Climate-sensitive Health Outcomes Research Articles

The Impact of Heat Waves on Health Care Services in Low- or Middle-Income Countries: Protocol for a Systematic Review.

Heat waves significantly impact ecosystems and human health, especially that of vulnerable populations, and are associated with increased morbidity and mortality. Besides being directly related to climate-sensitive health outcomes, heat waves have indirectly increased the burden on our health care systems. Although the existing literature examines the impact of heat waves and morbidity, past research has mostly been conducted in high-income countries (HICs), and studies on the impact of heat waves on morbidity in low- or middle-income countries (LMICs) are still scarce. This paper presents the protocol for a systematic review that aims to provide evidence of the impact of heat waves on health care services in LMICs. We will identify peer-reviewed studies from 3 online databases, including the Web of Science, PubMed, and SCOPUS, published from January 2002 to April 2023, using the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. Quality assessment will be conducted using the Navigation Guide checklist. Key search terms include heatwaves, extreme heat, hospitalization, outpatient visit, burden, health services, and morbidity. This systematic review will provide insight into the impact of heat waves on health care services in LMICs, especially on emergency department visits, ambulance call-outs, hospital admissions, outpatient department visits, in-hospital mortality, and health care operational costs. The results of this review are anticipated to help policymakers and key stakeholders obtain a better understanding of the impact of heat waves on health care services and prioritize investments to mitigate the effects of heat waves in LMICs. This entails creating a comprehensive heat wave plan and ensuring that adequate infrastructure, capacity, and human resources are allocated in the health care sector. These measures will undoubtedly contribute to the development of resilience in health care systems and hence protect the health and well-being of individuals and communities. PROSPERO CRD42022365471; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=365471. DERR1-10.2196/44702.

Barriers to climate change and health research in India: a qualitative study

ObjectivesAlmost a quarter of the global burden of disease and mortalities is attributable to environmental causes, the magnitude of which is projected to increase in the near future. However, in...

Evaluating the representation of disaster hazards in SNOMED CT: gaps and opportunities.

Climate change, an underlying risk driver of natural disasters, threatens the environmental sustainability, planetary health, and sustainable development goals. Incorporating disaster-related health impacts into electronic health records helps to comprehend their impact on populations, clinicians, and healthcare systems. This study aims to: (1) map the United Nations Office for Disaster Risk Reduction and International Science Council (UNDRR-ISC) Hazard Information Profiles to SNOMED CT International, a clinical terminology used by clinicians, to manage patients and provide healthcare services; and (2) to determine the extent of clinical terminologies available to capture disaster-related events. Concepts related to disasters were extracted from the UNDRR-ISC's Hazard Information Profiles and mapped to a health terminology using a procedural framework for standardized clinical terminology mapping. The mapping process involved evaluating candidate matches and creating a final list of matches to determine concept coverage. A total of 226 disaster hazard concepts were identified to adversely impact human health. Chemical and biological disaster hazard concepts had better representation than meteorological, hydrological, extraterrestrial, geohazards, environmental, technical, and societal hazard concepts in SNOMED CT. Heatwave, drought, and geographically unique disaster hazards were not found in SNOMED CT. To enhance clinical reporting of disaster hazards and climate-sensitive health outcomes, the poorly represented and missing concepts in SNOMED CT must be included. Documenting the impacts of climate change on public health using standardized clinical terminology provides the necessary real time data to capture climate-sensitive outcomes. These data are crucial for building climate-resilient healthcare systems, enhanced public health disaster responses and workflows, tracking individual health outcomes, supporting disaster risk reduction modeling, and aiding in disaster preparedness, response, and recovery efforts.

Coding for climate: sourcing better climate-health data from medical billing

While evidence points to climate change adversely impacting health and wellbeing, there remains a great need for more authoritative and actionable data that better describes the full magnitude and scope of this growing crisis. Given the uncertainty inherent to current detection and attribution studies, the improved specificity offered by the 10th revision of the International Classification of Diseases (ICD-10) coding of climate-sensitive health outcomes at the point of care may help to better quantify the connection between more intense and frequent extreme weather events and specific health sequela. With improved application of the available ICD-10 codes designed to capture climate-sensitive health outcomes, the ICD-10 system can function as a leading indicator. In this collaboration, publicly available ICD-10 code data was downloaded from Centers for Medicare and Medicaid Services archives and cross-referenced with 29 keywords (e.g. heat, hurricane, smoke, etc) determined by relevance to climate impacts on human health from consensus literature. We identified 46 unique ICD-10 codes for climate-sensitive health conditions. By highlighting the need for broader application of these codes and advocating for the development of new codes that better document the growing burden of climate-sensitive health outcomes, we hope to drive the development of more evidence-based, health-protective interdisciplinary climate action strategies across health systems.

Feasibility, acceptability and validation of wearable devices for climate change and health research in the low-resource contexts of Burkina Faso and Kenya: Study protocol.

As the epidemiological transition progresses throughout sub-Saharan Africa, life lived with diseases is an increasingly important part of a population's burden of disease. The burden of disease of climate-sensitive health outcomes is projected to increase considerably within the next decades. Objectively measured, reliable population health data is still limited and is primarily based on perceived illness from recall. Technological advances like non-invasive, consumer-grade wearable devices may play a vital role in alleviating this data gap and in obtaining insights on the disease burden in vulnerable populations, such as heat stress on human cardiovascular response. The overall goal of this study is to investigate whether consumer-grade wearable devices are an acceptable, feasible and valid means to generate data on the individual level in low-resource contexts. Three hundred individuals are recruited from the two study locations in the Nouna health and demographic surveillance system (HDSS), Burkina Faso, and the Siaya HDSS, Kenya. Participants complete a structured questionnaire that comprises question items on acceptability and feasibility under the supervision of trained data collectors. Validity will be evaluated by comparing consumer-grade wearable devices to research-grade devices. Furthermore, we will collect demographic data as well as the data generated by wearable devices. This study will provide insights into the usage of consumer-grade wearable devices to measure individual vital signs in low-resource contexts, such as Burkina Faso and Kenya. Vital signs comprising activity (steps), sleep (duration, quality) and heart rate (hr) are important measures to gain insights on individual behavior and activity patterns in low-resource contexts. These vital signs may be associated with weather variables-as we gather them from weather stations that we have setup as part of this study to cover the whole Nouna and Siaya HDSSs-in order to explore changes in behavior and other variables, such as activity, sleep, hr, during extreme weather events like heat stress exposure. Furthermore, wearable data could be linked to health outcomes and weather events. As a result, consumer-grade wearables may serve as a supporting technology for generating reliable measurements in low-resource contexts and investigating key links between weather occurrences and health outcomes. Thus, wearable devices may provide insights to better inform mitigation and adaptation interventions in these low-resource settings that are direly faced by climate change-induced changes, such as extreme weather events.

Toward an integrated system of climate change and human health indicators: a conceptual framework

Environmental health indicators are helpful for tracking and communicating complex health trends, informing science and policy decisions, and evaluating public health actions. When provided on a national scale, they can help inform the general public, policymakers, and public health professionals about important trends in exposures and how well public health systems are preventing those exposures from causing adverse health outcomes. There is a growing need to understand national trends in exposures and health outcomes associated with climate change and the effectiveness of climate adaptation strategies for health. To date, most indicators for health implications of climate change have been designed as independent, individual metrics. This approach fails to take into account how exposure-outcome pathways for climate-attributable health outcomes involve multiple, interconnected components. We propose reframing climate change and health indicators as a linked system of indicators, which can be described as follows: upstream climate drivers affect environmental states, which then determine human exposures, which ultimately lead to health outcomes; these climate-related risks are modified by population vulnerabilities and adaptation strategies. We apply this new conceptual framework to three illustrative climate-sensitive health outcomes and associated exposure-outcome pathways: pollen allergies and asthma, West Nile virus infection, and vibriosis.

Trends and gaps in climate change and health research in North America

The Intergovernmental Panel on Climate Change (IPCC) 5th Assessment Report (2014) assessed the state of climate change and health knowledge, globally through the Human Health: Impacts, Adaptation, and Co-Benefits Chapter and regionally through chapters, such as the North America Chapter. With IPCC's 6th Assessment Report scheduled to be released in 2021-22, we asked: how has climate change and health research in North America advanced since the IPCC's 5th Assessment Report in 2014? Specifically, we systematically identified and examined trends in the extent, range, and nature of climate-health research conducted in North America. We used a scoping review methodology to systematically identify literature and map publication trends. A search string was used to search five academic databases. Two independent reviewers first screened titles and abstracts, and then the full texts of articles for relevance. Research articles and reviews using systematic methods published since 2013 were eligible for inclusion, and no language restrictions were applied. To be included, articles had to measure and link climatic variables or hazards to health outcomes in North America. Relevant articles were analysed using descriptive statistics to explore publication trends. The number of climate-health articles has significantly increased since the last IPCC Assessment Report. Published research about climate change impacts, heat-related mortality and morbidity, and respiratory illness taking place in urban centres and in the USA continue to dominate the North American climate-health literature, reflected by the high proportion of articles published. Important research gaps on previously neglected climate-sensitive health outcomes, however, are beginning to be filled, including climate change impacts on mental health, nutrition, and foodborne disease. We also observed progress in research that included future projections of climate-health risks; however, projection research is still relatively nascent and under-studied for many climate-sensitive health outcomes in North America, and would benefit from considering social and demographic variables in models. Important research disparities in geographical coverage were noted, including research gaps in Canada and Mexico, and in rural and remote regions. Overall, these publication trends suggest an improved understanding of exposure-response relationships and future projections of climate-health risks for many climate-sensitive health outcomes in North America, which is promising and provides an evidence-base to inform the IPCC 6th Assessment Report. Despite these advancements and considering the urgent policy and practice implications, more research is needed to deepen our understanding of climate-sensitive health outcomes, as well as examine new arising issues that have limited evidence-bases. In particular, transdisciplinary and cross-sector research, that includes the social sciences, examining current and future climate-health adaptation, mitigation, and the adaptation-mitigation nexus should become a top priority for research, given the urgent need for this evidence to inform climate change policies, actions, and interventions.

Estimating The Costs Of Inaction And The Economic Benefits Of Addressing The Health Harms Of Climate Change.

National and international assessments have drawn attention to the substantial economic risks of climate change. The costs of climate-sensitive health outcomes responsive to meteorological or seasonal patterns are among the least studied of those risks. In this article we describe how cost valuation analyses that relate climate-sensitive health outcomes to damages in economic terms can illuminate the costs of inaction on the climate crisis and the economic savings of addressing this problem. We identify major challenges to expanding the application of climate-health valuation research and suggest solutions to overcome these obstacles to better characterize the burden of climate-sensitive health outcomes and health disparities. The projected health and economic harms of climate-sensitive risks could be enormous if climate change continues to accelerate and communities are not prepared to reduce or prevent their impact. Expanded valuation of climate-sensitive health outcomes can inform policies that slow climate change and promote stronger investments in health-protective climate change adaptation efforts.

Beyond the News: Health Risks of Climate Change


 
 
 
 Climate change is affecting the health of millions of people through altering the geographic distribution and incidence of climate-sensitive health outcomes, including through injuries, illnesses, and deaths due to extreme weather events, food-, water-, and vectorborne diseases, air pollution, aeroallergens, and malnutrition (1). The magnitude of impacts is projected to increase as the climate continues to change. The scope and scale of projected impacts mean that climate change will touch the professional and personal lives of many public health and health care professionals. Avoiding, preparing for, and effectively responding to the health risks of climate change will require broad engagement of scientists, decision-makers, and the public. Achieving this engagement means that increased scientific literacy is needed of the causes and implications of climate change for human health.
 There are growing numbers of assessments of the potential health impacts of climate change (1-4) and summaries for various audiences (5). Instead of summarizing current knowledge of the causes and consequences for human health of anthropogenic climate change, this paper will highlight a few issues that may help with understanding the human health impacts of climate change.
 
 
 

Health Risks Due To Climate Change: Inequity In Causes And Consequences.

Climate change has altered global to local weather patterns and increased sea levels, and it will continue to do so. Average temperatures, precipitation amounts, and other variables such as humidity levels are all rising. In addition, weather variability is increasing, causing, for example, a greater number of heat waves, many of which are more intense and last longer, and more floods and droughts. These changes are collectively increasing the number of injuries, illnesses, and deaths from a wide range of climate-sensitive health outcomes. Future health risks will be determined not just by the hazards created by a changing climate but also by the sensitivity of individuals and communities exposed to these hazards and the capacity of health systems to prepare for and effectively manage the attendant risks. These risks include deaths and injuries from extreme events (for example, heat waves, storms, and floods), infectious diseases (including food-, water-, and vectorborne illnesses), and food and water insecurity. These risks are unevenly distributed and both create new inequities and exacerbate those that already exist. Most of these risks are projected to increase with each additional unit of warming. Using an equity lens to move beyond incremental to transformational resilience would reduce vulnerability and improve sustainability for all, but substantial additional funding is required for proactive and effective actions by the health system.

10.D. Workshop: Health Impact assessment of climate change: monitoring and experiences

Abstract Most scientific communities and governments accept that a global warming process is occurring, and are concerned about its alarming potential environmental and health consequences. The extreme conditions associated to climate change such as severe storms, floods and prolonged heatwaves and droughts, are expected to increase considerably the burden of climate-sensitive diseases (e.g. heat-related illness, new and emerging infectious diseases, respiratory diseases or threats to food security). Poor countries are most at risk, but developed economies can also be strongly affected as illustrated by the large number of deaths associated to the European heat wave of 2003. Conducting health impact assessment of climate change (HIA-CCh) requires the analyses of complex interactions between humans and natural ecosystems, demanding an interdisciplinary approach and a wide range of tools and techniques. Those analyses should be simultaneously context specific and extend over time to track not only the full dimension of health impacts but also the efforts needed to adapt and build resilience. Standard indicators for climate-sensitive health outcomes alone will not adequately capture the changing risks typically related to climate change. In addition to them, indicators of vulnerability and exposure, adaptation planning and resilience for health, and learning and knowledge management are required. The present workshop aims at analysing and sharing expertise on how to conduct an HIA-CCh, with the following elements for discussion: Definition of the scope (both temporal and spatial) and the interdisciplinary team to be involved in the processSelection of indicators that will allow not only characterization of health impacts but also promoting and tracking adaptation activities at national and local health departmentsForesight climate change scenarios and how this can be incorporated into the decision-making processVulnerability risk in relation to impact assessment and health / health equity in the context of climate changeHow the proper HIA-CCh can have an impact on learning and changes in management frameworks Key messages Increasing public health’s adaptive capacity to face climate-sensitive threats is needed. Conducting HIA-CCh requires innovative management strategies and proper selection of indicators.

Building resilience of health systems to climate change in Pacific Least Developed Countries: implementation science

BackgroundThe Pacific Least Developed Countries (LDCs)—Kiribati, the Solomon Islands, Tuvalu, and Vanuatu—are among the countries most vulnerable to climate variability and change. Key climate change risks include loss of livelihoods, coastal settlements, infrastructure, ecosystem services, and economic stability; and interaction of sea level rise with high-water-level events, threatening low-lying coastal areas. These risks result in increased health impacts, including deaths and injuries from extreme events (eg, heatwaves, storms, and floods); increased risks of infectious diseases (including food-borne, water-borne, and vector-borne); food insecurity and malnutrition; and diffuse impacts from loss of livelihoods and migration. The young, older adults, women of reproductive age, and people with disabilities are most vulnerable. MethodsBuilding resilience to climate change requires that these countries develop National Climate Change and Health Action Plans, including Vulnerability and Adaptation assessments. FindingsTemperature, precipitation, and extreme weather events can influence the incidence, geographic distribution, and seasonality of climate-sensitive health outcomes. In addition, many hospitals and community health centres are highly vulnerable to cyclones, floods, storm surges, sea level rise, and disturbances in water supply caused by drought or salination of aquifers. The capacity to provide health services, particularly in emergency situations, is substantially affected if buildings and essential supplies and amenities are damaged. The majority of health facilities are not resilient to climate-induced pressures in terms of structural, non-structural, and functional safety. InterpretationThe most effective measures to reduce vulnerability are (i) short-term programmes that implement and improve basic public health measures, including the provision of safe water and improved sanitation, secure essential health care, and increase capacity for disaster preparedness and response; and (ii) longer-term programs that enhance national health systems and institutions with climate change-related risks integrated into health governance, strengthen health information management systems, and ensure effective and accessible delivery of health services. FundingLeast Developed Countries Fund under the United Nations Framework Convention on Climate Change.

Adaptation to health outcomes of climate change and variability at the city level: An empirical decision support tool

Adaptation to health risk due to climate variability and change at the city level is inadequate, particularly in developing economies. Here, coping strategies with short-term benefits, adopted by the residents contribute significantly to their resilience. Decision on effective adaptation, therefore, requires economic evaluation of the coping and adaptation strategies in practise. In the present paper a novel framework using household health production function (HPF) approach has been developed for evaluation of coping and adaptation strategies to serve as a decision tool for planners. The outcome informs decision makers about the benefits and effectiveness of coping, and shortcomings in the existing adaptation strategies, thus, contributing to stocktaking. The approach has been validated using a case of vector-borne disease of dengue, an important climate-sensitive health impact of climate change. A five step cyclical framework has been proposed which addresses uncertainty by avoiding the need for future projection of health outcomes and scenario building as it can be applied at any point of time in future and considers the current risk only. The strengths and weaknesses of the proposed tool are compared with other similar tools. The decision support tool has applicability for all climate-sensitive health outcomes at the city level.

Health and Environmental Sustainability:Public health issues for present and future

The medical definition of environmental causes of diseases would be all those factors that are not genetic. Environmental factors include all those factors those affect human health mediated by social conditions and individual choice or environment. ‘Sustainable’ includes the environmental issues and ‘development’ includes the economic issues. Climate change alters or disrupts natural systems, making it possible for vector, water, and food-borne diseases to spread or emerge. Climate change can affect the incidence of diseases associated with air pollutants and aeroallergens. Clean air is considered to be a basic requirement of human health and well-being. Poverty increases vulnerability to climatesensitive health outcomes directly by reducing the capacity to adapt to changing conditions. For countries in the early stages of development the major environmental hazards to health are associated with widespread poverty and severe lack of public infrastructure, such as access to drinking water, sanitation, and lack of health care as well as emerging problems of industrial pollution and also urban waste based pollution. A healthy population is a prerequisite for a productive and creative society, which in turn is needed to sustain national development. Social determinants affect the environmental conditions of an individual and may contribute to the fact that specific individuals or population groups more often experience less adequate or potentially harmful environmental conditions; may directly affect exposure beyond and in addition to the exposure. Enhancing environmental sustainability, through reducing carbon emissions, curtailing waste, and managing resources efficiently, will deliver healthy outcome, and provide broader social and economic benefits.

COPD, Asthma and Pneumothorax as Climate Sensitive Health outcomes

Background: Chronic Obstructive Pulmonary Disease(COPD), pneumothorax and asthma are climate sensitive diseases contributing a significant proportion of the respiratory disease morbidity. Even when the monsoon rainfall is high, recent years have witnessed an increase in the average temperature in Kerala. The study aims to determine the trends in hospital admissions for these diseases and associated factors during 2011 to 2015 at a tertiary care hospital in Thiruvananthapuram, India. Methods: Record based retrospective study was done at Chest Disease Hospital at Thiruvananthapuram, Kerala. Data regarding the patients admitted from January 2011 to December 2015 was collected and trend analysis was done. Change in occurrence over the 5 year period was estimated and associations with co-existing diseases were determined. Results:A significant difference in the occurrence of COPD cases was seen during the months of July to December when compared between 2011 and 2015 with a significant rise in mean age of occurrence(p<0.001). Similar findings was seen with asthma with seasonally varying occurrences resulting in increased hospital admissions. No such seasonal variation could be seen for pneumothorax. Conclusions: The consistently shifting age patterns and the seasonal variation in occurrences, are in line with evidences from around the world which points to the urgent focus to be given to climate related respiratory diseases. Steady increase in occurrence of asthma and significant association of COPD with several co-morbidities are important areas of concern.

How Development Choices Could Alter the Capacity of Health Systems

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.

Monitoring and Evaluation Indicators for Climate Change-Related Health Impacts, Risks, Adaptation, and Resilience.

Climate change poses a range of current and future health risks that health professionals need to understand, track, and manage. However, conventional monitoring and evaluation (M&E) as practiced in the health sector, including the use of indicators, does not adequately serve this purpose. Improved indicators are needed in three broad categories: (1) vulnerability and exposure to climate-related hazards; (2) current impacts and projected risks; and (3) adaptation processes and health system resilience. These indicators are needed at the population level and at the health systems level (including clinical care and public health). Selected indicators must be sensitive, valid, and useful. And they must account for uncertainties about the magnitude and pattern of climate change; the broad range of upstream drivers of climate-sensitive health outcomes; and the complexities of adaptation itself, including institutional learning and knowledge management to inform iterative risk management. Barriers and constraints to implementing such indicators must be addressed, and lessons learned need to be added to the evidence base. This paper describes an approach to climate and health indicators, including characteristics of the indicators, implementation, and research needs.

The past and future in understanding the health risks of and responses to climate variability and change.

Climate change and health was established as a formal field of endeavor in the early 1990s, with the number of publications increasing since the mid-2000s. The key findings in assessment reports from the Intergovernmental Panel on Climate Change in 1995, 2001, 2007, and 2014 indicate the progress in understanding the magnitude and pattern of the health risks of a changing climate. The assessments maintained a similar structure, focusing on assessing the state of knowledge of individual climate-sensitive health outcomes, with confidence in the key findings tending to increase over time with greater understanding. The knowledge base is smaller than for other key sectors (e.g., agriculture) because of limited research investment in climate change and health. Vulnerability, adaptation, and capacity assessments can inform prioritization of the significant research gaps in understanding and managing the health risks of a changing climate; filling these research gaps would provide policy- and decision-makers with insights to increase short- and longer-term resilience in health and other sectors. Research needs include to understand how climate and development pathways could interact to alter health risks over time, better understand upstream drivers of climate-sensitive health outcomes, project aggregate health impacts to understand the breadth and depth of challenges that may need to be managed at geographic scales of interest, and project the time of emergence of changes in the geographic range and intensity of transmission of infectious diseases and other climate conditions. Engagement with other sectors is needed to ensure that their mitigation and adaptation activities also promote and protect health and take the health sector's needs into account. Making progress in these areas is critical for protecting the health of future populations.

High Concentrations of Ozone Air Pollution on Mount Everest: Health Implications for Sherpa Communities and Mountaineers.

Surface ozone measurements were collected during ascending transects in the Mount Everest region of Nepal with passive nitrite-coated Ogawa filter samplers to obtain 8-hour personal exposures (2860-5364 m asl). In addition, the Nepal Climate Observatory-Pyramid, a GAW-WMO Global Station sited in the Khumbu Valley (5079 m asl), collected ozone mixing ratios with photometric gas analyzer. Surface ozone measurements increased with altitude with concentrations that exceed 100 ppb (8-hour exposure). Highest values were during the spring season and the result of diverse contributions: hemispheric background values, the descent of ozone-rich stratospheric air, and the transport of tropospheric pollutants occurring at different spatial scales. Multiple climate factors, including descending stratospheric ozone and imported anthropogenic air masses from the Indo-Gangetic Plain, contribute to ambient ozone exposure levels in the vicinity of Mount Everest that are similar to if not higher than those reported in industrialized cities.

The Health Effects of Climate Change in the WHO European Region

The evidence of observed health effects as well as projections of future health risks from climate variability and climate change is growing. This article summarizes new knowledge on these health risks generated since the IPCC fourth assessment report (AR4) was published in 2007, with a specific focus on the 53 countries comprising the WHO European Region. Many studies on the effects of weather, climate variability, and climate change on health in the European Region have been published since 2007, increasing the level of certainty with regard to already known health threats. Exposures to temperature extremes, floods, storms, and wildfires have effects on cardiovascular and respiratory health. Climate- and weather-related health risks from worsening food and water safety and security, poor air quality, and ultraviolet radiation exposure as well as increasing allergic diseases, vector- and rodent-borne diseases, and other climate-sensitive health outcomes also warrant attention and policy action to protect human health.