• Energy Research

Abstract Extreme heat events impact people and ecosystems across the globe, and they are becoming more frequent and intense in a warming climate. Responses to heat span sectors and geographic boundaries. Prior research has documented technologies or options that can be deployed to manage extreme heat and examples of how individuals, communities, governments and other stakeholder groups are adapting to heat. However, a comprehensive understanding of the current state of implemented heat adaptations—where, why, how and to what extent they are occurring—has not been established. Here, we combine data from the Global Adaptation Mapping Initiative with a heat-specific systematic review to analyze the global extent and diversity of documented heat adaptation actions (n = 301 peer-reviewed articles). Data from 98 countries suggest that documented heat adaptations fundamentally differ by geographic region and national income. In high-income, developed countries, heat is overwhelmingly treated as a health issue, particularly in urban areas. However, in low- and middle-income, developing countries, heat adaptations focus on agricultural and livelihood-based impacts, primarily considering heat as a compound hazard with drought and other hydrological hazards. 63% of the heat-adaptation articles feature individuals or communities autonomously adapting, highlighting how responses to date have largely consisted of coping strategies. The current global status of responses to intensifying extreme heat, largely autonomous and incremental yet widespread, establishes a foundation for informed decision-making as heat impacts around the world continue to increase.

Abstract Climate change adaptation responses are being developed and delivered in many parts of the world in the absence of detailed knowledge of their effects on public health. Here we present the results of a systematic review of peer-reviewed literature reporting the effects on health of climate change adaptation responses in low- and middle-income countries (LMICs). The review used the ‘Global Adaptation Mapping Initiative’ database (comprising 1682 publications related to climate change adaptation responses) that was constructed through systematic literature searches in Scopus, Web of Science and Google Scholar (2013–2020). For this study, further screening was performed to identify studies from LMICs reporting the effects on human health of climate change adaptation responses. Studies were categorised by study design and data were extracted on geographic region, population under investigation, type of adaptation response and reported health effects. The review identified 99 studies (1117 reported outcomes), reporting evidence from 66 LMICs. Only two studies were ex ante formal evaluations of climate change adaptation responses. Papers reported adaptation responses related to flooding, rainfall, drought and extreme heat, predominantly through behaviour change, and infrastructural and technological improvements. Reported (direct and intermediate) health outcomes included reduction in infectious disease incidence, improved access to water/sanitation and improved food security. All-cause mortality was rarely reported, and no papers were identified reporting on maternal and child health. Reported maladaptations were predominantly related to widening of inequalities and unforeseen co-harms. Reporting and publication-bias seems likely with only 3.5% of all 1117 health outcomes reported to be negative. Our review identified some evidence that climate change adaptation responses may have benefits for human health but the overall paucity of evidence is concerning and represents a major missed opportunity for learning. There is an urgent need for greater focus on the funding, design, evaluation and standardised reporting of the effects on health of climate change adaptation responses to enable evidence-based policy action.

Le changement climatique pose de multiples risques pour la population de Lima, la plus grande ville et capitale du Pérou, située sur la côte pacifique dans un écosystème désertique. Ces risques comprennent une pénurie d'eau accrue, une augmentation de la chaleur et l'introduction et l'émergence de maladies à transmission vectorielle et d'autres maladies sensibles au climat. Pour répondre à ces menaces, il est nécessaire que le gouvernement, à tous les niveaux, adopte davantage de stratégies d'atténuation et d'adaptation. Ici, des groupes de discussion ont été organisés avec des représentants de cinq municipalités de Lima pour déterminer les priorités, la perception du changement climatique et les processus décisionnels pour la mise en œuvre de projets au sein de chaque municipalité. Ces facteurs peuvent affecter la capacité et le désir d'une communauté de mettre en œuvre des stratégies d'adaptation et d'atténuation du changement climatique. Les résultats montrent que le changement climatique et d'autres facteurs environnementaux sont relativement peu prioritaires, alors que la sécurité publique et les services d'eau et d'assainissement sont les plus préoccupants. Peut-être le plus important, le changement climatique n'est pas bien compris parmi les municipalités. Les participants ont eu du mal à distinguer le changement climatique des autres problèmes environnementaux et n'ont pas pleinement compris ses causes et ses effets. Une meilleure compréhension de ce qu'est le changement climatique et pourquoi il est important qu'il devienne une priorité pour les municipalités. Différents aspects de la sensibilisation accrue au changement climatique semblent être liés au fait d'avoir vécu des événements météorologiques extrêmes, qu'ils soient liés ou non au changement climatique, et à un statut socio-économique plus élevé. El cambio climático plantea múltiples riesgos para la población de Lima, la ciudad más grande y capital de Perú, ubicada en la costa del Pacífico en un ecosistema desértico. Estos riesgos incluyen el aumento de la escasez de agua, el aumento del calor y la introducción y aparición de enfermedades transmitidas por vectores y otras enfermedades sensibles al clima. Para responder a estas amenazas, es necesario que el gobierno, en todos los niveles, adopte más estrategias de mitigación y adaptación. Aquí, se realizaron grupos focales con representantes de cinco municipios de Lima para determinar las prioridades, la percepción del cambio climático y los procesos de toma de decisiones para implementar proyectos dentro de cada municipio. Estos factores pueden afectar la capacidad y el deseo de una comunidad de implementar estrategias de adaptación y mitigación del cambio climático. Los resultados muestran que el cambio climático y otros factores ambientales tienen una prioridad relativamente baja, mientras que la seguridad pública y los servicios de agua y saneamiento son de la mayor preocupación. Quizás lo más importante es que el cambio climático no se entiende bien entre los municipios. Los participantes tuvieron problemas para distinguir el cambio climático de otros problemas ambientales y no entendieron completamente sus causas y efectos. Es necesario comprender mejor qué es el cambio climático y por qué es importante para que se convierta en una prioridad para los municipios. Diferentes aspectos de una mayor conciencia sobre el cambio climático parecen estar relacionados con haber experimentado fenómenos meteorológicos extremos, relacionados o no con el cambio climático, y con un mayor nivel socioeconómico. Climate change poses multiple risks to the population of Lima, the largest city and capital of Peru, located on the Pacific coast in a desert ecosystem. These risks include increased water scarcity, increased heat, and the introduction and emergence of vector-borne and other climate sensitive diseases. To respond to these threats, it is necessary for the government, at every level, to adopt more mitigation and adaptation strategies. Here, focus groups were conducted with representatives from five Lima municipalities to determine priorities, perception of climate change, and decision-making processes for implementing projects within each municipality. These factors can affect the ability and desire of a community to implement climate change adaptation and mitigation strategies. The results show that climate change and other environmental factors are of relatively low priority, whereas public safety and water and sanitation services are of highest concern. Perhaps most importantly, climate change is not well understood among the municipalities. Participants had trouble distinguishing climate change from other environmental issues and did not fully understand its causes and effects. Greater understanding of what climate change is and why it is important is necessary for it to become a priority for the municipalities. Different aspects of increased climate change awareness seem to be connected to having experienced extreme weather events, whether related or not to climate change, and to higher socioeconomic status. يشكل تغير المناخ مخاطر متعددة على سكان ليما، أكبر مدن وعاصمة بيرو، الواقعة على ساحل المحيط الهادئ في نظام إيكولوجي صحراوي. وتشمل هذه المخاطر زيادة ندرة المياه، وزيادة الحرارة، وإدخال وظهور الأمراض المنقولة بالنواقل وغيرها من الأمراض الحساسة للمناخ. للاستجابة لهذه التهديدات، من الضروري أن تعتمد الحكومة، على كل مستوى، المزيد من استراتيجيات التخفيف والتكيف. هنا، تم إجراء مجموعات التركيز مع ممثلين من خمس بلديات في ليما لتحديد الأولويات وتصور تغير المناخ وعمليات صنع القرار لتنفيذ المشاريع داخل كل بلدية. يمكن أن تؤثر هذه العوامل على قدرة ورغبة المجتمع في تنفيذ استراتيجيات التكيف مع تغير المناخ والتخفيف من حدته. تظهر النتائج أن تغير المناخ والعوامل البيئية الأخرى ذات أولوية منخفضة نسبيًا، في حين أن السلامة العامة وخدمات المياه والصرف الصحي هي مصدر قلق كبير. ربما الأهم من ذلك، أن تغير المناخ غير مفهوم جيدًا بين البلديات. واجه المشاركون صعوبة في التمييز بين تغير المناخ والقضايا البيئية الأخرى ولم يفهموا تمامًا أسبابه وآثاره. من الضروري زيادة فهم ما هو تغير المناخ ولماذا من المهم أن يصبح أولوية للبلديات. يبدو أن الجوانب المختلفة لزيادة الوعي بتغير المناخ مرتبطة بتجربة الظواهر الجوية القاسية، سواء كانت مرتبطة بتغير المناخ أم لا، وبارتفاع الوضع الاجتماعي والاقتصادي.

Assessing global progress on human adaptation to climate change is an urgent priority. Although the literature on adaptation to climate change is rapidly expanding, little is known about the actual extent of implementation. We systematically screened >48,000 articles using machine learning methods and a global network of 126 researchers. Our synthesis of the resulting 1,682 articles presents a systematic and comprehensive global stocktake of implemented human adaptation to climate change. Documented adaptations were largely fragmented, local and incremental, with limited evidence of transformational adaptation and negligible evidence of risk reduction outcomes. We identify eight priorities for global adaptation research: assess the effectiveness of adaptation responses, enhance the understanding of limits to adaptation, enable individuals and civil society to adapt, include missing places, scholars and scholarship, understand private sector responses, improve methods for synthesizing different forms of evidence, assess the adaptation at different temperature thresholds, and improve the inclusion of timescale and the dynamics of 536 responses.