The 2019 Report

1.1.1 Vulnerability to Extremes of Heat

Although vulnerability to heat in the low and medium Human Development Index (HDI) country groups is 27–38% lower than in the very high HDI group, it is increasing in all groups and, since 1990, it has increased by 19% in the low HDI group and by 20% in the medium HDI group.

1.1.2 Exposure of Vulnerable Populations to Heatwaves

Children younger than 1 year were affected by 626 million more person-days of heatwave exposure and adults older than 65 years were affected by 3·1 billion more person-days of heatwave exposure in 2020 than in the 1986–2005 average.

1.1.3 Heat and Physical Activity

The past four decades saw an increase in the number of hours in which temperatures were too high for safe outdoor exercise, with people in the low Human Development Index country group having an average loss of 3·7 h of safe exercise per day in 2020.

1.1.4 Change in Labour Capacity

295 billion hours of potential work were lost due to extreme heat exposure in 2020, with 79% of all losses in countries with a low Human Development Index occurring in the agricultural sector.

1.1.5 Heat and Sentiment

Exposure to heatwave events worsens expressed sentiment, with a 155% increase in negative expressions on Twitter during heatwaves in 2020 from the 2015–19 average.

1.1.6 Heat-Related Mortality

Heat-related deaths in people older than 65 reached a record high of an estimated 345000 deaths in 2019; between 2018 and 2019, all WHO regions, except for Europe, saw an increase in heat-related deaths in this vulnerable age group.

1.2.1 Wildfires

Nearly 60% of countries had an increase in the number of days people were exposed to very high or extremely high fire danger in 2017–20 compared with 2001–04, and 72% of countries had increased human exposure to wildfires across the same period.

1.2.2 Drought

In 2020, up to of 19% of the global land surface was affected by extreme drought in any given month.

1.3.1 Climate Suitability for Infectious Disease Transmission

The R0 for all arboviral diseases tracked has increased, and, in 2020, was 13% higher for transmission by A. aegypti and 7% higher for transmission by A. albopictus than in baseline years.

1.3.2 Vulnerability to Mosquito-Borne Diseases

While vulnerabilities to arboviruses transmitted by A. albopictus and A. aegypti have decreased across all countries since the year 2000, countries in the low Human Development Index group remain on average the most vulnerable

1.4.1 Terrestrial Food Security and Undernutrition

Crop yield potential continues to follow a downward trend, with 6·0% reduction in the crop yield potential of maize, 3·0% for winter wheat, 5·4% for soybean, and 1·8% for rice, relative to the 1981–2010 average crop yield potential.

1.5 Migration, Displacement and Sea-Level Rise

There are currently 569.6 million people settled below 5 metres above sea level, who could face risks from the direct and indirect hazards posed by the rising sea levels.

2.1.1 National Adaptation Plans for Health/2.1.2 National Assessments of Climate Change Impacts, Vulnerability and Adaptation for Health

45 (49%) of 91 countries in 2021 reported having done a climate change and health vulnerability and adaptation assessment. Additionally, 45 (49%) of 91 countries in 2021 reported having done a climate change and health vulnerability and adaptation assessment.

2.1.3 City-Level Climate Change Risk Assessments

In 2020, 546 (81%) of 670 cities reported having completed or being in the process of doing climate change risk assessments; heat-related illness was the most common climate-related health concern, identified by 169 (55%) of 308 cities.

2.3.3 Urban Green Space

Globally in 2020, 27% of urban centres were classified as being moderately green or above, an increase from 14% in 2010; the percentage of cities under this classification varied from 17% of urban centres in the low HDI country groups to 39% of urban centres in the very high HDI country group.

2.4 Spending on Adaptation for Health and Health-Related Activities

Globally, adaptation funding that is directed at health systems represents a small proportion of total climate change adaptation funding (0.3%), and only 5.6% of all transactions with adaptation potential were relevant to health in 2019–20.

3.1.2 Coal Phase-Out

In 2019, global coal use for all activities fell 1.2%. Global coal demand is expected to rise by 4.5% in 2021.

3.2 Clean Household Energy

While progress has been made in the use of clean fuels in the home, in 2019, only 12% of households in the low Human Devleopment Index (HDI) group primarily relied on clean fuels and technologies for cooking. In medium and high HDI group countries, the share of solid biofuel has fallen more rapidly and clean cooking fuel technology use has risen substantially.

3.5.2 Diet and Health Co-Benefits

Between 2017 and 2018 the estimated deaths due to excess red meat consumption rose by 1.8% to 842,000 deaths.

3.6 Mitigation in the Healthcare Sector

The healthcare sector was responsible for 4.9% of global greenhouse gas emissions in 2018. Healthcare emissions are positively associated with Human Development Index levels, largely through health spending, but minimal association is seen after emissions of 400 kg CO2eq per capita.

4.1.2 Costs of Heat-Related Mortality

The monetised value of global heat-related mortality increased by 6.7%, from 0.27% of gross world product in 2018 to 0.28% in 2019; Europe continued to be the worst affected region, facing costs equivalent to the average income of 6.1 million of its citizens.

4.1.3 Loss of Earnings from Heat-Related Labour Capacity Reduction

Working in conditions of extreme heat is a health risk; such conditions could reduce the capacity for paid labour, with an impact on workers’ earnings equivalent to 4–8% of GDP in the low HDI country group in 2020.

4.1.4 Costs of the Health Impacts of Air Pollution

Equivalent to the annual income of 78.1 million and 99.1 million people, the greatest economic costs of mortality due to air pollution fall on countries in the medium and high HDI country groups; costs relative to GDP decreased between 2015 and 2019 globally, with the exception of costs in southeast Asia.

4.2.5 Production- and Consumption-Based Attribution of CO² and PM^2.5 Emissions

In 2019, 18% of CO² and 17% of PM^2.5 global emissions were embodied in trade between countries of different Human Development Index levels.

5.1 Media Coverage of Health and Climate Change

In 2020, the upward trend in coverage of health and climate change continued but did not match the increase seen in 2019; in 2020, most of the coverage of health and climate change referred to COVID-19.

5.3 Coverage of Health and Climate Change in Scientific Journals

Original research on health and climate change increased 11-fold between 2007 and 2020, driven primarily by scientists in countries in the very high HDI group; the number of articles on health and climate change that addressed gender remained low; and in 2020, 7% of health and climate change articles referred to COVID-19.

5.4 Government Engagement in Health and Climate Change

In 2020, 47% of government leaders engaged with the health dimensions of climate change in their statements at the UN General Debate, which is more than double the proportion in 2019; this increase was linked to engagement with the COVID-19 pandemic.

5.5 Corporate Sector Engagement in Health and Climate Change

In 2020, engagement in health and climate change increased to its highest level among companies in the UN Global Compact. Over a third (38%) of companies referred to the health dimensions of climate change in their 2020 progress reports.