHAPs)

Abstract

Background and aim: adverse health effects from extreme heat remain a major risk, bound to increase in a changing climate. This paper assesses the status of heat impacts on health and their prevention in the European Region and discusses successes, failures and necessary action. Methods: results are based on a survey among the WHO European Region member states, a series of literature reviews intended to inform the update of the WHO Heat Health Action Planning guidance from 2008, and a review of the EEA Climate and Health observatory and Climate Adapt database. Results: though urbanization, population ageing and climate change are increasing heat vulnerability, heat-related mortality has decreased in several European countries. Heat health action plans (HHAP) progressively adopted since 2003 may have contributed to that reduction, although so far only 17 of the 53 member states of the WHO European Region have a HHAP, most (14) of them EU countries. All plans implemented basic core elements like alert systems and information plans, but most lack M&E, real time surveillance or influence over urban planning to reduce heat exposure. Involvement of subnational authorities remains low, and many plans are inadequately resourced and infrequently reviewed. Despite HHAPs being a prime example of climate change adaptation, their explicit presence in national adaptation plans and strategies in member states is far from generalized. Conclusions: our findings suggest limited progress in the adoption and rollout of HHAPs, with many European countries lacking one, particularly outside the EU. Many core HHAP elements are still insufficiently implemented and only better M&E will clarify their effectiveness and allow for improvements. The EU Mission on Adaptation could support progress in HHAPs and contribute to attaining the objectives of the EU climate change adaptation strategy and the WHO Ostrava Declaration. Keywords: Heat health action plans, Europe, Climate change, Adaptation