Interactive: Explore the data of the 2021 report

Scroll down to explore the indicator graphics from the 2021 Lancet Countdown Report


The 2021 Report of the Lancet Countdown on Health and Climate Change: Code Red for a Healthy Future

The health impacts of climate change are worsening across every indicator tracked, affecting people in all corners of the world.

In 2020, adults over 65 were affected by 3.1 billion more days of heatwave exposure than in the 1986 – 2005 average.

Older people in China, India, the USA, Japan and Indonesia were most affected.

In parallel, the vulnerability to heat is increasing across all countries, as a consequence of the aging population, increasing urbanisation, and higher rate of underlying health conditions.

The potential for outbreaks of dengue, chikungunya and Zika is increasing most rapidly in countries of very high human development index, including European countries.

Suitability for malaria infections is increasing in cooler highland areas of countries with a low human development index.

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

This value had rarely exceeded 13% between 1950 and 1999.

This is threatening water security, sanitation, and increasing the risk of wildfires. 134 of 185 countries had an increase in population wildfire exposure from 2001 to 2020.

Rising temperatures also shorten the time in which plants reach maturity, meaning smaller yields and an increased strain on our food systems. Maize has seen a 6% decrease in crop yield potential, wheat a 3% decrease and rice a 1.8% decrease, compared to 1981 – 2010 levels.

Climate change is exacerbating the hazards already faced by many – particularly in communities vulnerable to food and water insecurity, heatwaves, and the spread of infectious diseases – and acting to increase health inequities around the world.

Just as the world is failing to deliver an equitable response to COVID-19, there are deep inequities in the global response to climate change

In a 2021 World Health Organization survey of health and climate change, only 49% of countries reported having a national health and climate change plan or strategy….

….with 69% of these reporting insufficient financing as a barrier to their implementation.

Only 27% of urban centres had levels of green space classified as moderately green or above.

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.

Access to urban green spaces provides benefits to human physical and mental health. These benefits include reducing exposure to air pollution, relieving stress, and increasing social interaction and physical activity, with overall improved general health outcomes and lower mortality risk. Green space also helps climate change mitigation and adaptation by sequestering carbon and delivering local cooling benefits.

Only 37% of WHO member states reported high implementation of a national health emergency framework, in preparation for a multi-hazard public health emergency.

The level of implementation varied, with 89% of very high HDI group countries reporting medium-to-high implementation compared to 55% of low HDI group countries.

The carbon intensity of the global energy system fell slightly for the fifth year in a row to 56.0 tCO2e/TJ (excluding land use emissions) in 2018. However, progress remains very slow.

Progress has been made in the very high HDI country group since 1970…

…and carbon intensity in the high HDI country group could be at a possible peak.

However, driven by the need to develop, the low and medium HDI country groups have had a sustained growth in emissions per unit of energy since 1970.

Only 12% of households in low Human Development Index (HDI) group countries in 2019 primarily relied on clean fuels and technologies for cooking.

This drops to only 5% in rural households. This has profound health implications through exposure to indoor air pollution in the home.

Countries in the medium and high HDI groups face the highest rates of air pollution-related mortality as a result of higher industrial activity, poorer emissions controls and the continuing use of solid fuels in the domestic sector.

Deaths are lower in both low and very high HDI group countries for differing reasons – in low HDI countries there is lower industrial activity and a younger population, while very high HDI countries have cleaner electricity generation, industrial production and end-of-pipe emission controls.

The production of goods and services often drives greenhouse gas and PM2.5 emissions, thus contributing to impacts on health and wellbeing. In 2019, 18% of CO2 global emissions were embodied in trade between countries of different HDI levels.

The very high HDI country group contributed the most production-based (45%) CO2 emissions…

…and consumption-based (49%) CO2 emissions in 2019. Notably, the very high HDI country group was the only group with higher consumption-based emissions than production-based emissions, meaning the group outsourced their net consumption-related emissions.

In 2020, the 242 recorded climate-related extreme events totalled US$178 billion. When normalised by GDP, the losses in the medium HDI group countries were three times higher than in the very high HDI group.

While 60% of losses in the very high HDI group were insured, just 3% were insured in the medium HDI group, and effectively none were insured in the low HDI group. This creates larger economic burdens in already disadvantaged countries as losses are either not replaced or replaced through out-of-pocket expenses which reinforces inequities.

The global pandemic has driven increased engagement in health and climate change across multiple domains in society.

The number of articles on health and climate change increasing by 28% between 2019 and 2020 to reach its highest recorded level of 858 articles. Increasing scientific engagement in health and climate change is driven by very high HDI countries. In contrast, scientists in low HDI countries were lead authors of just 1% of journal articles.

91 heads of state made the connection between climate change and health in the 2020 UN General Debate, a more than 50% increase from the 2019 UN General Debate.

Leaders of the world have an unprecedented opportunity to deliver a future of improved health, reduced inequity, and economic and environmental sustainability. However, this will only be possible if the world acts together to ensure that no person is left behind.