The 2019 Report

1.1.2 Exposure of Vulnerable Populations to Heatwaves

Vulnerable populations – the elderly and children under 1 year of age - faced 3.7 billion more life-threatening heatwave days in 2021 than annually in 1986-2005, putting them at acute risk of heat stress, heat stroke, and other adverse physical and mental health manifestations.

1.2.1 Wildfires

Drier and hotter weather is making conditions increasingly suitable for the start and spread of wildfires, putting people' s health and safety at risk. Human exposure to days of very-high or extremely-high fire danger increased in 61% of countries from 2001–2004 to 2018–2021.

1.2.2 Drought

Droughts put food and water security at risk, threaten sanitation, affect livelihoods, and increase the risk of wildfires and infectious disease transmission. On average, 29% more global land area was affected by extreme drought for at least one month in a year in 2012–21 than in 1951–60

1.3 Climate Suitability for Infectious Disease Transmission

Climate change is affecting the distribution and transmission of many infectious diseases, including vector-borne, food-borne, and waterborne diseases. The climatic suitability for the transmission of dengue increased by 11·5% for Aedes aegypti and 12·0% for Aedes albopictus from 1951–60 to 2012–21

1.4 Food Security and Undernutrition

The increasing frequency of heatwaves resulted in an additional 98 million people reporting moderate to medium food insecurity in the 103 countries analysed in 2020, compared to the 1981-2010 average. This threatens to compound the impacts on food insecurity of the COVID-19 pandemic, and the energy and cost of living crises.

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

nsufficient climate change adaptation efforts have left health systems vulnerable to climate change-related health hazards. Only 48 of 95 countries have completed a climate change and health vulnerability and adaptation assessment, and in only 9 countries did these strongly influenced resource allocation.

2.2.3 Urban Green Space

Healthy and green urban redesign will promote physical activity and deliver more friendly, liveable cities. Today, just 27% of urban centres are classified as moderately-green or above.

2.2.5 Detection, Preparedness and Response to Health Emergencies

Even after the impact of the COVID-19 pandemic, only 63% of 177 countries reported high to very high implementation status for health emergency management in 2021, with only 35% of low or medium Human Development Index countries doing so.

3.1 Energy System and Health

Energy systems are the largest single source of greenhouse gas emissions and are major contributors to air pollution. CO2 emissions from fossil fuel combustion reached a record high in 2020. The carbon intensity from the energy system decreased by less than 1% since the year countries came together to adopt the UN Framework Convention on Climate Change.

3.2 Clean Household Energy

Dirty fuels still dominate the energy used in the domestic sector. Just 13% of rural households in low Human Development Index (HDI) countries had access to clean fuels and technologies for cooking in 2020, against 98% in high HDIcountries. In the 63 countries assessed, the air in people’s homes exceeded WHO small particulate pollution (PM2.5) guideline levels by 30-fold in 2020

3.3 Premature Mortality from Ambient Air Pollution by Sector

Transition towards sustainable energy, transportation, waste management and agricultural systems could help prevent the 3·3 million deaths attributable to anthropogenic PM2.5 in 2020, including the 1·2 million directly related to the combustion of fossil fuels

4.1.3 Loss of Earnings from Heat-Related Labour Capacity Loss

Heat exposure in 2021 led to income losses equivalent to substantial proportions of countries’ GDP (5.6% in the case of low Human Development Index countries), worsening the impact of the cost-of-living crisis, and worsening the socioeconomic conditions that contribute to good health.

4.2.4 Net Value of Fossil Fuel Subsidies and Carbon Prices

Despite their profound health harms, governments continue to encourage fossil fuel production and consumption. 69 (80%) of 86 countries reviewed had net-negative carbon prices (ie, provided a net subsidy to fossil fuels) for a net total of US$400 billion. These subsidies exceeded 10% of national health spending in 31 countries and exceeded 100% in 5 countries

4.2.6 Compatibility of Fossil Fuel Company Strategies With the Paris Agreement

Despite climate commitments to reduce their carbon impact, on the basis of their existing production strategies and market shares, 15 of the largest oil and gas companies would exceed their share of greenhouse gas emissions compatible with the 1·5°C climate target by an average of 87% (publicly-listed international companies) and 111% (state-owned national companies) in 2040, making the goals of the Paris Agreement unattainable

5.1 Media Coverage of Health and Climate Change

Media articles are a widely used source of public information that influence public perceptions on climate change, governments, and the social media agenda. Coverage of health and climate change in the media increased by 4.7% in 2021 from 2020, reaching a record high.

5.4 Government Engagement in Health and Climate Change

Government engagement with health and climate change is essential for health-centred climate action. Engagement with health and climate change from world leaders has increased since 2020, with 60% of countries drawing attention to climate change and health in the 2021 UN General Debate, and 86% of the updated NDC submissions referring to health