Tracking the health impacts of climate change

A changing climate has profound implications for human health, with more frequent heatwaves and extreme weather events, changing patterns of infectious disease, and the exacerbation of existing health challenges around the world. Indicators in this section track how these impact on human health.

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1.1 Health and Heat

Health and Heat

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1.1.1 Vulnerability to Extremes of Heat

People over 65 years of age, particularly those with chronic medical conditions (such as diabetes and heart, lung and kidney disease), are among the most vulnerable to the health effects of heatwaves. In a world that is increasingly warming due to climate change, this indicator measures the vulnerability to heat of populations around the world.

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Headline Finding

Populations in Europe and the Eastern Mediterranean are among the most vulnerable to the health effects of heat. However, the Western Pacific, South-East Asian and African Regions have all seen a dramatic increase in vulnerability of >10% since 1990.

Indicator Description

This indicator tracks a population’s vulnerability to heat using a composite index ranging from 0 to 100, which takes into account the proportion of the population over 65, prevalence of chronic disease, and the proportion of the population living in urban areas.

Caveats

This indicator does not capture the existence or absence of effective adaptation measures, such as heat early warning systems, cooling devices, and green areas in cities. 

This indicator was last updated in July 2019

Data Sources

– Global Burden of Disease Study, 2017. Institute for Health Metrics and Evaluation

– 2018 Revision of the World Urbanization Prospects. United Nations DESA/Population Division

 

1.1.2 Health and Exposure To Warming

It is clear that the Earth’s surface temperature of the Earth has warmed over 1°C since pre-industrial times. However, this temperature rise is not happening evenly across the planet, with areas where people live and work warming faster than the global average. In a world that is increasingly warming, this indicator measures the average temperature change experienced by human populations.

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Headline Finding

Human populations are concentrated in the areas most exposed to warming, experiencing warming at a rate four times that of the global average.

 

Indicator Description

This indicator tracks the population-weighted summer temperature change from a 1986-2005 baseline through to present day, a period during which the global average summer temperature rose by 0.2°C.

Caveats

This indicator estimates exposure based on data on where people live, but it does not estimate exposure where people work. 

This indicator was last updated in July 2019

Data Sources

– ERA Interim, 2019. European Centre for Medium-Range Weather Forecasts

– Gridded Population of the World. 4 ed (GPWv4), 2019. NASA

1.1.3 Exposure of Vulnerable Populations To Heatwaves

Exposure to extremes of heat results in a range of health consequences, including heat stress and heat stroke, worsening heart disease, and acute kidney injury. Populations over 65 are particularly vulnerable to these effects, and are being exposed to heatwaves in increasing numbers. This indicator tracks the change in the number of heatwaves experienced by vulnerable populations around the world.

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Headline Finding

In 2018, 220 million more heatwave exposures affecting vulnerable populations were observed – 11 million more than the previous record set in 2015, increasing risk of heat stress, heart disease, and kidney disease.

Caveats

A heatwave, as defined above, regardless of its duration, is classified as a single heatwave, which could result in an underestimation of exposure. 

This indicator was last updated in July 2019

Indicator Description

This indicator tracks the change in the number of heatwave exposure events (with one exposure event being one heatwave experienced by one person aged over 65) compared with the average number of events in the reference period (1986–2005). A heatwave was defined as a period more than 3 days at a given location where the minimum daily temperature was greater than the 99th percentile of the distribution of minimum daily temperature at that location over the 1986-2005 reference period for the summer months.

Data Sources

– ERA Interim, 2019. European Centre for Medium-Range Weather Forecasts

– Gridded Population of the World. 4 ed (GPWv4), 2019. NASA

1.1.4 Change in Labour Capacity

Our capacity to work is affected by temperature and humidity, particularly in highly active jobs in agriculture, industry, and manufacturing. Reduced work productivity can also result in flow on health and economic impacts for individuals and communities. As the world continues to warm, this indicator tracks the change in potential work hours lost due to high temperatures and sun exposure.

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Headline Finding

Higher temperatures continue to affect people’s ability to work. In 2018, 133.6 billion of potential work hours were lost due to rising temperatures – 45 billion hours more than in 2000.

Caveats

The distribution of agricultural, manufacturing and service sector workers used are country averages, applied evenly to each grid cell. 

This indicator was last updated in July 2019

Indicator Description

This indicator calculates hours of work lost by linking Wet Bulb Globe Temperature (including temperature, humidity, and solar radiation) with the amount of energy typically expended by workers in three sectors: agriculture, service, and industry. It then combines this calculation with the proportion of people working in each of these three sectors within each country to estimate the potential work hours lost per year.

Data Sources

– ERA Interim, 2019. European Centre for Medium-Range Weather Forecasts

– Gridded Population of the World. 4 ed (GPWv4), 2019. NASA

– ILOSTAT, 2019. ILO

1.2 Health and Extreme Weather Events

Health and Extreme Weather Events

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1.2.1 Wildfires

Wildfires cause a range of health impacts, ranging from direct thermal injuries through to exacerbation of acute and chronic lung disease from smoke and pollution. They will often cause substantial economic impacts, affecting vital infrastructure and emergency services. Climate change is creating hotter, drier conditions in many parts of the world, increasing the risk of wildfires. This indicator monitors the change in people exposed to wildfires globally.

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Headline Finding

152 out of 196 countries saw increases in populations exposed to wildfires from the early 2000s to present day. India alone experienced an annual daily population fire exposure increase of 21.8 million.

Indicator Description

This indicator tracks the change in human exposure to wildfires, in person-days (with one person-day being one person exposed to a wildfire in one day, a number obtained by multiplying the population exposed by the number of days of exposure). It was developed by overlaying satellite detected wildfires with human population density data.

Caveats

The satellite data does not account for cloud cover or smoke and data is not collected at night. It also assumes that are affected by a wildfire are the population limited to the same grid point as the fire and does not track exposure to wildfire smoke

 

This indicator was last updated in July 2019

Data Sources

Active Fire Data, 2019. NASA EarthData

Gridded Population of the World. 4 ed (GPWv4), 2019. NASA

1.2.2 Flood and Drought

Climate change is leading to increases in extremes of precipitation, causing both flood and drought. Floods result in direct injury, increase the spread of water-borne and vector-borne diseases, and impact mental health. Prolonged droughts affect access to water, hygiene and sanitation, and lead to reduced crop yields, food insecurity and malnutrition.

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Headline Finding

From 2000 to 2018, areas of South America have experienced significant increases in both flood and extreme rainfall, with areas of Brazil experiencing a full 12 months of drought throughout 2018.

Caveats

This indicator tracks meteorological drought and flood risk, which are a necessary but not sufficient condition for the occurrence of agricultural and hydrological drought and flood.

This indicator was last updated in July 2019

 

Indicator Description

This indicator tracks changes in the number of drought and extreme rainfall events (using the latter as a proxy for flooding). A drought event is defined as a month that has a Standard Precipitation Index of less than -1.5 and an extreme rainfall event is defined as when the five day precipitation average is greater than the 10-year return level.

Data Sources

– ERA Interim, 2019. European Centre for Medium-Range Weather Forecasts

– Gridded Population of the World. 4 ed (GPWv4), 2019. NASA

– CRU TS4.02, 2018. University of East Anglia Climatic Research Unit

1.4 Climate-Sensitive Infectious Diseases

Climate-Sensitive Infectious Diseases

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1.4.1 Climate Suitability for Infectious Disease Transmission

This indicator works to isolate the influence of a changing climate on the changing patterns of infectious disease. The suitability for transmission of many infectious diseases is influenced by shifts in temperature and precipitation. Dengue is a mosquito-borne disease that can cause febrile illnesses and, in severe cases, organ failure and death, with children under five particularly at risk. Vibrio bacteria are found in brackish marine waters and cause a range of human infections, including gastroenteritis, wound infections, septicaemia and cholera.  With temperatures changing across the globe, this indicator tracks how this is affecting the climate suitability for these infections.

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Headline Finding

Suitability for disease transmission has increased for dengue and pathogenic Vibrio species. The number of suitable days per year in the Baltic for pathogenic Vibrio transmission reached 107 in 2018, the highest since records began, and two times higher than the early 1980s baseline.

Caveats

These results are not based on case data. Control efforts, such as water, sanitation and hygiene programs, and vector control efforts, may help to mitigate these effects.

This indicator was last updated in July 2019

Indicator Description

Vectorial capacity for the transmission of dengue from Aedes aegypti and Aedes albopictus is calculated using a formula including: the biting rate of the mosquito; the probability of infection of the mosquito by the virus and transmission of the virus from the mosquito; and the daily survival probability of the mosquito, with each of these factors influenced by temperature. This is calculation compares a 1950-1954 baseline to 2013 to 2017. The environmental suitability for infections from Vibrio species is affected by sea surface temperature and salinity. Data for this indicator has been calculated from a 1982-1986 baseline through to 2014-2018.

Data Sources

– CRU TS4.02, 2018. University of East Anglia Climatic Research Unit

– Elevation data in netCDF, 2014. JISAO, University of Washington

– NOAA Earth System Research Laboratory, 2019. Physical Sciences Division

– Copernicus, 2019. Marine Environment Monitoring Service

– ERDDAP, Version 2.02 data from the MODIS sensor in the Aqua satellite, available at:-

– coastwatch.pfeg.noaa.gov for sea surface temperature.

– coastwatch.pfeg.noaa.gov for chlorophyll.

1.4.2 Vulnerability to Mosquito-Borne Diseases

Vulnerability to dengue infections is affected by physiological, social, financial, and geographical factors, as well as a community’s capacity to adapt. Improvements in public health have seen a global reduction in vulnerability. As both the climate suitability for dengue, and populations’ adaptive capacity are changing, this indicator tracks both of these to gain an overall picture of population vulnerability to dengue fever.

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Headline Finding

Improvements in public health have seen a 31% global fall in vulnerability to dengue. However, this trend is reversing in the Western Pacific and in South East Asia.

Caveats

The abundance models generate predictions and not observed frequencies in relation to climate conditions, and so should be considered a potential abundance estimate.

This indicator was last updated in July 2019

Indicator Description

This indicator tracks vulnerability to dengue fever, taking into account national adaptive capacity for the management of infectious diseases (defined as the degree of compliance with relevant International Health Regulations of the WHO), and the local vectorial capacity for dengue (which models the average daily rate of new dengue cases in a susceptible population, and is affected by temperature).

Data Sources

– CRU TS4.02, 2018. University of East Anglia Climatic Research Unit

– IHR core capacities data. WHO

1.5: Food Security and Undernutrition

The global number of undernourished people worldwide has been steadily increasing worldwide since 2014. Undernutrition overwhelmingly affects children under five years old, being responsible for more than half of the deaths globally for this age group. This indicator uses changes in climate to track declines in crop yield potential for the world’s major crops: maize, wheat, rice, and soybean.

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Headline Finding

All major crops tracked – maize, wheat, rice, and soybean – demonstrate that increases in temperature have reduced global crop yield potential, with concerning implications for global undernutrition.

Caveats

The temperature-driven change in crop duration is one of many factors affecting crop yield and does not reflect actual crop production.  Different ways of calculating the agri-climate index using different data sets would produce slightly different time series, as would the use of different agri-climate proxies.

This indicator was last updated in July 2019

 

Indicator Description

This indicator measures the climate suitability for crop growth, as a proxy for crop yield potential for maize, wheat, rice and soybean. The climate suitability is calculated taking into account the time taken in a year to accumulate the reference period (1981-2010) average growing season accumulated temperature total. Warmer climates lead to shorter periods of time to reach the accumulated temperature, and therefore to lower crop yields.

Data Sources

– FAOSTAT, 2019. FAO

– CRU TS4.02, 2018. University of East Anglia Climatic Research Unit

– WATCH-Forcing-Data-ERA-Interim, 1979 – 2012. EU

– Earth System Research Laboratory’s Physical Sciences Division, 2019. NOAA

Adaptation, Planning, and Resilience for Health

Indicators in this section track how communities, health systems, and governments are understanding the health risks of climate change, the strategies and resources they are deploying, and how adaptation and resilience measures are being implemented globally.

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2.1 Adaptation Planning and Assessment

Adaptation Planning and Assessment

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2.1.1 and 2.1.2 National Vulnerability and Health Adaptation Planning

The health impacts of climate change vary by location and population need, with vulnerability and adaptation assessments forming an essential first step in building local resilience. This indicator tracks the number of countries that have conducted national assessments of climate change impacts, vulnerability, and adaptation, as well as the number of countries that have developed national adaptation plans for health.

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Headline Finding

Countries are beginning to prepare for the health risks of climate change, with half of those surveyed reporting having a national health and climate change plan in place. Additionally, 48 of 101 countries surveyed in 2018 had completed a national assessment of health vulnerability to climate change. 40% of these assessments have influenced the allocation of resources.

Caveats

The survey sample is not a representative sample of all countries as this survey was voluntary, which might also lead to selection bias. Additionally, there is overrepresentation of Small Island Developing States within the respondents. 

This indicator was last updated in July 2019

Indicator Description

This indicator draws on the WHO 2018 Health and Climate Country Survey, which was completed by 101 WHO Member States. It tracks the countries that have a national health and climate change plan or strategy, current levels of their implementation and the commitment of national health funds towards their implementation. It also tracks countries that have conducted national assessments of vulnerability, impacts and adaptation for health and whether the results from these assessments have influenced policy prioritisation or financial resources.  

Data Source

– Health and Climate Country Survey, 2018. WHO

2.1.3 City-Level Climate Change Risk Assessments

Cities and local communities are at the forefront of the health impacts of climate change, and must be central to any adaptation response. This indicator tracks the proportion of global cities who have conducted climate change risk assessments.

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Headline Finding

In 2018, 69% of cities actively developing or having completed a comprehensive climate change risk or vulnerability assessment.

Indicator Description

This indicator draws on data from the CDP annual Cities Questionnaire, assessing the number of global cities that have undertaken a city-wide climate change risk or vulnerability assessment.

Caveats

This data is from the voluntary CDP data of annual global survey of cities, and as such may suffer from selection bias. The majority of responding cities are from High Income Countries (69%).

This indicator was last updated in July 2019

Data Sources

– Cities Data, 2019. CDP

2.2 Climate Information Services for Health

Climate information from meteorological services is essential in monitoring  disease outbreaks, extreme weather events, and other environmental hazards. They can also provide early warning systems, triggering responses in communication to the public and preparedness of health services and human resources. This indicator tracks the number of national meteorological and hydrological services that are providing services to the health sector.

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Headline Finding

Progress has been observed in the number of countries providing climate services to the health sector, increasing from 55 in 2018 to 70 in 2019.

Caveats

This indicator only considers climate services provided by national member states, and not by academic, private, regional, or other providers. The data is self-reported by countries and may therefore include reporting bias.

This indicator was last updated in July 2019

Indicator Description

This indicator takes data from the World Meteorological Organization Country Profile Database integrated questionnaire, which asks for information regarding the to which communities and sectors the National Member States provide products and information and the extent to which these products are used to improve decisions.

Data Sources

Country Profile data base. WMO

2.3 Adaptation Delivery and Implementation

Adaptation Delivery and Implementation

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2.3.1 Detection, Preparedness and Response to Health Emergencies

Health sector preparedness and response to acute public health emergencies related to climate change is an essential component of any adaptation response. This indicator tracks countries’ emergency preparedness through their implementation of a national health emergency framework.

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Headline Finding

109 countries report having a medium to high level of implementation of their national health emergency framework.

Indicator Description

This indicator monitors implementation of core capacity “C8” (the existence of a national health emergency framework), as tracked by the International Health Regulations of the WHO. Due to changes in the reporting format, data is disaggregated in “preparedness” and “response” for 2005 to 2017, but reported as a single value for 2018. 

Caveats

IHR monitoring questionnaires responses are self-reported, and the responding countries differ from year to year. The core capacities tracked by this indicator are not specific to climate driven risk changes, and they capture potential capacity – not action. Finally, it does not measure the quality of surveillance nor the effectiveness of emergency response plans.

This indicator was last updated in July 2019

Data Sources

– International Health Regulations monitoring framework. WHO

– International Health Regulations monitoring framework, SPAR, 2018. WHO

2.3.2 Air Conditioning - Benefits and Harms

Heatwaves are among the most immediate and severe of the health impacts of climate change. A variety of adaptation strategies exist, from effective ventilation and building regulations through to air conditioning for selected populations. Access to household air conditioning is highly protective against heatwave-related mortality, however its use also contributes to air pollution, greenhouse gas emissions, and increased urban heat island effect. This indicator tracks the coverage and greenhouse gas emissions of air conditioning use.

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Headline Finding

While global air conditioning use in 2016 reduced heatwave-related mortality, it also accounted for 10% of global electricity consumption – contributing to GHG emissions and air pollution.

Indicator Description

Using data from the International Energy Agency, this indicator calculates the global proportion of households using air conditioning. It also uses this IEA data to estimate the PM2.5 attributable premature mortality due to air conditioning use.

Caveats

Data is only available for a limited number of countries or country groups and the rest of the data is estimated as “rest of world”. The relative risk estimate used for the prevented fraction calculations is based on studies focused on European and US populations.

This indicator was last updated in July 2019

Data Sources

– International Energy Agency data on household air conditioning use.

2.4 Spending on Adaptation for Health and Health-Related Activities

Health is consistently identified as a key priority area for climate change adaptation, with countries increasingly allocating financial resources to deliver this. This indicator tracks total spending in the health sector.

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Headline Finding

In 2018, health adaptation spending increased by 11.2% globally, reaching 5% of total climate change adaptation spending.

Indicator Description

This indicator uses the “Adaptation and Resilience to Climate Change” dataset from kMatrix to track global spending on adaptation in the health sector.

Caveats

This indicator only tracks economic transactions for which there is transactional/financial data available.

This indicator was last updated in July 2019

Data Sources

– Adaptation and Resilience to Climate Change dataset, 2019. kMatrix Ltd

World Economic and Financial Surveys: World Economic Outlook Database, 2019. International Monetary Fund

THE HEALTH BENEFITS OF THE RESPONSE TO CLIMATE CHANGE

Tackling climate change could be the greatest global health opportunity of the 21st century. Many of the interventions required to mitigate and adapt bring enormous benefits for human health and wellbeing in the form of cleaner air, healthier diets, and more liveable cities. Indicators in this section track the world’s efforts to mitigate climate change, and the health benefits of this response.

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3.1 Energy System and Health

Energy System and Health

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3.1.1 Carbon Intensity of the Energy System

The power generation sector is the largest contributor to global greenhouse gas emissions. Burning fossil fuels contributes to the majority of these emissions, and to toxic air pollution. This indicator monitors the carbon intensity of the energy system and greenhouse gas emissions from power generation.

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Headline Finding

The carbon intensity of the global energy system has remained flat since 1990 . However, greenhouse gas emissions from fossil fuel combustion have returned to a growth trajectory, rising by 2·6% from 2016 to 2018.

Indicator Description

This indicator tracks the carbon intensity of the energy system, monitoring the total CO2 emitted from energy combustion, and the CO2 emitted per terajoule of total primary energy supply (which represents the total, unconverted energy a country has at its disposal, accounting for imports and exports).

Caveats

This indicator is unavailable for select countries.

This indicator was last updated in July 2019

Data Sources

– CO2 Emissions from Fuel Combustion Statistics, 2018. IEA

3.1.2 Coal Phase-Out

Coal-fired power is among the most polluting of all energy sources, harming public health and worsening climate change.  As of December, 2018, 30 national governments, along with many sub-national governments and businesses, have committed to coal phase-out for power generation through the Powering Past Coal Alliance. These indicators tracks progress towards coal phase-out.

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Headline Finding

Between 2016 and 2018 total primary energy supply from coal increased by 1.7%, reversing the previous downward trend.

Indicator Description

This indicator quantifies total primary energy supplied from all coal types used across all sectors, and the percent of total electricity generated from coal plants.

Caveats

This indicator is unavailable for select countries

This indicator was last updated in July 2019

Data Sources

– World Extended Energy Balances, 2019. IEA

3.1.3 Zero-Carbon Emission Electricity

The displacement of fossil fuels by renewable energy sources is an essential first step in mitigating climate change, which also results in a safer climate and cleaner air. To monitor this transition, this indicator tracks electricity generation from renewables.

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Headline Finding

In 2018, renewable energy continues to account for a large share (45%) of growth in electricity generation, with 27% of growth coming from wind and solar.

Indicator Description

This indicator tracks the total electricity generated from new renewables (which include all renewables except for hydro), and the share of the total electricity generated from these sources.

Caveats

This indicator is unavailable for select countries.

This indicator was last updated in July 2019

Data Sources

– World Extended Energy Balances, 2019. IEA

3.2 Access and Use of Clean Energy

Universal access to affordable, reliable, sustainable, and modern energy is not only central to health and wellbeing, but also essential to the response to climate change, helping reduce indoor air pollution and greenhouse gas emissions. In a world striving to achieve the Sustainable Development Goals, this indicator tracks household access and usage of clean energy.

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Headline Finding

Almost 3 billion people live without access to clean cooking fuels and technologies, and usage remains at just 7.5% of households in low-income countries, contributing to the health effects of household air pollution.

Indicator Description

This data tracks the usage of clean energy in the residential sector, drawing on data from the International Energy Agency. Clean energy usage is estimated at point of demand, and includes electricity of all sources, solar thermal and geothermal energy.

This indicator was last updated in July 2019

Data Sources

– SDG indicators, 2019. United Nations Statistics Division

– World Extended Energy Balances, 2019. IEA

– Energy access database, 2019. IEA

– Data for household fuel use for cooking was kindly provided by the WHO

3.3 Air Pollution, Energy and Transport

Air pollution is responsible for over several million premature deaths every year, with more than 90% of children around the world breathing in particulate pollution at unsafe levels. The majority of this pollution originates from sectors which also produce greenhouse gas emissions, presenting an opportunity for win-win interventions. This indicator tracks global PM2.5 attributable premature mortality by sector.

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Headline Finding

In 2016 there were 2.9 million premature deaths due to ambient PM2.5 pollution, with global mortality remaining stagnant. More than 440,000 premature deaths are estimated to be related to coal burning.

Indicator Description

This indicator models the premature deaths caused by air pollution from individual economic sectors, combining bottom-up emission calculations with atmospheric chemistry and dispersion coefficients. It also highlights the contribution to premature deaths from coal burning across all sectors.

Caveats

This indicator uses both country data and regional aggregated data. There are three deviations in the aggregation of countries as compared to the WHO regions: Sudan and Somalia are included in the ‘African Region’, and Algeria is included in the ‘Eastern Mediterranean’.

This indicator was last updated in July 2019

Data Sources

– Amann M, Bertok I, Borken-Kleefeld J, et al. Cost-effective control of air quality and greenhouse gases in Europe: Modeling and policy applications. Environmental Modelling & Software 2011; 26(12): 1489-501.

– World Energy Outlook, 2017. IEA

– GBD Results Tool, 2019. IHME

3.4 Sustainable and Healthy Transport

Building cities and transport systems which encourage cycling and physical activity will help respond to climate change and improve public health. Transitioning to cleaner fuels for road transport will work alongside this to reduce the health impacts of air pollution. This indicator tracks fuel use for road transportation on a per capita basis, by fuel type.

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Headline Finding

Although fossil fuels continue to dominate global road transport fuel use (96% of total), there was a 20.6% rise in fuel from electricity from 2015 to 2016.

Indicator Description

This indicator monitors fuel use for road transport by fuel type (fossil fuels, biofuels, and electricity) on a per capita basis.

Caveats

This indicator is unavailable for a number of countries.

This indicator was last updated in July 2019

Data Sources

– Global EB Outlook 2016: Beyond one million electric cars, 2016. IEA

3.5 Food, Agriculture and Health

Unhealthy diets, high in processed red meat and low in vegetables and fruit, are both a leading cause of death from non-communicable diseases, as well as drivers of high levels of greenhouse gas emissions from agriculture. This indicator works to quantify emissions from livestock and crops, helping to identify priority sectors for mitigation for health and for climate change.

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Headline Finding

Total emissions from livestock and crop production have increased by 14% and 10%, respectively, from 2000 to 2016, with 93% of livestock emissions attributed to ruminants.

Indicator Description

This indicator tracks emissions from livestock and crop production, providing the tonnes of CO2 equivalents emitted by animal or crop type, and by emission source.

Caveats

Data limitations – for example on grazing emissions from small island states – have been overcome with modelled outputs.

This indicator was last updated in July 2019

Data Sources

– Herrero M, Havlík P, Valin H, et al. Biomass use, production, feed efficiencies, and greenhouse gas emissions from global livestock systems. Proceedings of the National Academy of Sciences 2013; 110(52): 20888-93.

– FAOSTAT, 2019. FAO

– Chang J, Ciais P, Herrero M, et al. Combining livestock production information in a process-based vegetation model to reconstruct the history of grassland management. Biogeosciences 2016; 13(12): 3757-76.

– Carlson KM, Gerber JS, Mueller ND, et al. Greenhouse gas emissions intensity of global croplands. Nature Climate Change 2017; 7(1): 63

3.6 Mitigation in the Healthcare Sector

Health professionals have a responsibility to ‘first do no harm’, and a central role to play in the response to climate change. This indicator measures healthcare emissions that come directly from the sector and indirectly through purchased goods and services.

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Headline Finding

Global healthcare sector GHG emissions were approximately 4.6% of the global total emissions in 2018.

Indicator Description

This indicator models greenhouse gas emissions in global and national healthcare sectors, using economic multi-region input-output models in combination with WHO health expenditure data.

Caveats

The EXIOBASE model provides country-specific data for 42 countries, and the remaining data is aggregated into world regions. For the remaining countries, their healthcare sector emissions are estimated based on regional averages. 

This indicator was last updated in July 2019

Data Sources

– World Input-Output Database with environmental accounts, 2013

– EXIOBASE version 2.2

– Global Health Expenditure Database: Indicators and data, 2019. World Health Organization

– Basic Data Selection, 2019. United Nations Statistics Division

– Consumer price index, 2019. World Bank Group

Economics and Finance

The data here works to track the financial and economic dimensions of the effects of climate change, and of mitigation efforts required to respond to these changes. Indicators here monitor the economic costs of climate change and its drivers, as well as the investments and economic tools being deployed to transition to a low-carbon economy.

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4.1 Economic Losses due to Climate-Related Extreme Events

Climate-related extreme events result in direct deaths and injury, the spread of water-borne illness, and the destruction of habitats and infrastructure. Compounding this, these events often result in large economic costs, exacerbating the direct health impacts they produce. This indicator tracks the insured and uninsured economic losses from extreme events.

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Headline Finding

In 2018, 831 climate-related extreme events resulted in US$166 billion in economic losses and no measurable losses in low-income countries were covered by insurance.

Indicator Description

This indicator tracks the total measurable annual economic losses (insured and uninsured) relative to GDP, resulting from climate-related extreme events.

Caveats

Where these are available, data is taken from official institutions, but where not, estimates are calculated. In cases where only low-quality information is available, such as a description of the number of homes damaged or destroyed, assumptions on value and costs are made.

This indicator was last updated in July 2019

Data Sources

– NatCatSERVICE, 2019. Munch Re

4.2 Economic Costs of Air Pollution

Air pollution is responsible for over seven million deaths each year, resulting in profound economic costs. Efforts to mitigate climate change often reduce air pollution, resulting in significant cost-savings and a cost-effective intervention. This indicator tracks the economic costs of air pollution, and the cost-savings of improvements in air quality for Europe.

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Headline Finding

In Europe, improvements in particulate air pollution from human activity were seen from 2015 to 2016. If the levels of pollution for these two years remained the same over a person’s lifetime, this would lead to an annual average reduction in Years of Life Lost worth €5.2 billion.

Indicator Description

This indicator estimates the change in Years of Life Lost due to PM2.5 in European Union countries from 2015 to 2016, applied across 100 years to the 2015 population. A Value of a Life Year (€50,000) is then assigned to the Years of Life Lost to give an estimation of the annual average economic reduction of this change in PM2.5.

Caveats

Data is only available for EU countries and will be expanded in subsequent years. A Value of a Life Year of €50,000 is the lower bound estimate as suggested by the EU Impact Assessment Guidelines. This value does not take into account the health economic costs of healthcare delivery or societal economic costs such as workforce losses, thus representing an underestimation of real economic losses.

This indicator was last updated in July 2019

Data Sources

– Amann M, Bertok I, Borken-Kleefeld J, et al. Cost-effective control of air quality and greenhouse gases in Europe: Modeling and policy applications. Environmental Modelling & Software 2011; 26(12): 1489-501

– World Energy Outlook, 2017. IEA

4.3 Investing in a Low-Carbon Economy

Investing in a Low-Carbon Economy

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4.3.1 Investment in New Coal Capacity

Coal phase-out is both an essential first step in the response to climate change, and an important intervention to reduce morbidity and mortality from air pollution. This indicator monitors the future of coal-fired power generation by tracking investments in new coal-fired capacity.

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Headline Finding

The total number of Final Investment Decisions for coal plants declined by 30% in 2018, with costs and construction times for these plants increasing, in part due to the health concerns of air pollution.

Indicator Description

This indicator draws on data from the annual International Energy Agency to track global coal investment, as a percentage of a 2006 baseline.

This indicator was last updated in July 2019

Data Sources

– World Energy Investment, 2019. IEA

4.3.2 Investments in Zero-Carbon Energy and Energy Efficiency

Investment in zero-carbon energy and energy efficiency must continue to displace investment in fossil fuels if the world is to meet its commitments under the Paris Agreement. This indicator looks at the future of energy production, by monitoring global investment in zero-carbon energy, energy efficiency, fossil fuels, and electricity networks.

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Headline Finding

In 2018, investments in zero-carbon energy were 20% of total investments in the global energy system. By 2030 zero-carbon energy investments must account for at least 65% of total annual investments.

Indicator Description

This indicator draws on data from the International Energy Agency to assess four categories of investment: renewables and nuclear; energy efficiency; electricity networks; and fossil fuels.

This indicator was last updated in July 2019

Data Sources

– World Energy Investment, 2019. IEA

4.3.3 Employment in Low-Carbon and High-Carbon Industries

Ensuring a just and equitable transition to a low-carbon economy is essential, with advanced planning and intervention required to ensure employment opportunities are available in new industries. Following this transition, this indicator tracks employment in renewable and fossil fuel energy industries.

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Headline Finding

In 2018, renewable energy provided 11 million jobs – an increase of 4.2% from 2017. Employment in fossil fuel extraction industries also increased, by 2% from 2017.

Caveats

Fossil fuel extraction values include only direct employment, while renewable energy jobs include both direct and indirect employment. 

This indicator was last updated in July 2019

Indicator Description

This indicator tracks the number of jobs in the renewable and the fossil fuel energy industries. Data on direct and indirect employment in renewable energy industries draws on the International Renewable Energy Agency, and data on direct employment in fossil fuel extraction draws on IBISWorld.

Data Sources

– Renewable Energy and Jobs: Annual Review 2018. IRENA

– IBISWorld Industry Report: Global Coal Mining, 2018. IBISWorld

– IBISWorld Industry Report: Global Oil & Gas Exploration & Production, 2019. IBISWorld

4.3.4 Funds Divested from Fossil Fuels

Public health institutions have a long history of divesting from products which harm the health of their patients – whether they be tobacco, alcohol, or arms. Increasingly, they are choosing not to invest in the fossil fuel industry because of its impact on public health and on climate change. This indicator tracks fossil fuel divestment from health and medical institutions.

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Headline Finding

US$2.135 trillion new funds were committed to fossil fuel divestment in 2018. Health institutions accounted for around US$66.5 million of this.

Caveats

Due to confidentiality issues, the value of funds divested by each organization is not available. The year of divestment reflects the year when the commitment was recorded in 350.org.

This indicator was last updated in July 2019

 

Indicator Description

This indicator tracks the total global value of funds divested from fossil fuels, and the value of divested funds coming from health institutions, using self-reported data from 350.org. The following organisations classified as non-health institutions by 350.org have been considered as health institutions for the purpose of this indicator: HESTA Super Fund; Doctors for the Environment Australia; London School of Hygiene & Tropical Medicine; Berliner Ärzteversorgung / Berlin Doctor’s Pensionfund; HCF; The Royal College of General Practitioners; New Zealand Nurses Organisation.

Data Sources

– 350.org.

4.4 Pricing Greenhouse Gas Emissions from Fossil Fuels

Pricing Greenhouse Gas Emissions from Fossil Fuels

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4.4.1 Fossil Fuel Subsidies

The true cost of fossil fuels is not reflected in their market price, as they have negative externalities related to the health and economic impacts of their use. Fossil fuel subsidies artificially lower fossil fuel prices even further, promoting overconsumption and exacerbating greenhouse gas emissions and air pollution. As the world works to move away from fossil fuel use, this indicator tracks active fossil fuel consumption subsidies around the globe.

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Headline Finding

In 2018, fossil fuel consumption subsidies increased to US$427 billion – over a third higher than 2017 levels, and over 50% higher than 2016 levels.

Caveats

Only 42 (mostly non-OECD) countries are included in this indicator. However, these account for a large proportion of global fossil fuel subsidies. 

This indicator was last updated in July 2019

Indicator Description

This indicator draws on data from the International Energy Agency to track the value of fossil fuel consumption subsidies in 42 mostly non-OECD countries using the ‘price-gap’ approach, comparing average end-user prices paid by consumers with reference prices that correspond to the full cost of supply.

 

Data Sources

– Energy Subsidies, 2019. IEA

4.4.2 Coverage and Strength of Carbon Pricing

Carbon pricing mechanisms remain the most efficient way to limit climate change, promoting investment in a low-carbon economy. This indicator tracks the proportion of global greenhouse gas emissions subject to carbon pricing, and the strength of the pricing.

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Headline Finding

Carbon pricing instruments in early 2019 continue to cover 13.1% of global anthropogenic GHG emissions, but average prices were around 13% higher than in 2018.

Caveats

‘Baseline and Credit’ instruments are not included due to a lack of price data, and some instruments experience an overlap in coverage. As such, total emissions coverage is likely to be overestimated, although this effect is likely to be less than 2.5% of total coverage.

This indicator was last updated in July 2019

 

Indicator Description

This indicator draws on data from the World Bank Carbon Pricing Dashboard to track the extent to which greenhouse-gas emissions are priced around the globe. It reports the total amount of emissions covered by each carbon pricing instrument, their carbon price, and the percentage of global emissions each of them covers (based on the global anthropogenic greenhouse gas emissions in 2012).

Data Sources

– Carbon Pricing Dashboard, 2019. World Bank Group

– Revenue allocation information was from various sources (see the Lancet Countdown 2019 report Appendix)

4.4.3 Use of Carbon Pricing Revenues

Adequately pricing carbon emissions is essential for promoting investment in a low-carbon economy. Revenue from these interventions could be used to further advance mitigation or adaptation measures, or for other important public health initiatives. This indicator tracks the allocation of the revenue generated by carbon pricing.

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Headline Finding

Revenues from carbon pricing instruments increased by US$10 billion between 2017 and 2018, reaching US$43 billion. US$24.4 billion of these revenues were allocated to further climate change mitigation activities. In turn, US$258 million were allocated to climate change adaptation, and could be available for adaptation in the healthcare sector.

Indicator Description

This indicator tracks the allocation of the revenue generated by carbon pricing into four areas: mitigation; adaptation; revenue recycling; and general funds.

Caveats

Only revenue that may be considered government income is included. Instruments for which price data is not available, either due to the type of instrument or simply lack of data, are not included.

This indicator was last updated in July 2019

Data Sources

– Carbon Pricing Dashboard, 2019. World Bank Group

– Revenue allocation information was from various sources (see the Lancet Countdown 2019 report Appendix)

Public and Political Engagement

Public and political engagement underpins the foundations of the world’s collective response to climate change, with reductions in global emissions at the speed required by the Paris Agreement depending on engagement from all sectors of society. The indicators in this section track the links between health and climate change in the media, national governments, the corporate sector, and the broader public.

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5.1 Media Coverage of Health and Climate Change

Media coverage on climate change and on public health acts as an important proxy and driver of political and broader engagement. This indicator analyses coverage and content of health and climate change in key newspapers from around the world.

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Headline Finding

Media coverage of health and climate change continued to increase between 2007 and 2018, with the elite press paying attention to the health impacts of climate change and the co-benefits of climate change action.

Caveats

The selected newspapers cannot be taken to be representative of all media reporting in their countries, and the content analysis does not reflect the ways in which climate change and/or health is reported in the media nor the general messaging. Also, the search terms used are likely to have influenced the types of articles obtained, and databases might return hits of duplicate articles.

This indicator was last updated in July 2019

Indicator Description

This indicator has both a quantitative and qualitative component to its tracking of health and climate change in the media. In 2019, the focus has been on the qualitative work, presented above. For the United States and for India, this indicator assesses the content of health and climate change in elite press across multiple periods in 2018. Articles were automatically screened and then manually filtered, coded and analysed. For China, articles in the China People’s Daily were assessed from 2008 to 2018, with text corpus searched with natural language processing followed by manual filtering.

 

Data Sources

– People’s Daily Mandarin edition

– Nexis Uni® database

– Factiva© database

5.2 Individual Engagement in Health and Climate Change

Online activity is increasingly being used to understand and drive public and individual engagement, transforming individual access to global knowledge and debates. This indicator tracks individuals’ information-seeking behaviour on Wikipedia in relation to the link between climate change and health.

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Headline Finding

Individuals typically seek information about either health or climate change; where individuals seek information across these areas, it is primarily driven by an initial interest in health-related content.

Indicator Description

This indicator measures the number of clicks from health-related Wikipedia articles that lead to visits to climate change-related Wikipedia articles, and the number of visits to climate change-related articles that result in clicks to health-related pages. This “clickstream data” is used as a proxy for the degree to which individuals engage with health and climate change as related issues.

Caveats

The data the data is not geo-referenced, so it is not possible to infer the location page visits came from. Only English Wikipedia pages were considered in the analysis (approximately 50% of total Wikipedia pages), and while they are accessed globally, it is somewhat biased towards English-speaking countries.

This indicator was last updated in July 2019

Data Sources

– Ellery Wulczyn, Dario Taraborelli (2015). Wikipedia Clickstream. Figshare. https://figshare.com/articles/Wikipedia_Clickstream/1305770

5.3 Government engagement in health and climate change

Meeting the commitments under the Paris Agreement require accelerated and ambitious interventions from governments across the world. Ensuring these efforts maximise human health and wellbeing begins with these issues being recognised as important areas of concern, and as reasons for change. This indicator tracks references to health and climate change in the speeches of global leaders at the United Nations General Debate, the key event for Member States to speak about their nations’ priorities and concerns.

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Headline Finding

National leaders are increasingly drawing attention to health and climate change at the UN General Debate. This trend has been led by small island developing states, who comprised of 36% of the total countries referencing health and climate change in 2018.

Indicator Description

This indicator tracks mentions of climate change and health in statements made by national leaders at the UN General Debate, which is part of the annual UN General Assembly, as proxy of high-level political engagement on these two topics as separate and related issues.

This indicator was last updated in July 2019

Data Source

UN General Debate statements (official English versions)