How Development Choices Could Alter the Capacity of Health Systems

Abstract

Background: Individual and collective choices will determine the pattern of demographic, socioeconomic, and technologic changes that will, in turn, affect the transitioning to a more resilient and sustainable world, including the burden of climate-sensitive health outcomes. Methods: Using a set of socioeconomic development trajectories, the Shared Socioeconomic Pathways (SSPs), along with the World Health Organization’s Operational Framework for Building Climate Resilient Health Systems, we extend existing narratives to illustrate how aspects of health systems are likely to change over this century, and the implications of these trends for population health. Five narratives describe worlds with varying degrees of challenges to adaptation and mitigation. Results: Very different health system capacities and burdens of climate-sensitive health outcomes will likely arise under different development pathways, with substantial implications for population health. Transitioning to a more resilient and sustainable world to prepare for and manage the effects of climate change is likely to result in strengthened capacity to manage impacts that do arise and to better health outcomes overall. Continued significant fossil fuel use will likely result in high burdens of preventable conditions, such as undernutrition, malaria, and diarrheal diseases, coupled with reduced capacity to manage these challenges. The magnitude and pattern of health burdens and capacity of health systems will vary under other development pathways. Further research should examine how health systems are coping with health and climate change challenges, and the information, tools, and resources need to increase the capacity to manage future climate change-related health risks.