literature review about climate change

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• Published: 04 January 2021

Climate change and health in North America: literature review protocol

• Sherilee L. Harper   ORCID: orcid.org/0000-0001-7298-8765 1 ,
• Ashlee Cunsolo 2 ,
• Amreen Babujee 1 ,
• Shaugn Coggins 1 ,
• Mauricio Domínguez Aguilar 3 &
• Carlee J. Wright 1  

Systematic Reviews volume  10 , Article number:  3 ( 2021 ) Cite this article

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Climate change is a defining issue and grand challenge for the health sector in North America. Synthesizing evidence on climate change impacts, climate-health adaptation, and climate-health mitigation is crucial for health practitioners and decision-makers to effectively understand, prepare for, and respond to climate change impacts on human health. This protocol paper outlines our process to systematically conduct a literature review to investigate the climate-health evidence base in North America.

A search string will be used to search CINAHL®, Web of Science™, Scopus®, Embase® via Ovid, and MEDLINE® via Ovid aggregator databases. Articles will be screened using inclusion/exclusion criteria by two independent reviewers. First, the inclusion/exclusion criteria will be applied to article titles and abstracts, and then to the full articles. Included articles will be analyzed using quantitative and qualitative methods.

This protocol describes review methods that will be used to systematically and transparently create a database of articles published in academic journals that examine climate-health in North America.

Peer Review reports

The direct and indirect impacts of climate change on human health continue to be observed globally, and these wide-ranging impacts are projected to continue to increase and intensify this century [ 1 , 2 ]. The direct climate change effects on health include rising temperatures, which increase heat-related mortality and morbidity [ 3 , 4 , 5 ], and increased frequency and intensity of storms, resulting in increased injury, death, and psychological stressors [ 2 , 6 , 7 , 8 ]. Indirect climate change impacts on health occur via altered environmental conditions, such as climate change impacts on water quality and quantity, which increase waterborne disease [ 9 , 10 , 11 , 12 , 13 ]; shifting ecosystems, which increase the risk of foodborne disease [ 14 , 15 , 16 ], exacerbate food and nutritional security [ 17 , 18 ], and change the range and distribution of vectors that cause vectorborne disease [ 19 , 20 ]; and place-based connections and identities, leading to psycho-social stressors and potential increases in negative mental health outcomes and suicide [ 6 , 8 ]. These wide-ranging impacts are not uniformly or equitably distributed: children, the elderly, those with pre-existing health conditions, those experiencing lower socio-economic conditions, women, and those with close connections to and reliance upon the local environment (e.g. Indigenous Peoples, farmers, fishers) often experience higher burdens of climate-health impacts [ 1 , 2 , 21 ]. Indeed, climate change impacts on human health not only are dependent on exposure to climatic and environmental changes, but also depend on climate change sensitivity and adaptive capacity—both of which are underpinned by the social determinants of health [ 1 , 22 , 23 ].

The inherent complexity, great magnitude, and widespread, inequitable, and intersectional distribution of climate change impacts on health present an urgent and grand challenge for the health sector this century [ 2 , 24 , 25 ]. Climate-health research and evidence is critical for informing effective, equitable, and timely adaptation responses and strategies. For instance, research continues to inform local to international climate change and health vulnerability and adaptation assessments [ 26 ]. However, to create evidence-based climate-health adaptation strategies, health practitioners, researchers, and policy makers must sift and sort through vast and often unmanageable amounts of information. Indeed, the global climate-health evidence base has seen exponential growth in recent years, with tens of thousands of articles published globally this century [ 22 , 25 , 27 , 28 ]. Even when resources are available to parse through the evidence base, the available research evidence may not be locally pertinent to decision-makers, may provide poor quality of evidence, may exclude factors important to decision-makers, may overlook temporal and geographical scales over which decision-makers have impact, and/or may not produce information in a timely manner [ 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ].

Literature reviews that utilize systematic methods present a tool to efficiently and effectively integrate climate-health information and provide data to support evidence-based decision-making. Furthermore, literature reviews that use systematic methods are replicable and transparent, reduce bias, and are ultimately intended to improve reliability and accuracy of conclusions. As such, systematic approaches to identify, explore, evaluate, and synthesize literature separates insignificant, less rigorous, or redundant literature from the critical and noteworthy studies that are worthy of exploration and consideration [ 38 ]. As such, a systematic approach to synthesizing the climate-health literature provides invaluable information and adds value to the climate-health evidence base from which decision-makers can draw from. Therefore, we aim to systematically and transparently create a database of articles published in academic journals that examine climate-health in North America. As such, we outline our protocol that will be used to systematically identify and characterize literature at the climate-health nexus in North America.

This protocol was designed in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) Guidelines [ 39 , 40 ] and presented in accordance with the PRISMA-P checklist.

Research questions

Research on climate change and human health encompasses a diverse range of health outcomes, climate change exposures, populations, and study designs. Given the breadth and depth of information needed by health practitioners and decision-makers, a variety of research questions will be examined (Table 1 ).

Search strategy

The search strategy, including the search string development and selection of databases, was developed in consultation with a research librarian and members of the research team (SLH, AC, and MDA). The search string contains terms related to climate change [ 41 , 42 ], human health outcomes [ 1 , 25 , 43 , 44 ], and study location (Table 2 ). Given the interdisciplinary nature of the climate-health nexus and to ensure that our search is comprehensive, the search string will be used to search five academic databases:

CINAHL® will be searched to capture unique literature not found in other databases on common disease and injury conditions, as well as other health topics;

Web of Science™ will be searched to capture a wide range of multi-disciplinary literature;

Scopus® will be searched to capture literature related to medicine, technology, science, and social sciences;

Embase® via Ovid will be searched to capture a vast range of biomedical sciences journals; and

MEDLINE® via Ovid will be searched to capture literature on biomedical and health sciences.

No language restrictions will be placed on the search. Date restrictions will be applied to capture literature published on or after 01 January 2013, in order to capture literature published after the Intergovernmental Panel on Climate Change (IPCC) Fifth Assessment Report (which assessed literature accepted for publication prior to 31 August 2013). An initial test search was conducted on June 10, 2019, and updated on February 14, 2020; however, the search will be updated to include literature published within the most recent full calendar year prior to publication.

To explore the sensitivity of our search and capture any missed articles, (1) a snowball search will be conducted on the reference lists of all the literature that meet the inclusion criteria and (2) a hand search of three relevant disciplinary journals will be conducted:

Environmental Health Perspectives , an open access peer-reviewed journal that is a leading disciplinary journal within environmental health sciences;

The Lancet , a peer-reviewed journal that is the leading disciplinary journal within public health sciences; and

Climatic Change , a peer-reviewed journal covering cross-disciplinary literature that is a leading disciplinary journal for climate change research.

Citations will be downloaded from the databases and uploaded into Mendeley™ reference management software to facilitate reference management, article retrieval, and removal of duplicate citations. Then, de-duplicated citations will be uploaded into DistillerSR® to facilitate screening.

Article selection

Inclusion and exclusion criteria.

To be included, articles must evaluate or examine the intersection of climate change and human health in North America (Fig. 1 ). Health is defined to include physical, mental, emotional, and social health and wellness [ 1 , 25 , 43 , 44 ] (Fig. 1 ). This broad definition will be used to examine the nuanced and complex direct and indirect impacts of climate change on human health. To examine the depth and breadth of climate change impacts on health, climate change contexts are defined to include seasonality, weather parameters, extreme weather events, climate, climate change, climate variability, and climate hazards [ 41 , 42 ] (Fig. 1 ). However, articles that discuss climate in terms of indoor work environments, non-climate hazards due to geologic events (e.g. earthquakes), and non-anthropogenic climate change (e.g. due to volcanic eruptions) will be excluded. This broad definition of climate change contexts will be used in order to examine the wide range and complexity of climate change impacts on human health. To be included, articles need to explicitly link health outcomes to climate change in the goal statement, methods section, and/or results section of the article. Therefore, articles that discuss both human health and climate change—but do not link the two together—will be excluded. The climate-health research has to take place in North America to be included. North America is defined to include Canada, the USA, and Mexico in order to be consistent with the IPCC geographical classifications; that is, in the Fifth Assessment Report, the IPCC began confining North America to include Canada, Mexico, and the USA [ 45 ] (Fig. 1 ). Articles published in any language will be eligible for inclusion. Articles need to be published online on or after 01 January 2013 to be included. No restrictions will be placed on population type (i.e. all human studies will be eligible for inclusion).

Inclusion and exclusion criteria to review climate change and health literature in North America

Level 1 screening

The title and abstract of each citation will be examined for relevance. A stacked questionnaire will be used to screen the titles and abstracts; that is, when a criterion is not met, the subsequent criteria will not be assessed. When all inclusion criteria are met and/or it is unclear whether or not an inclusion criterion is met (e.g. “unsure”), the article will proceed to Level 2 screening. If the article meets any exclusion criteria, it will not proceed to Level 2 screening. Level 1 screening will be completed by two independent reviewers, who will meet to resolve any conflicts via discussion. The level of agreement between reviewers will be evaluated by dividing the total number of conflicts by the total number of articles screened for Level 1.

Level 2 screening

The full text of all potentially relevant articles will be screened for relevance. A stacked questionnaire will also be used to screen the full texts. In Level 2 screening, only articles that meet all the inclusion criteria will be included in the review (i.e. “unsure” will not be an option). Level 2 screening will be completed by two independent reviewers, who will meet to resolve any conflicts via discussion. The level of agreement between reviewers will be evaluated by dividing the total number of conflicts by the total number of articles screened for Level 2 (Fig. 2 ).

Flow chart of screening questions for the literature review on climate change and health in North America

Data extraction and analysis

A data extraction form will be created in DistillerSR® ( Appendix 2 ) and will be tested by three data extractors on a sample of articles to allow for calibration on the extraction process (i.e. 5% of articles if greater than 50 articles, 10% of articles if less than or equal to 50 articles). After completing the calibration process, the form will be adapted based on feedback from the extractors to improve usability and accuracy. The data extractors will then use the data extraction form to complete data extraction. Reviewers will meet regularly to discuss and resolve any further issues in data extraction, in order to ensure the data extraction process remains consistent across reviewers.

Data will be extracted from original research papers (i.e. articles containing data collection and analysis) and review articles that reported a systematic methodology. This data extraction will focus on study characteristics, including the country that the data were collected in, focus of the study (i.e. climate change impact, adaptation, and/or mitigation), weather variables, climatic hazards, health outcomes, social characteristics, and future projections. The categories within each study characteristic will not be mutually exclusive, allowing more than one response/category to be selected under each study characteristic. For the country of study, Canada, the USA, and/or Mexico will be selected if the article describes data collection in each country respectively. Non-North American regions will be selected if the article not only collects data external to North America, but also includes data collection within Canada, the USA, and/or Mexico. For the study focus, data will be extracted on whether the article focuses on climate change impacts, adaptation, and/or mitigation within the goals, methods, and/or results sections of the article. Temperature, precipitation, and/or UV radiation will be selected for weather variables if the article utilizes these data in the goal, methods, and/or results sections. Data will be extracted on the following climatic hazards if the article addresses them in the goal, methods, and/or results sections: heat events (e.g. extreme heat, heat waves), cold events (e.g. extreme cold, winter storms), air quality (e.g. pollution, parts per million (PPM) data, greenhouse gas emissions), droughts, flooding, wildfires, hurricanes, wildlife changes (including changes in disease vectors such as ticks or mosquitos), vegetation changes (including changes in pollen), freshwater (including drinking water), ocean conditions (including sea level rise and ocean acidity/salinity/temperature changes), ice extent/stability/duration (including sea ice and freshwater ice), coastal erosion, permafrost changes, and/or environmental hazards (e.g. exposure to sewage, reduced crop productivity).

Data will be extracted on the following health outcomes if the article focuses on them within the goal, methods, and/or results sections: heat-related morbidity and/or mortality, respiratory outcomes (including asthma, chronic obstructive pulmonary disease), cardiovascular outcomes (including heart attacks or stroke), urinary outcomes (e.g. urinary tract infections, renal failure), dermatologic concerns, mental health and wellness (e.g. suicide, emotional health), fetal health/birth outcomes and/or maternal health, cold exposure, allergies, nutrition (including nutrient deficiency), waterborne disease, foodborne disease, vectorborne disease, injuries (including accidents), and general morbidity and/or mortality. Data on the following social characteristics will also be extracted from the articles if they are included in the goal, methods, and/or results sections of the article: access to healthcare, sex and/or gender, age, income, livelihood (including data on employment, occupation), ethnicity, culture, Indigenous Peoples, rural/remote communities (“rural”, “remote”, or similar terminology must be explicitly mentioned), urban communities (“urban”, “city”, “metropolitan”, or similar terminology must be explicitly used), coastal communities (use of “coastal”, or similar terms must be explicitly mentioned), residence location (zipcode/postal code, neighbourhood, etc.), level of education, and housing (e.g. data on size, age, number of windows, air conditioning). Finally, data will be collected on future projections, including projections that employ qualitative and/or quantitative methods that are included in the goal, methods, and/or results sections of the article.

Descriptive statistics and regression modelling will be used to examine publication trends. Data will be visualized through the use of maps, graphs, and other visualization techniques as appropriate. To enable replicability and transparency, a PRISMA flowchart will be created to illustrate the article selection process and reasons for exclusion. Additionally, qualitative thematic analyses will be conducted. These analyses will utilize constant-comparative approaches to identify patterns across articles through the identification, development, and refinement of codes and themes. Article excerpts will be grouped under thematic categories in order to explore connections in article characteristics, methodologies, and findings.

Quality appraisal of studies included in the systematic scoping review will be performed using a framework based on the Mixed Methods Appraisal Tool (MMAT) [ 46 ] and the Confidence in the Evidence from Reviews of Qualitative Research (CERQual) tool [ 47 ]. This will enable appraisal of evidence in reviews that contain qualitative, quantitative, and mixed methods studies, as well as appraisal of methodological limitations in included qualitative studies. These tools may be adapted to include additional questions as required in order to fit the scope and objectives of the review. A minimum of two reviewers will independently appraise the included articles and discuss judgements as needed. The findings will be made available as supplementary material for the review.

Climate-health literature reviews using systematic methods will be increasingly critical in the health sector, given the depth and breadth of the growing body of climate change and health literature, as well as the urgent need for evidence to inform climate-health adaptation and mitigation strategies. To support and encourage the systematic and transparent identification and synthesis of climate-health information, this protocol describes our approach to systematically and transparently create a database of articles published in academic journals that examine climate-health in North America.

Availability of data and materials

Not applicable.

Abbreviations

Confidence in the Evidence from Reviews of Qualitative Research

Intergovernmental Panel on Climate Change

Mixed Methods Appraisal Tool

Parts per million

Preferred Reporting Items for Systematic review and Meta-Analyses

Preferred Reporting Items for Systematic review and Meta-Analyses, Protocol Extension

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Acknowledgements

We would like to thank Maria Tan at the University of Alberta Library for the advice, expertise and guidance provided in developing the search strategy for this protocol. Special thanks to those who assisted with methodology refinement, including Etienne de Jongh, Katharine Neale, and Tianna Rusnak.

Funding was provided by the Canadian Institutes for Health Research (to SLH and AC). The funding body had no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.

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Ashlee Cunsolo

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SLH, AC, and MDA contributed to the conceptualization, methodology, writing, and editing of the manuscript. AB contributed to the methodology, writing, and editing of the manuscript. SC contributed to the writing and editing of the manuscript. CJW contributed to visualization, writing, and editing of the manuscript. The authors have read and approved the final manuscript.

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Additional file 1..

Search strategy for CINAHL®, Web of Science™, Scopus®, Embase® via Ovid, and MEDLINE® via Ovid.

Data extraction form

• *Categories were not mutually exclusive; that is, more than one category could be selected

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Harper, S.L., Cunsolo, A., Babujee, A. et al. Climate change and health in North America: literature review protocol. Syst Rev 10 , 3 (2021). https://doi.org/10.1186/s13643-020-01543-y

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Climate change mitigation and Sustainable Development Goals: Evidence and research gaps

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Affiliation Climate Economics and Risk Management, Department of Technology, Management and Economics, Technical University of Denmark, Kongens Lyngby, Denmark

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Citation: Pathak M, Patel S, Some S (2024) Climate change mitigation and Sustainable Development Goals: Evidence and research gaps. PLOS Clim 3(3): e0000366. https://doi.org/10.1371/journal.pclm.0000366

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Funding: The authors received no specific funding for this work.

Competing interests: The authors have declared that no competing interests exist.

Never in the past three decades have the interlinkages between sustainable development and climate change been more pressing. The projected date when the remaining carbon budget will be exhausted if continuing at the current rate of emissions [ 1 ] is estimated to be around 2030- which also coincides with the timeline for achieving the Sustainable Development Goals (SDGs). Recent global assessments clearly show the collective global performance on the targets relating to climate change, biodiversity and SDGs is abysmally poor [ 2 , 3 ]. Urgent efforts are needed to achieve both deep and rapid emissions reductions and to meet the SDGs to set the world on a pathway towards sustainable development.

The appreciation of interconnections between climate change and equity and sustainable development is not recent. In 1992, Working Group III of the Intergovernmental Panel on Climate Change (IPCC) was restructured with a mandate to assess cross-cutting economic and other issues related to climate change including placing socio-economic perspectives in the context of sustainable development. IPCC’s Second Assessment Report in 1995 explicitly highlighted the different starting points of countries, trade-offs between economic growth and sustainability, distributional impacts of mitigation and adaptation actions and issues of intertemporal equity. This understanding has further deepened since then. Successive IPCC reports have highlighted the implications of efforts aimed at achieving targets under Climate Action (SDG 13) on SDGs [ 2 , 4 , 5 ]. There is now more evidence to show synergies of several climate actions with SDGs outweigh the trade-offs [ 6 ] Such actions include active transport, passive building design, clean energy, circular economy and urban green and blue infrastructure ( Fig 1 ) [ 7 ].

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https://doi.org/10.1371/journal.pclm.0000366.g001

A quick literature search on Scopus for papers focusing on climate change mitigation and SDGs showed 433 papers (Scopus search using search strings for each individual SDGs, for example: (TITLE-ABS-KEY ("SDG 1" OR "SDG1") AND TITLE-ABS-KEY ("Climate") AND TITLE-ABS-KEY ("mitigation" OR "mitigate"))). SDG 7 (Affordable and clean energy), SDG 2 (Zero Hunger) and 15 (Life on Land) were the most studied while SDGs 4 (Quality Education), 5 (Gender Equality), 10 (Reduced inequality) and 16 (Peace, Justice and strong institutions) received less attention.

Despite numerous studies, there’s limited evidence of the SDGs being perceived as a valuable tool for making decisions regarding climate action. Firstly, many of the existing studies highlight the potential of mitigation actions supporting SDG achievement through theoretical or modelled methods with few empirical studies demonstrating ex-post evaluation of specific interventions. In particular, there is limited literature on trade-offs and understanding of distributional effects for specific groups [ 8 ]. Secondly, a study on mapping SDG interactions of mitigation actions would not necessarily reveal the full picture. For example, urban public transport could show potential synergies with multiple SDGs however, it wouldn’t necessarily provide evidence on whether benefits could accrue to the most vulnerable groups. Similarly, a new urban transit system could have potential synergies with SDGs 3, 6, 9 and 11, however, this would fail to capture the near-term trade-offs e.g. relocation or costs or emissions.

It becomes more challenging when a particular action can result in mixed impacts, presenting both synergies and trade-offs across indicators within the same SDG. For example, while renewable energy can create green employment opportunities (synergy SDG 8 Target 8.5), it remains uncertain whether these jobs will ensure a safe and secure working environment for all workers throughout the supply chain (trade-off SDG 8, target 8.8). Mitigation options often work across sectors and systems and such interactions are not yet fully dealt with in existing studies.

Additionally, there are gaps in studies and available data for various crucial indicators worldwide, [ 6 ] which complicates the comprehensive assessment of comparing these key indicators across different countries, projects or entities. For instance, the Sustainable Development Report 2023 (Includes time-series data for 122 SDG indicators (out of 169 indicators) for 193 UN member states.) which measures progress across indicators for UN member states compiles data for 3 indicators to construct the index for SDG 13—all of which are related to emissions. Adaptation-related indicators are missing. Finally, studies do not cover temporal and spatial dimensions or the status of these interactions for alternate warming scenarios.

What does this mean for the scientific community?

Addressing the gaps identified presents an opportunity to enhance our understanding of progress towards SDGs and reduce missed opportunities [ 9 , 10 ]. Action that takes into account co-impacts can increase efficiency, reduce costs and support early and ambitious climate action, particularly in developing countries where there are simultaneous development priorities [ 11 ].

A business-as-usual approach to understanding mitigation SDG interactions has made progress but this is not enough. Data, indicators and methodologies, resources, the huge scope of SDGs, limitations of capturing non-measurable development dimensions and capacity constraints remain major challenges for in-depth research in this area [ 12 , 13 ]. New research therefore must focus on the SDGs and targets that have received limited attention and find ways to generate and report data ensuring access and transparency. Where specific data is not available, alternative approaches are needed for e.g. establishing reliable assumptions for utilizing proxy data through expert engagement. Developing indices specific to each goal and setting up reporting guidelines is essential for comparing progress. Failure to report the complete set of indicators limits comparability across goals and targets, and risks missing key priority areas.

Future research needs to focus on comprehensive assessments. For example, demonstrating how, where and to what speed and scale the implementation of a particular intervention resulted in synergies or trade-offs and whether these impacts are sustained. Similarly, going beyond acknowledging trade-offs towards a deeper understanding of what the trade-offs are, for which groups and whether and how these were resolved particularly in relation to questions around power and politics. In-depth studies require both time and resources. Funding needs to be directed to interdisciplinary research as well as building capacity of researchers to undertake such assessments. Quantitative studies involving new tools or modeling exercises, if complemented by qualitative approaches, can deliver more useful insights on synergies and trade-offs, particularly in situations where data is limited. Research institutions and universities can contribute by creating standardized templates and guidelines, as well as consistently reporting data using these templates.

Climate change mitigation research relies significantly on Integrated Assessment Models (IAMs) to provide a comprehensive perspective on the interactions between socio-economic systems and earth systems. Existing models do not fully capture all development dimensions [ 14 ] or climate change adaptation though efforts are underway. Future research can focus on developing SD/G-compatible scenario storylines that prioritize development. More work is needed on variables and assumptions to better incorporate equity and justice issues [ 15 ] Modeling teams need to work closely with experts on various aspects of adaptation and sustainable development, including poverty, urbanisation, human well-being and biodiversity.

In conclusion, research frameworks and practices to assess mitigation SDG interactions are inadequate in their present form. Given the urgency, researchers and funders need to move away from business-as-usual approaches towards more in-depth assessments that significantly advance knowledge.

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• Published: 12 May 2022

What does neighbourhood climate action look like? A scoping literature review

• Neelakshi Joshi   ORCID: orcid.org/0000-0001-8947-1893 1 , 2 ,
• Sandeep Agrawal 1 &
• Shirley Lie 1  

Climate Action volume  1 , Article number:  10 ( 2022 ) Cite this article

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• Urban ecology

Cities are recognized as an important scale for framing and implementing plans and policies for action on climate change. Within the structure of cities, it is in urban neighbourhoods that climate action becomes tangible and has the potential to engage communities. Despite its importance, scholarly literature has played limited attention to the scale of the neighbourhood as a site for locating climate action. The objective of our paper is to provide an overview of the role of neighbourhoods in leading bottom-up climate action and its implications for urban planning based on a qualitative scoping review. Our findings indicate that neighbourhoods are conceptualized as a physically bounded scale for climate action as well as a web of social networks and relationships enabling this action. Neighbourhood climate action aims to achieve neighbourhood scale sustainability and resilience by engaging with residents, municipalities, local academic institutions, neighbourhood associations and non-governmental agencies. Scholars engage with a wide range of concepts like place-based attachment and social mobilization as well as established practice-oriented tools in defining and measuring neighbourhood climate action. However, the neighbourhood scale struggles with limited resources and power in creating sustained climate action as well as in engaging with and addressing socio-economically marginalized communities.

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Introduction.

More than half of the world’s population lives in cities and directly or indirectly influences a majority of the global greenhouse gas (GHG) emissions (United Nations, 2019 ). Large population concentrations also make cities vulnerable to the impacts of climate change (IPCC, 2018 ; Pelling, 2003 ). Cities are thus recognized as an important scale for framing and implementing plans and policies for action on climate change (Bulkeley et al., 2011 ). Climate action is a broad term that covers both mitigation and adaptation efforts to address climate change and is covered under Goal 13 of the United Nations Sustainable Development Goals (United Nations, 2015 ). To respond to the global call to reduce GHG emissions and prepare for climate change, cities across the globe have formulated climate action plans (Guyadeen et al., 2019 ; Hughes, 2019 ). However, given the magnitude of action required to address climate change, there is a growing consensus among scholars to engage with and magnify the scale and scope of bottom-up and community-led local climate action (Cloutier et al., 2018 ; Seyfang & Smith, 2007 ).

Urban neighbourhoods are an important scale of physical and social organization within the structure of cities (Rohe, 2009 ). It is in neighbourhoods that climate action gets “contested, deconstructed and reconstructed” (Wittmayer et al., 2014 ). Further, the neighbourhood scale is easily recognized by urban residents as a place for participation and experimentation around climate action (Rohe, 2009 ). Neighbourhood climate action moves beyond the individual or the state, and focuses on the community (Aylett, 2013 ; Joshi et al., 2022 ). Concepts like low-carbon localism are beginning to define and create a framework for bottom-up climate action in urban neighbourhoods (Bradley et al., 2017 ). Further, the COVID-19 pandemic had restricted people’s movement and brought back the focus on their immediate neighbourhood surroundings (Joshi et al., 2020 ; Moreno et al., 2021 ).

The role of cities in addressing climate action has increasingly been the subject of scholarly enquiry (Bulkeley et al., 2011 ; Hölscher & Frantzeskaki, 2021 ; Wolfram, 2017 ). Urban studies are building on the lessons learnt from sustainable urbanism and moving towards carbon urbanism (Hughes et al., 2020 ; Long & Rice, 2019 ). In comparison, limited attention has been paid to the scale of the urban neighbourhood as a site for addressing GHG emissions (Pulselli et al., 2018 ; Welegedara et al., 2021 ) and locating climate action (Bradley et al., 2017 ; Gilderbloom et al., 2017 ). To understand the scale of this gap, we mapped research articles between 1980 and 2020 on three research databases, namely Scopus, Web of Science (WS) and Google Scholar (GS), to compare the volume of research on ‘cities + climate action’ against ‘neighbourhood + climate action’. Figure  1 and Table  1 show that post 2000, there has been a substantial increase in research output on cities and climate action. Research on neighbourhoods has also begun receiving attention. However, it is significantly low when compared to cities.

Comparison of the number of published research article on “cities + ‘climate action’” vs ‘neighbourhood + climate action’ between 1980 and present

We argue that there is a need to advance the knowledge on neighbourhood climate action on three accounts. First, climate action has added a focus and momentum to the broad agenda of sustainable development by focusing on scaling up mitigation and adaptation efforts within a limited time frame (Soergel et al., 2021 ; Tosun, 2022 ). A multi-scalar perspective helps understand actions that can be taken at international, national, regional and local scales to act on climate change (Bulkeley, 2021 ; Bulkeley & Newell, 2010 ). Urban neighbourhoods are one such site of local, bottom-up climate action. While there is well-synthesised knowledge on neighbourhoods as sites of locating sustainable urban development (Grazieschi et al., 2020 ; Luederitz et al., 2013 ), locating climate action at the neighbourhood scale is an attempt to further push the boundaries of the multi-scale perspective towards addressing climate change. Second, the focus and momentum created by the urgent call for climate action has opened up room for experimentation and financing for supporting bottom-up climate action (Broto & Bulkeley, 2013 ; Evans & Karvonen, 2014 ; Heiskanen et al., 2015 ). However, we do not know enough about the knowledge, skills, capacities and willingness at the neighbourhood scale to participate in bottom-up climate action. Finally, as societies attempt to transition and transform towards a low carbon future, new modes of governance and power sharing might be needed to create and sustain bottom-up climate action (Anguelovski, 2015 ; Brand, 2016 ; Bruch, 2017 ; Kivimaa et al., 2017 ). Exploring neighbourhoods as sites for climate action is one possible venue to explore these ideas (Joshi et al., 2022 ).

Against this backdrop, we present a scoping review of the literature on neighbourhood climate action. We aim to synthesise existing research with the aim of creating broad contours for understanding the concept of neighbourhood climate action by answering the research question: what constitutes neighbourhood climate action? Based on 68 research articles addressing the topic, we elaborate upon the scale of the neighbourhood as a place for situating bottom-up climate action within the city. The “ Review methodology ” section elaborates upon the review methodology adopted for selecting and analysing research articles. The “ Key findings ” section discusses the key findings in terms of conceptualizing neighbourhoods, types of mitigation and adaptation actions and the governance structures and actors involved. Finally, the “ Conclusion and future directions of research ” section highlights the key gaps that emerged from the literature review as well as identifies future areas of research at the neighbourhood scale. The synthesised findings are useful for researchers as well as social groups in identifying the opportunities and challenges associated with the neighbourhood scale as a site for situating climate action.

Review methodology

Literature reviews are a tool for knowledge advancement in academic literature. They capture both the breadth and depth of existing knowledge and bring out the gaps to lay the foundation of future research (Xiao & Watson, 2019 ). Among the multiple methodologies that exist to conduct a literature review, the choice is determined and defined by the nature of the research question and the method adopted to collect, evaluate and present information (Paré et al., 2015 ). Given the broad nature of our research question and limited comprehensive knowledge on the topic, we adopted a scoping review approach to provide a snapshot of research on the subject (Arksey & O’Malley, 2005 ; Colquhoun et al., 2014 ).

We adopted the five step approach for conducting a scoping review laid forth by (Arksey & O’Malley, 2005 ). This involves identifying the research question, identifying relevant studies, establishing a study selection criterion, charting the data and collating, summarizing and reporting the results.

The broad research question that we intend to address is: what constitutes neighbourhood climate action? We began our search with the Boolean string “neighbo*rhood*” AND “climate action” on three research databases, namely, Scopus, Web of Science (WS) and Google Scholar (GS). GS was intentionally added for making the search comprehensive and to include grey literature sources. This yielded 20 results on Scopus, 26 results on web of science and 10730 results on GS as of October 2020. As GS results were substantially large in number, we constrained our search to the first 100 results, sorted in the order of relevance.

We exported the first set of 146 search results to a web-based literature review manager called Covidence. We found Covidence to be a convenient platform for screening our search results as it allowed multiple researchers to review and vote on inclusion or exclusion of studies. It also automatically identified removed 28 duplicate research items. The inclusion criteria set for the research were English language articles from countries of the Global North between the years 2000 and 2020. Further, the conceptualization of neighbourhoods as a unit of human settlements in cities was used. Countries of the Global North were purposively selected for this scoping review for a similar conceptualisation of the concept of neighbourhood, neighbourhood planning and climate action. Studies published after the year 2000 were selected as Scopus and WS did not show any studies before that period.

For the next stage, we conducted a title and abstract review based on the inclusion criteria. Each research article was reviewed and voted on by two researchers. Conflicts in voting, if any, were discussed based on the inclusion criteria and finally a total of 61 research articles were taken up for full text review.

Each of the 61 review articles was read by at least two researchers. Through this process, we further eliminated 15 research articles but added 22 articles through the process of backward casting by identifying articles from the existing reference lists. A total of 68 research articles were thus taken up for full text review. Among them were 59 peer-reviews papers, 4 conference proceedings, 3 book chapters, 1 working paper and 1 doctoral dissertation. Figure  2 summarises the workflow adopted for identifying and selecting research articles for this study.

Workflow diagram for including and excluding studies for the scoping review

We extracted both quantitative and qualitative data from the research articles. Quantitative data, extracted using Microsoft Excel, included a word count of keywords, countries, and regions where the study was conducted, nature of climate action (adaptation or mitigation or both), nature of the neighbourhood (existing or new) and nature of study design (qualitative, quantitative, or mixed). Qualitative data, extracted using NViVo, included inductively coding the articles for recurring themes. These included the conceptualisation of neighbourhood and its relevance as a scale for climate action and conceptualisation of climate action. We also used the qualitative analysis to elaborate upon the theoretical and conceptual foundations of neighbourhood climate action, research methods adopted, actors involved and finally the challenges highlighted by the existing research. The following section presents the results of our analysis.

Key findings

A keyword analysis of 68 research articles resulted in 296 keywords. Climate change (16) and neighbourhood (8) were the two most prominent keywords. This was followed by sustainability (4) and sustainability transitions (4) and resilience (5), vulnerability (3) and adaptation (2), indicating that these are foundational concepts upon which neighbourhood climate action rests. Governance (10) and planning (16) appear in multiple iterations, e.g. climate change governance, collaborative governance, neighbourhood planning, community planning, etc. Fig.  3 graphically presents the keyword analysis, and the “ Conceptualizing neighbourhoods and their role in climate action ” to “ Challenges ” sections elaborate of key themes of neighbourhood climate action, identified through inductive coding.

Results of the keyword analysis

Conceptualizing neighbourhoods and their role in climate action

Neighbourhood is defined as the fundamental building block of the city (Rohe, 2009 ). Neighbourhoods function like cells within the organism of a city (Castrignanò & Landi, 2013 ). Two distinct aspects emerge in the conceptualization of the neighbourhood from this literature review. First, the neighbourhood as a physical entity composed of a physical boundary, buildings, streets, trees and other physical infrastructure. Second is the neighbourhood as a social entity that provides space for social interactions, relationships and collective identities to form. The physical and social aspects come together to create an understanding of the neighbourhood as a community of place defined on a Euclidean map (Taylor Aiken, 2014 ). However, within a neighbourhood, heterogeneous values and communities of interest may exist (Taylor Aiken, 2014 ). Neighbourhoods are thus an intricate interaction between buildings, transport, green spaces, human activity and structures (Evola et al., 2016 ).

The scale of the neighbourhood is small enough to demand its own urban design and public policy, yet big enough to create an impact at the city scale (Oliver & Pearl, 2018 ). It is at the scale of the neighbourhood that large scale global problems are “contested, deconstructed and reconstructed” (Wittmayer et al., 2014 ). The neighbourhood is an important site of public participation and civic action as the scale is easily identifiable to its residents and provides a space around which everyday life is organized (Rohe, 2009 ; Rowlands, 2011 ). Local action has the potential to reshape citizenship, change power relations, increase participation in decision making and encourage democratization and transformation in cities (Anguelovski, 2015 ). Historically, the neighbourhood scale has received limited attention in terms of power and resources (Rohe, 2009 ) in comparison to the city. However, action on climate change provides an opportunity to explore the neighbourhood as a site for bottom-up action. A focus on neighbourhoods shifts the attention of climate action from the individual or the state, to the community (Aylett, 2013 ). It is an opportunity to re-imagine local capacities in the face of capitalist globalism and question if the local is a mere product of global forces or has its own culture and identity (Massey, 2004 ).

The challenges brought about by climate change present an opportunity to explore new models, structures and organizations at the neighbourhood scale (Rowlands, 2011 ). On the one hand, the physical design of the neighbourhood can influence and support low carbon habits like walking or taking public transport (Rohe, 2009 ). Decisions taken at a neighbourhood scale, like the amount of green space, influence the community’s response to climate shocks and stresses (Uda & Kennedy, 2018 ).

On the other hand, social capital existing in a neighbourhood presents an opportunity to build partnerships and networks and open up new ways of problem solving around climate action (Slater & Robinson, 2020 ). Neighbourhood scale actors promoting climate action are intimately connected with city, regional, national and international actors in negotiating their geographical agency and responsibility (Shaw et al., 2018 ). However, group identity and a sense of belonging to a neighbourhood are important to encourage participation in neighbourhood-based collective action around climate change (Rees & Bamberg, 2014 ). In such neighbourhoods, people often feel a greater magnitude of responsibility towards their neighbours and the neighbourhood (Massey, 2004 ; McGee, 2011 ) and provide immediate help in case of disasters or emergencies (Aldrich & Meyer, 2015 ).

Climate change mitigation and adaptation at the neighbourhood scale

Among the 68 papers that we reviewed, 16 dealt with neighbourhood mitigation actions, 18 dealt with adaptation, 18 addressed both and 16 papers presented underlying theoretical concepts.

Neighbourhood scale action in addressing climate change mitigation typically dealt with issues around energy efficiency of buildings (Fisher & Irvine, 2010 ; Westerhoff et al., 2018 ), low-carbon mobility solutions (Shelton, 2008 ), renewable energy production and planning (Aylett, 2013 ; Evola et al., 2016 ; Hettinga et al., 2018 ), waste management (Pulselli et al., 2018 ) and water efficiency (Scarfo, 2011 ). Some initiatives intend to motivate sustainable consumption cultures (Middlemiss, 2008 ) and to develop skills needed for leading low carbon lives which include activities like bike repair workshops and renewable energy workshops (Büchs et al., 2012 ). GHGs were often the unit for measuring the impact of actions and projects advocated for low-carbon impacts (Pulselli et al., 2018 ). Literature on mitigation efforts often overlaps or builds upon existing literature on neighbourhood scale sustainability (Wittmayer et al., 2014 ). Neighbourhood scale climate action creates a space for social mobilization for climate action by aiming to build public support for climate action, creating capacity as well as engaging citizens to co-create and co-implement mitigation projects (Westerhoff et al., 2018 ).

Literature focusing on neighbourhood scale adaptation typically dealt with heat stress (Guardaro et al., 2020 ; Maragno et al., 2020 ) and flooding (Meyer et al., 2018 ) as critical focus areas. As adaptation is context specific, certain studies also dealt with place specific issues, e.g. wild fire adaptation (McGee, 2011 ). Neighbourhood scale adaptation projects aim to build collective adaptive capacity, both physical and social, among residents to prepare them for unpredictability and respond to disturbances (Cretney & Bond, 2014 ). Projects like neighbourhood greening and community gardens presented an opportunity for addressing both mitigation and adaptation goals (Cloutier et al., 2018 ; Klerks et al., 2019 ; Shelton, 2008 ). Urban greening aims to improve quality of life by incorporating natural elements into built environments (Cloutier et al., 2018 ). However, challenges remain in mainstreaming small scale urban greening projects (Cloutier et al., 2018 ). Adaptation studies often built upon the concept of neighbourhood resilience. Neighbourhood resilience is the ability of a neighbourhood to deal with physical, social and political stresses and disturbances resulting from climate change (Andrew et al., 2020 ; Castrignanò & Landi, 2013 ; Guardaro et al., 2020 ). Adaptation thinking has gradually developed from highlighting global and national macroeconomic markets to the locally assessed susceptibility and resilience within socio-ecological systems (Groulx, 2017 ). Neighbourhood resilience is a foundation upon which climate change adaptation goals can be built (Kwok et al., 2019 ). To bridge the action on mitigation and adaptation, certain scholars engage with the socio-ecological systems thinking and explore avenues like neighbourhood greening (Dieleman, 2013 ; Groulx, 2017 ).

Neighbourhoods, particularly the new neighbourhoods, present an opportunity to be designed and modelled for a low carbon footprint (Wang et al., 2016 ). Leadership in Energy and Environmental Design for New Neighbourhoods (LEED ND) and Building Research Establishment Environmental Assessment Method for Communities (BREEAM C) are examples of two performance-based tools that work on an indicator-based approach in designing sustainable neighbourhoods (Reith & Orova, 2015 ; Wang et al., 2016 ). Within existing neighbourhoods, GHG footprint mapping tools help residents to measure and manage their consumption patterns (Jones et al., 2018 ). Some positive impacts of mitigation action can further address adaptation efforts to combat energy shortage, heatwaves and extreme precipitation (Uda & Kennedy, 2018 ). However, some scholars argue that the focus on the neighbourhood as a sustainability product misses the discussion on the process of sustainability and deeper community engagement (Oliver & Pearl, 2018 ). Further, other scholars point out that the scale of the city as well as individual buildings have gained attention in terms of sustainability and carbon accounting tools, whereas the scale of the neighbourhood has largely remained unexplored (Palermo et al., 2018 ; Pulselli et al., 2018 ). To measure neighbourhood resilience, Kwok et al. ( 2019 ) suggest combining both scientific and local knowledge gained from neighbourhood-level stakeholders and city-level authorities.

Key theories and concepts

In this section, we elaborate upon the underlying theories and concepts that researchers engage with when exploring climate action at a neighbourhood scale. Neighbourhood climate action shares a similar concepts foundation as bottom-up climate action. Our review illustrates how these foundational concepts are applied at a neighbourhood scale and provide analytical sharpness to the concepts of bottom-up climate action.

Place attachment

Place attachment is an important aspect in inspiring neighbourhood climate action (Devine-Wright, 2013 ). Place attachment is an emotional connection between people and place that can influence human behaviours and responses toward climate change (Devine-Wright, 2013 ; Dulic et al., 2011 ; Groulx, 2017 ). This concept can act as both an enabler and a barrier in undertaking adaptation and mitigation efforts. On the one hand, place attachment helps boost residents' involvement in neighbourhood projects (Kwok et al., 2019 ). Community groups share the same value over the same places perceive adaptation as protection to their landscapes that triggers trust and collective action (Groulx, 2017 ). Place attachment encourages residents to spend more time to connect with others and together watch their neighbourhoods evolve (Anguelovski, 2015 ). Participating in community-based adaptation planning can further improve residents' familiarity with climate change impacts on specific places. On the other hand, place attachment sometimes leads to residents’ misperception of government policies and a resistance to change (Groulx, 2017 ). A failure to recognise emotional bonds that people have with a particular place might lead to community resistance (Devine-Wright, 2013 ). Thus, understanding place-based assets and susceptibilities is critical in developing adaptation strategy at the local scale by both residents and the government (Groulx, 2017 ).

Place-based attachment often lends itself to mutualism. Mutualism is defined by Rowlands ( 2011 ) as “collective action, pooling resources and obtaining an outcome which is greater than the sum of the parts”. Cooperative housing models as means of providing affordable housing at a neighbourhood scale are cited as a successful example of mutualism in practice. Mutualism is proposed as a concept to re-imagine neighbourhoods, especially as they gear to take action on climate change. Finally, social neighbourhood identity, social bonding, trust, perceived efficacy of collective action and group-based guilty consciousness related to climate change plays a role in determining participation in neighbourhood climate action (Hielscher et al., 2011 ; Rees & Bamberg, 2014 ). Social bonding and community belonging can boost residents’ involvement in collective actions (Anguelovski, 2015 ). “Bottom-to-bottom networks” are manifested within the neighbourhood where people connect and undertake such actions for environmental renewal projects. These networks help neighbourhood actors address local challenges using existing resources, creativity and intuition (Anguelovski, 2015 ).

Social capital

Social capital is another dominant concept when discussing neighbourhood climate action. Social capital at a neighbourhood scale refers to the benefits individuals derive from being part of a neighbourhood network (Purdue, 2001 ). Neighbourhood organizations are often found to be leaders in building and maintaining social capital in a neighbourhood (Ruef & Kwon, 2016 ). This form of social capital is seen as an ideal approach to enhance adaptive capacities of communities toward disasters since the impacts resulting from disasters may affect the resources rooted in social networks (Kwok et al., 2019 ). Social capital is an underlying need for effective social mobilization in the neighbourhood around climate change (Westerhoff et al., 2018 ).

Social learning

Social learning as a product of collaborative problem solving is a desired outcome of climate action at a neighbourhood scale (Evers et al., 2016 ; Slater & Robinson, 2020 ; Stevenson & Petrescu, 2016 ). The dialog and conflict generated among groups in addressing climate action help people understand each other better (Evers et al., 2016 ) as well as create culture and values needed to achieve climate action (Slater & Robinson, 2020 ). Stevenson & Petrescu ( 2016 ) indicate that social learning is important to raise people’s awareness, develop community capacities and increase neighbourhood resilience. Additionally, they emphasizes that social learning with the intention to strengthen social capital at neighbourhood level could be achieved through collaborations between residents and academics, which often come in the form of research.

Other concepts

Some scholars press on the need to recognise the unique position of each neighbourhood based on its history (Elwood, 2002 ), socio-economic conditions (Passe et al., 2020 ) and urban legislative framework (Bradley et al., 2017 ). Neighbourhood environment history (Kellogg, 2002 ), for example, holds the knowledge of urban nature and ecosystem. By considering environmental history, it is expected that neighbourhood planning could have a strong information background and enhance the sense of place through ecological resources utilization and motivate residents to engage in neighbourhood adaptation projects.

Methods employed

This section discusses the methods adopted in research on neighbourhood climate action. Fifty-one out of 68 papers adopted a qualitative approach, 12 adopted a quantitative approach and 5 papers adopted a mixed methods approach.

Qualitative research designs were dominant in the research papers addressing neighbourhood climate action. Key-informant interviews, focus groups discussions and document reviews were largely employed for data collection. Multiple researchers adopted action research designs involving neighbourhood residents, researchers, city representatives, urban planners, local NGOs and local businesses (Hendricks et al., 2018 ; Hettinga et al., 2018 ; Hirsch et al., 2011 ; Wittmayer et al., 2014 ). Certain research projects stretched the actor constellations to engage particular demographic groups like senior citizens and school students (Meyer et al., 2018 ). Action research designs were found to be particularly helpful generating new, bottom-up data at the neighbourhood scale (Hendricks et al., 2018 ; Hettinga et al., 2018 ). Community-based experimentation, where residents could participate and reflect on small scale climate action projects, is another emergent research design (Cloutier et al., 2018 ; Dieleman, 2013 ; Elwood, 2002 ; Guardaro et al., 2020 ; Simíc et al., 2017 ). Experimentation was also useful in understanding the role and capacity of civic actors and community organizations (Elwood, 2002 ; Kivimaa et al., 2017 ).

Among quantitative papers, the focus lies on quantitative assessment of GHG emissions at a neighbourhood scale (Jones et al., 2018 ; Pulselli et al., 2018 ), developing an indicator-based system to design low carbon neighbourhoods (Wang et al., 2016 ) and designing decision support for neighbourhood and city organizations (Hettinga et al., 2018 ). Scenario development tools are useful for existing neighbourhoods to understand aspects that need retrofitting to reduce GHG emissions (Evola et al., 2016 ). Further, researchers stress on the need to make data easily accessible and understandable, for example, through innovative visualisations (Pulselli et al., 2018 ). Quantitative methods were also used to evaluate the social determinants of neighbourhood climate action. For instance, Rees and Bamberg ( 2014 ) employ a quantitative survey among 538 city residents to understand how the motivation to participate in neighbourhood-based climate protection is determined by social identity, perceived collective efficacy and group-based emotions.

A limited number of papers adopted a mixed research design. Given the physical and social dimensions of neighbourhood climate action, Passe et al. ( 2020 ) highlights the merit of a mixed methods approach. Mixing expert quantitative interviews with qualitative neighbourhood surveys is one example (Kennedy et al., 2013 ). Dulic et al. ( 2011 ) compare quantitative results from a survey taken by students before and after trying a game prototype on climate change impacts and compare it against qualitative interviews with subject experts. Further, integration of spatial analysis tools along with quantitative or qualitative methods is useful in generating context-specific granular data (Maragno et al., 2020 ; Shelton, 2008 ).

Governance structures and actors involved

Given the complex nature of climate action, new constellations of actors and new structures of power are emerging at the neighbourhood scale (Aylett, 2013 ). Recognising the role of neighbourhoods in addressing climate change requires their integration in multi-level governance and scalar politics (Dieleman, 2013 ; Shaw et al., 2018 ). This is important as vagueness on how the actors and their role may delay action on climate change (Guardaro et al., 2020 ). Among the papers that we reviewed, a number of actors such as residents, neighbourhood organizations, city representatives, urban planners and architects, NGOs and researchers were largely engaged with projects on neighbourhood climate action. Some researchers highlighted the need to involve vulnerable populations within a neighbourhood (Passe et al., 2020 ) as well as local businesses (Murota, 2014 ) and institutions like schools or youth organizations (Meyer et al., 2018 ; Simíc et al., 2017 ).

Projects based on neighbourhood climate action can broadly be divided into three categories:

City government-led project: These are the projects where residents are invited to participate in various capacities. The nature of participation varies from mere consultation to co-production (Rohe, 2009 ). Government led programs often have better financial and knowledge resources but need to partner with the residents for deeper and wider project impacts (McGee, 2011 ; Meyer et al., 2018 ). Engaging residents in adaptation strategies helps build physical and social community resilience to hazards as well as develops a relationship between governments and residents (McGee, 2011 ). Civic actors tend to act as a bridge between residents and the municipality by making them work collaboratively rather than confrontationally (Cloutier et al., 2018 ; Elwood, 2002 ; Kivimaa et al., 2017 ). Further, moving from a centralised to a diverse and decentralized governance structure builds resilience against change and ensures continuity (Dieleman, 2013 ).

Projects initiated by neighbourhood residents or citizen organizations: Neighbourhood organizations and homeowner associations are often successful in forming durable partnerships with residents in comparison to external agencies (Andrew et al., 2020 ; Aylett, 2013 ; Elwood, 2002 ). Further, they help in building ‘communal social capital’ (Purdue, 2001 ) within their communities by bringing people with similar and dissimilar interests together. Community-based organizations also have the potential to utilize ‘collaborative social capital’ (Aylett, 2013 ; Purdue, 2001 ) based on their relationship with external institutions and organizations. However, local change agents express frustration over a lot of expectation around climate action but very limited resources or agency to do so (Smith et al., 2013 ). Rowlands ( 2011 ) suggests replacing the existing top down structure of neighbourhood management with small scale neighbourhood trusts involving residents.

Researcher or NGO led projects: These are often designed around action research or experimentation. Though often short term in nature, these projects are a chance to build or strengthen valuable social infrastructure within neighbourhoods that can address climate change beyond the span of a pilot project (Klerks et al., 2019 ). Meyer et al. ( 2018 ) present an interesting constellation of actors for a participatory action research project that included high school and university students, community activists and researchers. The project provided a co-learning opportunity where students and researchers learnt nuances of community action research and community activists learnt tools and methods for assessing and addressing climate change impacts in the neighbourhood. Co-production, as a means of generating knowledge around climate action, is also gaining ground in research and policy development of the built environment (Stevenson & Petrescu, 2016 ).

With the push and pull of power and responsibilities at the neighbourhood scale, collaborative governance structures, similar to those adopted in successful neighbourhood revitalisation projects, are coming to the fore (Elwood, 2002 ; Rohe, 2009 ). Cross-sector collaborations attempt to engage community members, government officials, business owners and NGOs (Simo & Bies, 2007 ). Cross-sector collaborations would have a high success rate if they are driven by dedicated stakeholders and champions. Further, devolution of power to the neighbourhoods, as is being done in the UK, presents initial evidence on how residents often favour a preservation of local environment, character and social well-being over a pro-growth agenda (Bradley et al., 2017 ). Experience from projects designed with neighbourhood residents can help identify and assess the correlation between potential risks and weak infrastructure within their neighbourhood (Hendricks et al., 2018 ). Partnering with community groups also becomes essential to develop a constructive climate policy, as well as to produce effective engagement strategies that are best suited for policy makers and community residents (Hirsch et al., 2011 ).

The scale of the neighbourhood presents exciting opportunities to address the challenges of climate change. However, literature recognises multiple challenges associated with scale, time frame, perspective and data for successful and sustained climate action at the neighbourhood scale (Kellogg, 2002 ). We summarise them under four headings:

Social challenges: Wittmayer et al. ( 2014 ) argue that the scale of neighbourhood as a cohesive geographical and social entity cannot be taken for granted before designing local scale climate action. Individual social interest can influence potential volunteers to be engaged in supporting neighbourhood initiatives or stay inactive (Krebs et al., 2013 ). Similarly, a social capital approach may overlook certain community groups who do not belong to the dominant neighbourhood social network (Kennedy et al., 2013 ; Kwok et al., 2019 ). There is a risk of social networks being exclusionary and exercising their powers over others resulting in loss of trust and participation from the residents (Ruef & Kwon, 2016 ). Further, new suburban neighbourhoods might have limited or no experience with community networks or environmental activism (Kennedy et al., 2013 ; Smith et al., 2013 ). Dieleman ( 2013 ) points to a need for developing teaching and training tools to build collaboration among residents.

Data challenges: Multiple authors point towards the lack of neighbourhood scale data collection and analysis systems needed to design effective policies and programs. Localized and granular data at neighbourhood scale data can help in designing more tailor made plans and policies for mitigation and adaptation (Passe et al., 2020 ; Wang et al., 2016 ). There is a need for neighbourhood scale data to develop decision support systems. These include neighbourhood GHG accounting tools that can help quantify and visualize the scale of action needed to mitigate climate change (Pulselli et al., 2018 ). Researchers notice the interconnectedness of multiple intricate systems in mapping and visualizing climate change impacts in a neighbourhood like tree canopy concentration and storm water drainage (Shelton, 2008 ). Tools are also needed to assess neighbourhood energy demands as well as demonstrate the quantifiable impact of building retrofits or mixed-use developments (Palermo et al., 2018 ). However, collecting data at a neighbourhood scale can be challenging, particularly human use and behaviour data, because of time, resources and privacy concerns (Passe et al., 2020 ).

Power and resource challenges: Local change agents point towards the mismatch between the expectation with regards to climate action and the limited resources or agency to do so (Smith et al., 2013 ). While neighbourhood climate action creates high expectations from community groups, they often have limited power and mandate to start and sustain long term projects around climate action (Büchs et al., 2012 ; Lufkin & Rey, 2014 ; Taylor Aiken, 2014 ). One example is the tension that neighbourhood groups face when negotiating space and resources for community gardens in a city against developers and city governments (Shaw et al., 2015 ). Here, the collective and collaborative models that underline neighbourhood climate action are juxtaposed against capitalistic and individualistic societal realities (Elwood, 2002 ; Rowlands, 2011 ).

Continuity challenges: Collaborative action at a neighbourhood scale is a process that requires time to build (Guardaro et al., 2020 ). However, often neighbourhood scale projects are short- lived in nature. While experimentations and action research projects are important, it is important to embed them within the long term planning (Cloutier et al., 2018 ; Simíc et al., 2017 ) and community structure of the neighbourhood to ensure continuity (Murota, 2014 ).

Conclusion and future directions of research

Given the scale of action required to address climate change in cities, neighbourhoods emerge as the next frontier in urban climate action research. Neighbourhoods have the potential to locally respond to the global problems of climate change. Their unique scale, located at the intersection of the city and the individual/building, affords them with multiple opportunities to stir collective climate action. Proximity and tangibility of participating in climate action encourages neighbourhood residents to collectively address mitigation and adaptation challenges. Neighbourhood climate action builds upon the rich literature and practice around neighbourhood renewal (Rohe, 2009 ; Rowlands, 2011 ) and sustainability (Grazieschi et al., 2020 ; Luederitz et al., 2013 ) by underlining the new skills (Cloutier et al., 2018 ), tools (Pulselli et al., 2018 ) and constellations (Aylett, 2013 ) needed to address climate change at the neighbourhood scale. Neighbourhood climate action further provides a contextual boundary and analytical sharpness to bottom-up action for sustainability (Seyfang & Haxeltine, 2012 ; Seyfang & Smith, 2007 ) by bringing forth the unique planning mechanisms (Bradley et al., 2017 ; Rohe, 2009 ), motivations (Kwok et al., 2019 ; Ruef & Kwon, 2016 ) and challenges (Aylett, 2013 ; Pulselli et al., 2018 ) of the neighbourhood scale.

Existing scientific literature provides multiple examples of successful neighbourhood scale projects from neighbourhood greening, infrastructure mapping to energy upgrades. However, challenges remain in terms of social cohesiveness, resources, power and continuity to scale up and magnify neighbourhood climate action. In this paper, we have provided a broad conceptualisation to the concept of neighbourhood climate action. This can serve as a basis for future empirical analysis of neighbourhood climate action efforts as well as form a basis for focused systemic reviews. Here, we present four future venues of research and action to address these challenges and gaps in knowledge:

A socio-technical-ecological conceptualisation of the neighbourhood: The neighbourhood emerges as a complex entity with physical components like buildings, roads and other built infrastructure, a social network of people and ecological network of trees, plants, drains and other natural components. Quantitative research largely views neighbourhood is a physical entity whereas qualitative research addressed its social component in terms of special interest groups and residents, their networks and relationships. There is a need to develop a mix of technical, social and ecological criteria and scenarios through a mixed research designs where tangible aims like reduced GHG emissions also address intangible benefits like community building and social learning. This is also an opportunity to create neighbourhood scale data support systems that can help design locally relevant climate action projects. Given that neighbourhood governance systems have diverse participating actor, communicating climate data to multiple groups also requires further exploration.

Socio-economic variables: Multiple papers in this review have indicated that neighbourhood climate action is often weakest in the most vulnerable neighbourhoods (Gilderbloom et al., 2017 ; Guardaro et al., 2020 ; Hendricks et al., 2018 ; Passe et al., 2020 ). Neighbourhoods that exhibit social and physical vulnerability to climate change often do not have the resources or time to participate in engagement activities around adaptation and resilience building (Meyer et al., 2018 ). This brings forth the socio-economic variability across neighbourhoods and their capacity to address climate change. Further, our review was limited to the socio-economic context of the Global North. Comparing and contrasting these findings with cities and neighbourhoods located in the Global South will help broaden the conceptualization of neighbourhoods, their governance structures and possibilities of interventions.

Temporal continuity: The small scale and local nature of neighbourhood scale projects is often short lived. There are opportunities to ensure continuity by exploring ways of translation of city level climate goals into neighbourhood action plans (Cloutier et al., 2018 ; Hirsch et al., 2011 ). A longitudinal replication of case studies and projects can provide insights into how action research or experimentation projects sustained climate action. If not, what governance or institutional structures could facilitate this? Further, rather than existing as silos, do projects integrate with the multi-level governance structures?

Capacity development: Locating climate action at the neighbourhood demands development of new skills and capacities of stakeholders for addressing the issue. These range from learning to work as a group to collecting and understanding locally relevant data. Similarly, an exploration into the devolution of power at the neighbourhood scale, in different political contexts, to ensure that participation goes beyond top-down consultation needs further exploration.

As cities prepare to re-imagine their structure in a post pandemic world as well as be equal partners in the action against climate change, the scale of the neighbourhood promises to be an exciting venue for research and practice.

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Acknowledgements

We would like to acknowledge the financial support from Alberta Ecotrust for conducting this review as part of the project: Co-Creating Neighbourhood Climate Action Strategies in Edmonton.

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Joshi, N., Agrawal, S. & Lie, S. What does neighbourhood climate action look like? A scoping literature review. Clim Action 1 , 10 (2022). https://doi.org/10.1007/s44168-022-00009-2

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A Systematic Literature Review of the Impact of Climate Change on the Global Demand for Psychiatric Services

Affiliations.

• 1 Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany.
• 2 Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-900, Brazil.
• 3 Private Clinic Meiringen, 3860 Meiringen, Switzerland.
• 4 Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland.
• PMID: 36673946
• PMCID: PMC9858749
• DOI: 10.3390/ijerph20021190

Climate Change (CC) imposes important global health risks, including on mental health (MH). They are related mostly to psychological suffering caused by climate-related events and to the heat-vulnerability caused by psychiatric disorders. This growing burden may press MH services worldwide, increasing demand on public and private systems in low-, middle-, and high-income countries. According to PRISMA, two independent reviewers searched four databases for papers published before May 2022 that associated climate-related events with healthcare demand for psychiatric conditions. Of the 7432 papers retrieved, we included 105. Only 29 were carried out in low- and middle-income countries. Twelve related the admission numbers to (i) extreme events, while 93 to (ii) meteorological factors-mostly heat. Emergency visits and hospitalizations were significantly higher during hot periods for MH disorders, especially until lag 5-7. Extreme events also caused more consultations. Suicide (completed or attempted), substance misuse, schizophrenia, mood, organic and neurotic disorders, and mortality were strongly affected by CC. This high healthcare demand is evidence of the burden patients may undergo. In addition, public and private services may face a shortage of financial and human resources. Finally, the increased use of healthcare facilities, in turn, intensifies greenhouse gas emissions, representing a self-enforcing cycle for CC. Further research is needed to better clarify how extreme events affect MH services and, in addition, if services in low- and middle-income countries are more intensely demanded by CC, as compared to richer countries.

Keywords: climate change; mental health; psychiatric services; services demand.

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Conflict of interest statement

The authors declare no conflict of interest.

PRISMA diagram for Systematic Literature…

PRISMA diagram for Systematic Literature Reviews [28].

Included studies according to the…

Included studies according to the year of publication.

Global distribution of studies. Note:…

Global distribution of studies. Note: white color corresponds to missing studies in that…

Forest plot of significant results…

Forest plot of significant results (relative risk), divided by type of demanded service.…

Proportion of meteorological factors used…

Proportion of meteorological factors used by the authors. ‘Warmer than average’ was usually…

Heat and MH according to…

Heat and MH according to the percentage of studies found to be statistically…

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Examining the impact of climate change risks on pregnancy through a climate justice lens: a review.

1. Introduction

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Keenan, O.J.; Papatheodorou, S.; Ghosh, A.K. Examining the Impact of Climate Change Risks on Pregnancy through a Climate Justice Lens: A Review. Atmosphere 2024 , 15 , 975. https://doi.org/10.3390/atmos15080975

Keenan OJ, Papatheodorou S, Ghosh AK. Examining the Impact of Climate Change Risks on Pregnancy through a Climate Justice Lens: A Review. Atmosphere . 2024; 15(8):975. https://doi.org/10.3390/atmos15080975

Keenan, Olivia J., Stefania Papatheodorou, and Arnab K. Ghosh. 2024. "Examining the Impact of Climate Change Risks on Pregnancy through a Climate Justice Lens: A Review" Atmosphere 15, no. 8: 975. https://doi.org/10.3390/atmos15080975

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• Volume 11, Issue 6
• Health effects of climate change: an overview of systematic reviews
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• http://orcid.org/0000-0003-4548-2229 Rhea J Rocque 1 ,
• Caroline Beaudoin 2 ,
• http://orcid.org/0000-0002-4716-6505 Ruth Ndjaboue 2 , 3 ,
• Laura Cameron 1 ,
• Louann Poirier-Bergeron 2 ,
• Rose-Alice Poulin-Rheault 2 ,
• Catherine Fallon 2 , 4 ,
• http://orcid.org/0000-0002-4114-8971 Andrea C Tricco 5 , 6 ,
• http://orcid.org/0000-0003-4192-0682 Holly O Witteman 2 , 3
• 1 Prairie Climate Centre , The University of Winnipeg , Winnipeg , Manitoba , Canada
• 2 Faculty of Medicine , Université Laval , Quebec , QC , Canada
• 3 VITAM Research Centre for Sustainable Health , Quebec , QC , Canada
• 4 CHUQ Research Centre , Quebec , QC , Canada
• 5 Li Ka Shing Knowledge Institute , Toronto , Ontario , Canada
• 6 Dalla Lana School of Public Health , University of Toronto , Toronto , Ontario , Canada
• Correspondence to Dr Rhea J Rocque; rhea.rocque{at}gmail.com

Objectives We aimed to develop a systematic synthesis of systematic reviews of health impacts of climate change, by synthesising studies’ characteristics, climate impacts, health outcomes and key findings.

Design We conducted an overview of systematic reviews of health impacts of climate change. We registered our review in PROSPERO (CRD42019145972). No ethical approval was required since we used secondary data. Additional data are not available.

Data sources On 22 June 2019, we searched Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Cochrane and Web of Science.

Eligibility criteria We included systematic reviews that explored at least one health impact of climate change.

Data extraction and synthesis We organised systematic reviews according to their key characteristics, including geographical regions, year of publication and authors’ affiliations. We mapped the climate effects and health outcomes being studied and synthesised major findings. We used a modified version of A MeaSurement Tool to Assess systematic Reviews-2 (AMSTAR-2) to assess the quality of studies.

Results We included 94 systematic reviews. Most were published after 2015 and approximately one-fifth contained meta-analyses. Reviews synthesised evidence about five categories of climate impacts; the two most common were meteorological and extreme weather events. Reviews covered 10 health outcome categories; the 3 most common were (1) infectious diseases, (2) mortality and (3) respiratory, cardiovascular or neurological outcomes. Most reviews suggested a deleterious impact of climate change on multiple adverse health outcomes, although the majority also called for more research.

Conclusions Most systematic reviews suggest that climate change is associated with worse human health. This study provides a comprehensive higher order summary of research on health impacts of climate change. Study limitations include possible missed relevant reviews, no meta-meta-analyses, and no assessment of overlap. Future research could explore the potential explanations between these associations to propose adaptation and mitigation strategies and could include broader sociopsychological health impacts of climate change.

• public health
• social medicine

Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study. All data relevant to the study are included in the article or uploaded as supplementary information. Additional data are not available.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/ .

https://doi.org/10.1136/bmjopen-2020-046333

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Strengths and limitations of this study

A strength of this study is that it provides the first broad overview of previous systematic reviews exploring the health impacts of climate change. By targeting systematic reviews, we achieve a higher order summary of findings than what would have been possible by consulting individual original studies.

By synthesising findings across all included studies and according to the combination of climate impact and health outcome, we offer a clear, detailed and unique summary of the current state of evidence and knowledge gaps about how climate change may influence human health.

A limitation of this study is that we were unable to access some full texts and therefore some studies were excluded, even though we deemed them potentially relevant after title and abstract inspection.

Another limitation is that we could not conduct meta-meta-analyses of findings across reviews, due to the heterogeneity of the included systematic reviews and the relatively small proportion of studies reporting meta-analytic findings.

Finally, the date of the systematic search is a limitation, as we conducted the search in June 2019.

Introduction

The environmental consequences of climate change such as sea-level rise, increasing temperatures, more extreme weather events, increased droughts, flooding and wildfires are impacting human health and lives. 1 2 Previous studies and reviews have documented the multiple health impacts of climate change, including an increase in infectious diseases, respiratory disorders, heat-related morbidity and mortality, undernutrition due to food insecurity, and adverse health outcomes ensuing from increased sociopolitical tension and conflicts. 2–5 Indeed, the most recent Lancet Countdown report, 2 which investigates 43 indicators of the relationship between climate change and human health, arrived at their most worrisome findings since the beginning of their on-going annual work. This report underlines that the health impacts of climate change continue to worsen and are being felt on every continent, although they are having a disproportionate and unequal impact on populations. 2 Authors caution that these health impacts will continue to worsen unless we see an immediate international response to limiting climate change.

To guide future research and action to mitigate and adapt to the health impacts of climate change and its environmental consequences, we need a complete and thorough overview of the research already conducted regarding the health impacts of climate change. Although the number of original studies researching the health impacts of climate change has greatly increased in the recent decade, 2 these do not allow for an in-depth overview of the current literature on the topic. Systematic reviews, on the other hand, allow a higher order overview of the literature. Although previous systematic reviews have been conducted on the health impacts of climate change, these tend to focus on specific climate effects (eg, impact of wildfires on health), 6 7 health impacts (eg, occupational health outcomes), 8 9 countries, 10–12 or are no longer up to date, 13 14 thus limiting our global understanding of what is currently known about the multiple health impacts of climate change across the world.

In this study, we aimed to develop such a complete overview by synthesising systematic reviews of health impacts of climate change. This higher order overview of the literature will allow us to better prepare for the worsening health impacts of climate change, by identifying and describing the diversity and range of health impacts studied, as well as by identifying gaps in previous research. Our research objectives were to synthesise studies’ characteristics such as geographical regions, years of publication, and authors’ affiliations, to map the climate impacts, health outcomes, and combinations of these that have been studied, and to synthesise key findings.

We applied the Cochrane method for overviews of reviews. 15 This method is designed to systematically map the themes of studies on a topic and synthesise findings to achieve a broader overview of the available literature on the topic.

Research questions

Our research questions were the following: (1) What is known about the relationship between climate change and health, as shown in previous systematic reviews? (2) What are the characteristics of these studies? We registered our plan (CRD42019145972 16 ) in PROSPERO, an international prospective register of systematic reviews and followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 17 to report our findings, as a reporting guideline for overviews is still in development. 18

Search strategy and selection criteria

To identify relevant studies, we used a systematic search strategy. There were two inclusion criteria. We included studies in this review if they (1) were systematic reviews of original research and (2) reported at least one health impact as it related (directly or indirectly) to climate change.

We defined a systematic review, based on Cochrane’s definition, as a review of the literature in which one ‘attempts to identify, appraise and synthesize all the empirical evidence that meets pre-specified eligibility criteria to answer a specific research question [by] us[ing] explicit, systematic methods that are selected with a view aimed at minimizing bias, to produce more reliable findings to inform decision making’. 19 We included systematic reviews of original research, with or without meta-analyses. We excluded narrative reviews, non-systematic literature reviews and systematic reviews of materials that were not original research (eg, systematic reviews of guidelines.)

We based our definition of health impacts on the WHO’s definition of health as, ‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’. 20 Therefore, health impacts included, among others, morbidity, mortality, new conditions, worsening/improving conditions, injuries and psychological well-being. Included studies could refer to climate change or global warming directly or indirectly, for instance, by synthesising the direct or indirect health effects of temperature rises or of natural conditions/disasters made more likely by climate change (eg, floods, wildfires, temperature variability, droughts.) Although climate change and global warming are not equivalent terms, in an effort to avoid missing relevant literature, we included studies using either term. We included systematic reviews whose main focus was not the health impacts of climate change, providing they reported at least one result regarding health effects related to climate change (or consequences of climate change.) We excluded studies if they did not report at least one health effect of climate change. For instance, we excluded studies which reported on existing measures of health impacts of climate change (and not the health impact itself) and studies which reported on certain health impacts without a mention of climate change, global warming or environmental consequences made more likely by climate change.

On 22 June 2019, we retrieved systematic reviews regarding the health effects of climate change by searching from inception the electronic databases Medline, CINAHL, Embase, Cochrane, Web of Science using a structured search (see online supplemental appendix 1 for final search strategy developed by a librarian.) We did not apply language restrictions. After removing duplicates, we imported references into Covidence. 21

Supplemental material

Screening process and data extraction.

To select studies, two trained analysts first screened independently titles and abstracts to eliminate articles that did not meet our inclusion criteria. Next, the two analysts independently screened the full text of each article. A senior analyst resolved any conflict or disagreement.

Next, we decided on key information that needed to be extracted from studies. We extracted the first author’s name, year of publication, number of studies included, time frame (in years) of the studies included in the article, first author’s institution’s country affiliation, whether the systematic review included a meta-analysis, geographical focus, population focus, the climate impact(s) and the health outcome(s) as well as the main findings and limitations of each systematic review.

Two or more trained analysts (RR, CB, RN, LC, LPB, RAPR) independently extracted data, using Covidence and spreadsheet software (Google Sheets). An additional trained analyst from the group or senior research team member resolved disagreements between individual judgments.

Coding and data mapping

To summarise findings from previous reviews, we first mapped articles according to climate impacts and health outcomes. To develop the categories of climate impacts and health outcomes, two researchers (RR and LC) consulted the titles and abstracts of each article. We started by identifying categories directly based on our data and finalised our categories by consulting previous conceptual frameworks of climate impacts and health outcomes. 1 22 23 The same two researchers independently coded each article according to their climate impact and health outcome. We then compared coding and resolved disagreements through discussion.

Next, using spreadsheet software, we created a matrix to map articles according to their combination of climate impacts and health outcomes. Each health outcome occupied one row, whereas climate impacts each occupied one column. We placed each article in the matrix according to the combination(s) of their climate impact(s) and health outcome(s). For instance, if we coded an article as ‘extreme weather’ for climate and ‘mental health’ for health impact, we noted the reference of this article in the cell at the intersection of these two codes. We calculated frequencies for each cell to identify frequent combinations and gaps in literature. Because one study could investigate more than one climate impact and health outcome, the frequency counts for each category could exceed the number of studies included in this review.

Finally, we re-read the Results and Discussion sections of each article to summarise findings of the studies. We first wrote an individual summary for each study, then we collated the summaries of all studies exploring the same combination of categories to develop an overall summary of findings for each combination of categories.

Quality assessment

We used a modified version of AMSTAR-2 to assess the quality of the included systematic reviews ( online supplemental appendix 2 ). The purpose of this assessment was to evaluate the quality of the included studies as a whole to get a sense of the overall quality of evidence in this field. Therefore, individual quality scores were not compiled for each article, but scores were aggregated according to items. Since AMSTAR-2 was developed for syntheses of systematic reviews of randomised controlled trials, working with a team member with expertise in knowledge synthesis (AT), we adapted it to suit a research context that is not amenable to randomised controlled trials. For instance, we changed assessing and accounting for risk of bias in studies’ included randomised controlled trials to assessing and accounting for limitations in studies’ included articles. Complete modifications are presented in online supplemental appendix 2 .

Patient and public involvement

Patients and members of the public were not involved in this study.

Articles identified

As shown in the PRISMA diagram in figure 1 , from an initial set of 2619 references, we retained 94 for inclusion. More precisely, following screening of titles and abstracts, 146 studies remained for full-text inspection. During full-text inspection, we excluded 52 studies, as they did not report a direct health effect of climate change (n=17), did not relate to climate change (n=15), were not systematic reviews (n=10), or we could not retrieve the full text (n=10).

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The flow chart for included articles in this review.

Study descriptions

A detailed table of all articles and their characteristics can be found in online supplemental appendix 3 . Publication years ranged from 2007 to 2019 (year of data extraction), with the great majority of included articles (n=69; 73%) published since 2015 ( figure 2 ). A median of 30 studies had been included in the systematic reviews (mean=60; SD=49; range 7–722). Approximately one-fifth of the systematic reviews included meta-analyses of their included studies (n=18; 19%). The majority of included systematic reviews’ first authors had affiliations in high-income countries, with the largest representations by continent in Europe (n=30) and Australia (n=24) ( figure 3 ). Countries of origin by continents include (from highest to lowest frequency, then by alphabetical order): Europe (30); UK (9), Germany (6), Italy (4), Sweden (4), Denmark (2), France (2), Georgia (1), Greece (1) and Finland (1); Australia (24); Asia (21); China (11), Iran (4), India (1), Jordan (1), Korea (1), Nepal (1), Philippines (1), Taiwan (1); North America (16); USA (15), Canada (1); Africa (2); Ethiopia (1), Ghana (1), and South America (1); Brazil (1).

Number of included systematic reviews by year of publication.

Number of publications according to geographical affiliation of the first author.

Regarding the geographical focus of systematic reviews, most of the included studies (n=68; 72%) had a global focus or no specified geographical limitations and therefore included studies published anywhere in the world. The remaining systematic reviews either targeted certain countries (n=12) (1 for each Australia, Germany, Iran, India, Ethiopia, Malaysia, Nepal, New Zealand and 2 reviews focused on China and the USA), continents (n=5) (3 focused on Europe and 2 on Asia), or regions according to geographical location (n=6) (1 focused on Sub-Saharan Africa, 1 on Eastern Mediterranean countries, 1 on Tropical countries, and 3 focused on the Arctic), or according to the country’s level of income (n=3) (2 on low to middle income countries, 1 on high income countries).

Regarding specific populations of interest, most of the systematic reviews did not define a specific population of interest (n=69; 73%). For the studies that specified a population of interest (n=25; 26.6%), the most frequent populations were children (n=7) and workers (n=6), followed by vulnerable or susceptible populations more generally (n=4), the elderly (n=3), pregnant people (n=2), people with disabilities or chronic illnesses (n=2) and rural populations (n=1).

We assessed studies for quality according to our revised AMSTAR-2. Complete scores for each article and each item are available in online supplemental appendix 4 . Out of 94 systematic reviews, the most commonly fully satisfied criterion was #1 (Population, Intervention, Comparator, Outcome (PICO) components) with 81/94 (86%) of included systematic reviews fully satisfying this criterion. The next most commonly satisfied criteria were #16 (potential sources of conflict of interest reported) (78/94=83% fully), #13 (account for limitations in individual studies) (70/94=75% fully and 2/94=2% partially), #7 (explain both inclusion and exclusion criteria) (64/94=68% fully and 19/94=20% partially), #8 (description of included studies in adequate detail) (36/94=38% fully and 41/94=44% partially), and #4 (use of a comprehensive literature search strategy) (0/94=0% fully and 80/94=85% partially). For criteria #11, #12, and #15, which only applied to reviews including meta-analyses, 17/18 (94%) fully satisfied criterion #11 (use of an appropriate methods for statistical combination of results), 12/18 (67%) fully satisfied criterion #12 (assessment of the potential impact of Risk of Bias (RoB) in individual studies) (1/18=6% partially), and 11/18 (61%) fully satisfied criterion #15 (an adequate investigation of publication bias, small study bias).

Climate impacts and health outcomes

Regarding climate impacts, we identified 5 mutually exclusive categories, with 13 publications targeting more than one category of climate impacts: (1) meteorological (n=71 papers) (eg, temperature, heat waves, humidity, precipitation, sunlight, wind, air pressure), (2) extreme weather (n=24) (eg, water-related, floods, cyclones, hurricanes, drought), (3) air quality (n=7) (eg, air pollution and wildfire smoke exposure), (4) general (n=5), and (5) other (n=3). Although heat waves could be considered an extreme weather event, papers investigating heat waves’ impact on health were classified in the meteorological impact category, since some of these studies treated them with high temperature. ‘General’ climate impacts included articles that did not specify climate change impacts but stated general climate change as their focus. ‘Other’ climate impacts included studies investigating other effects indirectly related to climate change (eg, impact of environmental contaminants) or general environmental risk factors (eg, environmental hazards, sanitation and access to clean water.)

We identified 10 categories to describe the health outcomes studied by the systematic reviews, and 29 publications targeted more than one category of health outcomes: (1) infectious diseases (n=41 papers) (vector borne, food borne and water borne), (2) mortality (n=32), (3) respiratory, cardiovascular and neurological (n=23), (4) healthcare systems (n=16), 5) mental health (n=13), (6) pregnancy and birth (n=11), 7) nutritional (n=9), (8) skin diseases and allergies (n=8), (9) occupational health and injuries (n=6) and (10) other health outcomes (n=17) (eg, sleep, arthritis, disability-adjusted life years, non-occupational injuries, etc)

Figure 4 depicts the combinations of climate impact and health outcome for each study, with online supplemental appendix 5 offering further details. The five most common combinations are studies investigating the (1) meteorological impacts on infectious diseases (n=35), (2) mortality (n=24) and (3) respiratory, cardiovascular and neurological outcomes (n=17), (4) extreme weather events’ impacts on infectious diseases (n=14), and (5) meteorological impacts on health systems (n=11).

Summary of the combination of climate impact and health outcome (frequencies). The total frequency for one category of health outcome could exceed the number of publications included in this health outcome, since one publication could explore the health impact according to more than one climate factor (eg, one publication could explore both the impact of extreme weather events and temperature on mental health).

For studies investigating meteorological impacts on health, the three most common health outcomes studied were impacts on (1) infectious diseases (n=35), (2) mortality (n=24) and (3) respiratory, cardiovascular and neurological outcomes (n=17). Extreme weather event studies most commonly reported health outcomes related to (1) infectious diseases (n=14), (2) mental health outcomes (n=9) and (3) nutritional outcomes (n=6) and other health outcomes (eg, injuries, sleep) (n=6). Studies focused on the impact of air quality were less frequent and explored mostly health outcomes linked to (1) respiratory, cardiovascular and neurological outcomes (n=6), (2) mortality (n=5) and (3) pregnancy and birth outcomes (n=3).

Summary of findings

Most reviews suggest a deleterious impact of climate change on multiple adverse health outcomes, with some associations being explored and/or supported with consistent findings more often than others. Some reviews also report conflicting findings or an absence of association between the climate impact and health outcome studied (see table 1 for a detailed summary of findings according to health outcomes).

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Summary of findings from systematic reviews according to health outcome and climate impact

Notable findings of health outcomes according to climate impact include the following. For meteorological factors (n=71), temperature and humidity are the variables most often studied and report the most consistent associations with infectious diseases and respiratory, cardiovascular, and neurological outcomes. Temperature is also consistently associated with mortality and healthcare service use. Some associations are less frequently studied, but remain consistent, including the association between some meteorological factors (eg, temperature and heat) and some adverse mental health outcomes (eg, hospital admissions for mental health reasons, suicide, exacerbation of previous mental health conditions), and the association between heat and adverse occupational outcomes and some adverse birth outcomes. Temperature is also associated with adverse nutritional outcomes (likely via crop production and food insecurity) and temperature and humidity are associated with some skin diseases and allergies. Some health outcomes are less frequently studied, but studies suggest an association between temperature and diabetes, impaired sleep, cataracts, heat stress, heat exhaustion and renal diseases.

Extreme weather events (n=24) are consistently associated with mortality, some mental health outcomes (eg, distress, anxiety, depression) and adverse nutritional outcomes (likely via crop production and food insecurity). Some associations are explored less frequently, but these studies suggest an association between drought and respiratory and cardiovascular outcomes (likely via air quality), between extreme weather events and an increased use of healthcare services and some adverse birth outcomes (likely due to indirect causes, such as experiencing stress). Some health outcomes are less frequently studied, but studies suggest an association between extreme weather events and injuries, impaired sleep, oesophageal cancer and exacerbation of chronic illnesses. There are limited and conflicting findings for the association between extreme weather events and infectious diseases, as well as for certain mental health outcomes (eg, suicide and substance abuse). At times, different types of extreme weather events (eg, drought vs flood) led to conflicting findings for some health outcomes (eg, mental health outcomes, infectious diseases), but for other health outcomes, the association was consistent independently of the extreme weather event studied (eg, mortality, healthcare service use and nutritional outcomes).

The impact of air quality on health (n=7) was less frequently studied, but the few studies exploring this association report consistent findings regarding an association with respiratory-specific mortality, adverse respiratory outcomes and an increase in healthcare service use. There is limited evidence regarding the association between air quality and cardiovascular outcomes, limited and inconsistent evidence between wildfire smoke exposure and adverse birth outcomes, and no association is found between exposure to wildfire smoke and increase in use of health services for mental health reasons. Only one review explored the impact of wildfire smoke exposure on ophthalmic outcomes, and it suggests that it may be associated with eye irritation and cataracts.

Reviews which stated climate change as their general focus and did not specify the climate impact(s) under study were less frequent (n=5), but they suggest an association between climate change and pollen allergies in Europe, increased use of healthcare services, obesity, skin diseases and allergies and an association with disability-adjusted life years. Reviews investigating the impact of other climate-related factors (n=3) show inconsistent findings concerning the association between environmental pollutant and adverse birth outcomes, and two reviews suggest an association between environmental risk factors and pollutants and childhood stunting and occupational diseases.

Most reviews concluded by calling for more research, noting the limitations observed among the studies included in their reviews, as well as limitations in their reviews themselves. These limitations included, among others, some systematic reviews having a small number of publications, 24 25 language restrictions such as including only papers in English, 26 27 arriving at conflicting evidence, 28 difficulty concluding a strong association due to the heterogeneity in methods and measurements or the limited equipment and access to quality data in certain contexts, 24 29–31 and most studies included were conducted in high-income countries. 32 33

Previous authors also discussed the important challenge related to exploring the relationship between climate change and health. Not only is it difficult to explore the potential causal relationship between climate change and health, mostly due to methodological challenges, but there are also a wide variety of complex causal factors that may interact to determine health outcomes. Therefore, the possible causal mechanisms underlying these associations were at times still unknown or uncertain and the impacts of some climate factors were different according to geographical location and specificities of the context. Nonetheless, some reviews offered potential explanations for the climate-health association, with the climate factor at times, having a direct impact on health (eg, flooding causing injuries, heat causing dehydration) and in other cases, having an indirect impact (eg, flooding causing stress which in turn may cause adverse birth outcomes, heat causing difficulty concentrating leading to occupational injuries.)

Principal results

In this overview of systematic reviews, we aimed to develop a synthesis of systematic reviews of health impacts of climate change by mapping the characteristics and findings of studies exploring the relationship between climate change and health. We identified four key findings.

First, meteorological impacts, mostly related to temperature and humidity, were the most common impacts studied by included publications, which aligns with findings from a previous scoping review on the health impacts of climate change in the Philippines. 10 Indeed, meteorological factors’ impact on all health outcomes identified in this review are explored, although some health outcomes are more rarely explored (eg, mental health and nutritional outcomes). Although this may not be surprising given that a key implication of climate change is the long-term meteorological impact of temperature rise, this finding suggests we also need to undertake research focused on other climate impacts on health, including potential direct and indirect effects of temperature rise, such as the impact of droughts and wildfire smoke. This will allow us to better prepare for the health crises that arise from these ever-increasing climate-related impacts. For instance, the impacts of extreme weather events and air quality on certain health outcomes are not explored (eg, skin diseases and allergies, occupational health) or only rarely explored (eg, pregnancy outcomes).

Second, systematic reviews primarily focus on physical health outcomes, such as infectious diseases, mortality, and respiratory, cardiovascular and neurological outcomes, which also aligns with the country-specific previous scoping review. 10 Regarding mortality, we support Campbell and colleagues’ 34 suggestion that we should expand our focus to include other types of health outcomes. This will provide better support for mitigation policies and allow us to adapt to the full range of threats of climate change.

Moreover, it is unclear whether the distribution of frequencies of health outcomes reflects the actual burden of health impacts of climate change. The most commonly studied health outcomes do not necessarily reflect the definition of health presented by the WHO as, ‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’. 20 This suggests that future studies should investigate in greater depth the impacts of climate change on mental and broader social well-being. Indeed, some reviews suggested that climate change impacts psychological and social well-being, via broader consequences, such as political instability, health system capacity, migration, and crime, 3 4 35 36 thus illustrating how our personal health is determined not only by biological and environmental factors but also by social and health systems. The importance of expanding our scope of health in this field is also recognised in the most recent Lancet report, which states that future reports will include a new mental health indicator. 2

Interestingly, the reviews that explored the mental health impacts of climate change were focused mostly on the direct and immediate impacts of experiencing extreme weather events. However, psychologists are also warning about the long-term indirect mental health impacts of climate change, which are becoming more prevalent for children and adults alike (eg, eco-anxiety, climate depression). 37 38 Even people who do not experience direct climate impacts, such as extreme weather events, report experiencing distressing emotions when thinking of the destruction of our environment or when worrying about one’s uncertain future and the lack of actions being taken. To foster emotional resilience in the face of climate change, these mental health impacts of climate change need to be further explored. Humanity’s ability to adapt to and mitigate climate change ultimately depends on our emotional capacity to face this threat.

Third, there is a notable geographical difference in the country affiliations of first authors, with three quarters of systematic reviews having been led by first authors affiliated to institutions in Europe, Australia, or North America, which aligns with the findings of the most recent Lancet report. 2 While perhaps unsurprising given the inequalities in research funding and institutions concentrated in Western countries, this is of critical importance given the significant health impacts that are currently faced (and will remain) in other parts of the world. Research funding organisations should seek to provide more resources to authors in low-income to middle-income countries to ensure their expertise and perspectives are better represented in the literature.

Fourth, overall, most reviews suggest an association between climate change and the deterioration of health in various ways, illustrating the interdependence of our health and well-being with the well-being of our environment. This interdependence may be direct (eg, heat’s impact on dehydration and exhaustion) or indirect (eg, via behaviour change due to heat.) The most frequently explored and consistently supported associations include an association between temperature and humidity with infectious diseases, mortality and adverse respiratory, cardiovascular and neurological outcomes. Other less frequently studied but consistent associations include associations between climate impacts and increased use of healthcare services, some adverse mental health outcomes, adverse nutritional outcomes and adverse occupational health outcomes. These associations support key findings of the most recent Lancet report, in which authors report, among others, increasing heat exposure being associated with increasing morbidities and mortality, climate change leading to food insecurity and undernutrition, and to an increase in infectious disease transmission. 2

That said, a number of reviews included in this study reported limited, conflicting and/or an absence of evidence regarding the association between the climate impact and health outcome. For instance, there was conflicting or limited evidence concerning the association between extreme weather events and infectious diseases, cardiorespiratory outcomes and some mental health outcomes and the association between air quality and cardiovascular-specific mortality and adverse birth outcomes. These conflicting and limited findings highlight the need for further research. These associations are complex and there exist important methodological challenges inherent to exploring the causal relationship between climate change and health outcomes. This relationship may at times be indirect and likely determined by multiple interacting factors.

The climate-health link has been the target of more research in recent years and it is also receiving increasing attention from the public and in both public health and climate communication literature. 2 39–41 However, the health framing of climate change information is still underused in climate communications, and researchers suggest we should be doing more to make the link between human health and climate change more explicit to increase engagement with the climate crisis. 2 41–43 The health framing of climate communication also has implications for healthcare professionals 44 and policy-makers, as these actors could play a key part in climate communication, adaptation and mitigation. 41 42 45 These key stakeholders’ perspectives on the climate-health link, as well as their perceived role in climate adaptation and mitigation could be explored, 46 since research suggests that health professionals are important voices in climate communications 44 and especially since, ultimately, these adverse health outcomes will engender pressure on and cost to our health systems and health workers.

Strengths and limitations

To the best of our knowledge, the current study provides the first broad overview of previous systematic reviews exploring the health impacts of climate change. Our review has three main strengths. First, by targeting systematic reviews, we achieve a higher order summary of findings than what would have been possible by consulting individual original studies. Second, by synthesising findings across all included studies and according to the combination of climate impact and health outcome, we offer a clear, detailed and unique summary of the current state of evidence and knowledge gaps about how climate change may influence human health. This summary may be of use to researchers, policy-makers and communities. Third, we included studies published in all languages about any climate impact and any health outcome. In doing so, we provide a comprehensive and robust overview.

Our work has four main limitations. First, we were unable to access some full texts and therefore some studies were excluded, even though we deemed them potentially relevant after title and abstract inspection. Other potentially relevant systematic reviews may be missing due to unseen flaws in our systematic search. Second, due to the heterogeneity of the included systematic reviews and the relatively small proportion of studies reporting meta-analytic findings, we could not conduct meta-meta-analyses of findings across reviews. Future research is needed to quantify the climate and health links described in this review, as well as to investigate the causal relationship and other interacting factors. Third, due to limited resources, we did not assess overlap between the included reviews concerning the studies they included. Frequencies and findings should be interpreted with potential overlap in mind. Fourth, we conducted the systematic search of the literature in June 2019, and it is therefore likely that some recent systematic reviews are not included in this study.

Conclusions

Overall, most systematic reviews of the health impacts of climate change suggest an association between climate change and the deterioration of health in multiple ways, generally in the direction that climate change is associated with adverse human health outcomes. This is worrisome since these outcomes are predicted to rise in the near future, due to the rise in temperature and increase in climate-change-related events such as extreme weather events and worsened air quality. Most studies included in this review focused on meteorological impacts of climate change on adverse physical health outcomes. Future studies could fill knowledge gaps by exploring other climate-related impacts and broader psychosocial health outcomes. Moreover, studies on health impacts of climate change have mostly been conducted by first authors affiliated with institutions in high-income countries. This inequity needs to be addressed, considering that the impacts of climate change are and will continue to predominantly impact lower income countries. Finally, although most reviews also recommend more research to better understand and quantify these associations, to adapt to and mitigate climate change’s impacts on health, it will also be important to unpack the ‘what, how, and where’ of these effects. Health effects of climate change are unlikely to be distributed equally or randomly through populations. It will be important to mitigate the changing climate’s potential to exacerbate health inequities.

Ethics statements

Patient consent for publication.

Not required.

Acknowledgments

The authors gratefully acknowledge the contributions of Selma Chipenda Dansokho, as research associate, and Thierry Provencher, as research assistant, to this project, and of Frederic Bergeron, for assistance with search strategy, screening and selection of articles for the systematic review.

• Portier C ,
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Twitter @RutNdjab, @ATricco, @hwitteman

Contributors RN, CF, ACT, HOW contributed to the design of the study. CB, RN, LPB, RAPR and HOW contributed to the systematic search of the literature and selection of studies. RR, HOW, LC conducted data analysis and interpretation. RR and HOW drafted the first version of the article with early revision by CB, LC and RN. All authors critically revised the article and approved the final version for submission for publication. RR and HOW had full access to all the data in the study and had final responsibility for the decision to submit for publication.

Funding This study was funded by the Canadian Institutes of Health Research (CIHR) FDN-148426. The CIHR had no role in determining the study design, the plans for data collection or analysis, the decision to publish, nor the preparation of this manuscript. ACT is funded by a Tier 2 Canada Research Chair in Knowledge Synthesis. HOW is funded by a Tier 2 Canada Research Chair in Human-Centred Digital Health.

Competing interests None declared.

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A theoretical model of climate anxiety and coping

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• Published: 11 August 2024
• Volume 4 , article number  94 , ( 2024 )

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• Tara J. Crandon   ORCID: orcid.org/0000-0002-5915-7040 1 , 2 ,
• James G. Scott 1 , 3 , 4 , 5 ,
• Fiona J. Charlson 2 , 5 , 6 &
• Hannah J. Thomas 1 , 2 , 5  

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Research on climate anxiety is rapidly growing, with ongoing exploration of population prevalence, contributing factors, and mitigation strategies that transform anxiety into helpful action. What remains unclear is whether and how to delineate climate anxiety from mental ill health. A limited conceptualization of climate anxiety restricts efforts to identify and support those adversely affected. This paper draws on psychological and existential theories to propose a theoretical model of climate anxiety and coping, extending previous conceptualizations. The model theorizes that climate change evokes an existential conflict that manifests affectively as climate anxiety (and other emotional experiences), wherein cognitive and behavioral coping processes are activated. These processes fall on a continuum of adaptivity, depending on functional impact. Responses might range from meaningful engagement with activities that address climate change to maladaptive strategies that negatively impact personal, social, and occupational functioning. Applications of this model in research and practice are proposed.

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1 Introduction

Climate change has negative implications for population mental health and well-being [ 1 ]. Direct exposure to extreme weather events is associated with trauma-related disorders, as well as elevated anxiety, depression, substance use, grief, and suicidal ideation [ 2 , 3 ]. In addition, temperature fluctuation is associated with anger, stress, increased fatigue, major depressive disorder, self-harm, and suicide attempts [ 3 , 4 ]. Climate change may also indirectly cause significant social, economic, and environmental risk factors for mental illness, including forced migration, food scarcity, and conflict between and within nations [ 2 , 5 , 6 , 7 ]. Irrespective of degree of exposure to such stressors, psychological and emotional responses to anthropogenic climate change are well documented [ 7 , 8 ]. Simple awareness of the climate crisis can evoke ‘climate anxiety’ [ 6 ].

The definition of climate anxiety varies across different fields of research; however, it is commonly understood as a fear of environmental change and its impacts [ 9 ], as well as a cognizance that the ecological foundations of the planet are in the process of collapse [ 9 ]. Reports of those with lived experience of climate anxiety has brought attention to this phenomenon in the media, across research and in healthcare [ 10 , 11 ]. Despite growing efforts to expand scientific knowledge on climate anxiety, a conceptual psychological understanding of how one copes is yet to be developed [ 12 , 13 ]. This restricts the ability to accurately identify and provide meaningful support to those affected [ 12 , 14 ]. This review aims to:

Provide an overview of the historical background, theories and measures of climate anxiety, with consideration of broader theoretical perspectives on anxiety and coping,

Respond to recommendations made by systematic reviews to refine the definition of climate anxiety and clarify its adaptivity or helpfulness,

Propose an integrated theoretical model to conceptualize the experience of climate anxiety and how people may cope with these feelings; and,

Draw on the model to discuss considerations and approaches that may be relevant for researchers and practitioners working with or exploring climate anxiety (see Fig.  1 for a summary).

A summary of considerations and approaches that could be relevant for research and practice, as proposed by the theoretical model of climate anxiety and coping

1.1 A history of research on climate anxiety

1.1.1 eco-anxiety.

While climate anxiety is a subject that has grown in interest more recently, research investigating attitudes towards global environmental issues (e.g., ozone depletion, global warming) dates back to the 1980’s. Between 1982 and 1986, 12 European studies showed that on average, 34–38% of the public were concerned or worried about changes to the climate as a result of carbon dioxide emissions [ 15 ]. In a 1994 global survey of environmental attitudes, the proportion of those viewing global warming as a “serious threat” varied by country, from 20–40% in countries such as Nigeria, India, and the United States to more than 70% in Brazil, Germany and Portugal [ 16 ].

Research on mental health and the environment proliferated from the 1990’s to the early 2000’s, with evidence suggesting that contact with the natural world is beneficial to well-being and can enhance feelings of relaxation, peacefulness and tranquility [ 17 ]. The term ‘Eco-anxiety’ subsequently emerged in print media feature articles, predominantly in political discourse or in interviews with ‘eco-psychologists’. Initially, there was a focus on nature-based therapeutic treatment approaches (e.g., wilderness therapy, green exercise) to support individuals reporting distress regarding environmental issues and disconnection from nature [ 18 , 19 , 20 , 21 ]. With increasing reports of distress over climate change in the news and in healthcare, research turned its attention to climate change and mental health symptoms, reporting associations between concern or distress about climate change with anxiety, stress, and impairments to daily living (e.g., interfering with work, school or relationships) [ 22 , 23 , 24 ]. The term eco-anxiety was soon adopted into the literature and has been characterized as a “chronic fear of environmental doom” [ 25 , 26 ].

1.1.2 Climate anxiety and its impacts on wellbeing

In recent years, the introduction of the term ‘climate anxiety’ has provided increased specificity in terminology. While climate anxiety continues to be used interchangeably with eco-anxiety in the literature, eco-anxiety is more broadly understood as encompassing emotional distress towards environmental issues and is not specific to climate change [ 9 ]. In contrast, climate anxiety may involve anxiety, dread, and despair specifically in response to climate change-related issues, including loss of natural places, ecological collapse and anticipated future harm due to climate change-related stressors (e.g., extreme weather disasters, forced migration). Awareness of climate change is sufficient to elicit climate anxiety [ 21 , 24 , 27 ], where worries may be about the implications for oneself, others, future generations, animals, the environment, or the future state of the world [ 28 ]. Awareness may occur through direct exposure (e.g., experiencing extreme weather-related events or gradual environmental changes over time) as well as indirect exposure (e.g., news, media or education around climate change-related issues) [ 29 ]. Empirical research on eco anxiety and climate anxiety continues to grow rapidly, and several systematic reviews have been conducted on the topic (see Table  1 for a summary). Collectively, these reviews highlight the need to strengthen the conceptualization of climate anxiety and to explore avenues of support for those who are affected by it [ 12 , 13 , 30 , 31 , 32 ]. In responding to these recommendations, the adaptivity (i.e., helpfulness) of climate anxiety must be clarified, which we attempt to address within this paper.

A growing consensus is that for some, climate anxiety can become maladaptive and interfere with functioning [ 24 , 33 , 34 , 35 , 36 ]. Based on experiences with clients in clinical practice, Hickman [ 10 ] proposes different levels of severity from mild (some distress that responds to distraction, reassurance, and individual action, e.g., altering diet and recycling used materials) to severe (changes in cognition such as intrusive thinking, terror, no trust in solutions or experts, and an inability to regulate emotional responses). This severe level of climate anxiety appears to overlap in some respects with clinical anxiety disorders, particularly in relation to a significant level of distress leading to impairments in personal, social, and occupational functioning [ 37 , 38 ]. For some, climate anxiety may even exacerbate pre-existing mental health problems such as generalized anxiety [ 39 ]. However, fundamental to clinical anxiety disorders is that the response is often out of proportion to the threat or a maladaptive response to uncertainty, whereas climate change carries complex, real and devastating impacts on human life.

1.1.3 Considering the function of climate anxiety

Given the negative implications of climate change, climate anxiety could serve a constructive purpose. Emotions are psychological states accompanied by cognitive processes, behavioral responses, and patterns of neurophysiological changes [ 40 , 41 ]. According to Basic Emotion Theory, emotions enable one to respond to threats and opportunities in the environment [ 42 ]. Anxiety particularly functions as a warning sign when survival or well-being is threatened, triggering adaptive responses to eliminate the threat [ 43 ]. Autonomic, neurobiological, cognitive, and behavioral patterns may be activated as a means of escaping or managing the danger (e.g., fight, flight, freeze responses) [ 24 , 34 ]. Common catalysts for anxiety are situations i) that are open to different interpretations (ambiguous situations), ii) in which there is no prior experience to draw from (novel situations) or iii) where it is unclear what may transpire (unpredictable situations). These conditions, which lead to high uncertainty and a level of uncontrollability, may exacerbate perceptions of threat [ 44 , 45 ]. In turn, anxiety and the accompanying cognitive and behavioral processes are enacted to try to manage the ongoing threat and the underlying uncertainty, when unable to eliminate the threat completely [ 45 ].

Climate anxiety could therefore be, to an extent, necessary to motivate the transition to a sustainable future. As such, it is important to avoid the use of terminology that unhelpfully pathologizes the experience. It is also worth noting that many individuals may respond to feelings of climate anxiety in ways that are constructive (e.g., activism, research, helping others) [ 29 , 46 ], with some studies showing associations between climate anxiety and pro-environmental behavior, environmental activism and increased engagement with politics [ 47 , 48 ]. Emerging evidence also suggests that climate anxiety can potentially lead to a gain in functioning (such as being more motivated or more socially connected) when accompanied by more balanced (i.e., more hopeful or positive) re-appraisal styles of thinking [ 49 ]. Climate anxiety may therefore be the alarm bell signaled when one appraises climate change as catastrophic and uncertain. This response prompts an individual to act in order to reduce or manage the threat of climate change. It can thus be argued that it is how someone copes with climate change and anxiety, rather than the emotion itself, that varies in adaptivity.

1.1.4 Considering coping with anxiety and other emotions

Coping is a cognitive and behavioral process activated to manage, tolerate, or reduce adversity or stress [ 50 , 51 ]. Several styles of coping are evidenced in the climate change literature, especially in work with young people [ 52 , 53 , 54 ]. Firstly, emotion-focused coping involves attempts to soothe, regulate, or remove emotions engendered by the climate crisis. Problem-focused coping relates to thinking about, talking about, and acting on climate mitigation. Meaning-focused coping involves a positive or more balanced re-appraisal of climate change through hope and trust. Distancing refers to the strategies one uses to move away from or distract oneself from climate change or their negative emotions toward it. Lastly, de-emphasizing the seriousness of climate change can range from apathy to skepticism, and even denial. Pihkala [ 55 ] synthesizes some of these ideas using a process model, which posits that eco anxiety and ecological grief activate a process of coping. Three dimensions of coping are described: action, grieving (and the processing of other emotions) and distancing. As individuals traverse these coping tasks over time, it is theorized that they may then enter a phase of living with the climate crisis. During this phase, coping becomes focused on action, emotional engagement (including grieving), and self-care (which can include distancing). Pihkala [ 55 ] suggests that difficulties in adjustment or coping could lead to anxiety, depression, and problematic avoidance. Indeed, we argue that coping strategies can become adaptive or maladaptive depending on the effect to one’s well-being and functioning.

While attempting to cope with climate anxiety, other emotional responses may understandably arise, which may require further use of coping resources. For example, learning about ineffectual government responses or how corporations contribute to emissions, may provoke anger, frustration, and feelings of betrayal [ 33 ]. Alternatively, ecological grief may be felt in response to physical ecological losses (e.g., species, environmental landscapes), loss of environmental and cultural knowledge, sense of place and home, and to security, stability, and even life [ 34 , 56 ]. This grief can become disenfranchised (prolonged and exacerbated) when invalidated by others through dismissal or minimization [ 26 , 27 , 29 ]. Failure to prevent these ecological losses due to collective inaction may prompt feelings of hopelessness or helplessness [ 39 ]. On the other hand, connecting with nature, others, or one’s values within the context of climate change, could lead to hope, connection, optimism, gratitude, or soliphilia (a feeling of love and sense of responsibility to protect the planet) [ 52 , 57 , 58 , 59 ]. These emotional states could overlap and intersect with climate anxiety, influencing the way one cognitively and/or behaviorally responds [ 60 ]. Evidence suggests anxiety combined with anger or hope, for example, may prompt pro-environmental behavior [ 35 , 60 ]. While it can be hypothesized that climate anxiety is an initial emotional response typically evoked by the threats of climate change, it is important to acknowledge that emotions are sensitive to situational factors such as context, cultural norms, personality, and cognitive attributions [ 41 , 60 , 61 , 62 ]. Therefore, as the context of the climate crisis continues to change, emotional states including climate anxiety may oscillate in salience, valence (pleasant to unpleasant), arousal (passive to activated), duration and intensity or severity [ 10 ]. This too will have flow-on effects for coping. Other emotional responses to climate change, which are difficult to disentangle from climate anxiety, should therefore be incorporated in measurement and research.

1.2 Considering existing measures of climate anxiety

Existing measures of climate anxiety provide compelling evidence of climate anxiety as a multi-dimensional construct. In particular, Clayton and Karazsia [ 24 ] developed the Climate Change Anxiety Scale, identifying two unique dimensions: cognitive-emotional impairment and functional impairment [ 24 , 63 , 64 ]. Hogg and others [ 65 ] also developed and validated a scale and identified four underlying constructs of climate anxiety: affective symptoms, rumination, behavioral symptoms and anxiety regarding one’s negative impact on the planet. Although both scales helpfully point to the presence of affective, cognitive, and behavioral experiences, each has some conceptual limitations. Firstly, there is a tendency in both scales to focus on impairment. While capturing the presence of potentially unhelpful responses, the scales do not capture the range and presence of adaptive responses. By overlooking the potential for an individual to respond or cope constructively, research and intervention efforts are somewhat limited. Furthermore, individuals who experience climate anxiety whose coping may fall on the adaptive end of the continuum may require different types of support, which could be detected if measures focus primarily on coping.

Another limitation to existing measures is that they reduce the cognitive dimension of climate anxiety to excessive preoccupation with climate change or one’s own distress. This potentially overemphasizes repetitive thinking /excessive worry and limits the role that specific cognitive appraisals may have in developing and maintaining climate anxiety. While some climate anxious individuals may excessively worry, others may de-emphasize the seriousness of the threats, filter scientific versus catastrophic information, or reappraise the climate crisis by drawing on hope and trust in mitigation efforts [ 18 , 66 ]. These cognitive patterns may in turn influence both emotions (e.g., anxiety, dread, fear) and associated behaviors (e.g., pro-environmental behavior, avoidance).

Despite limitations, existing measures of climate anxiety are a useful platform for which to develop and extend the forthcoming theoretical conceptualization. Based on the current state of the literature, we argue that climate anxiety is best considered as an expected and understandable emotional response that encompasses emotions (e.g., fear, anxiety, dread) and physiological symptoms typical of anxiety (e.g., feeling tense). Yet how an individual processes or copes with these emotions (cognitively or behaviorally) likely falls on a continuum of adaptivity depending on functional impact of the coping response [ 67 ]. When coping becomes highly maladaptive, this may be attributable to pre-existing or underlying symptoms of a diagnosable mental health disorder.

This conceptualization aligns with both suggestions that climate anxiety emotions should not be considered a mental health disorder, but also that coping can become clinically maladaptive and lead to functional impairment. Individuals should be supported to express their experiences of climate anxiety, which may help them to develop more helpful and adaptive coping strategies [ 18 , 46 ]. To further illustrate and expand on this conceptualization, broader psychological theories of anxiety will be drawn on to propose a theoretical model of climate anxiety and coping.

1.3 Considering broader theoretical perspectives

1.3.1 cognitive psychology.

Of the many cognitive theories that explain why or how an individual experiences anxiety, two will be applied to climate anxiety. Beck and Clark’s [ 68 ] information processing model proposes that the experience of anxiety is characterized by (1) an automatic detection of a threat (rapid, memory-based), (2) primal threat mode activation (e.g., escape/avoidance behavior or physiological arousal), and (3) conscious appraisal and reflective thinking (emotionally and/or logically reasoned) used to determine the best course of action to eliminate the threat [ 29 , 68 ]. Further, this conscious appraisal comprises thought content ( what the individual thinks) and thought process (the way the individual thinks). Applied to climate anxiety, an individual’s thoughts (content and process) may arise as a way to make sense of climate change and their feelings towards it, with the function of determining an appropriate course of action. For example, there is evidence that hopeful efficacy beliefs [ 69 ], meaning-focused thoughts and problem-focused thinking [ 70 ], are associated with environmental action and engagement. This, however, may not always be adaptive. Beck and Clark [ 68 ] suggest that dominance of the primal threat mode can lead to thinking that is unconstructive, excessive, or pathological. An individual experiencing climate anxiety may have less capacity for constructive thought when consistently under threat by adversity in life as well as climate-induced stressors (e.g., migration). For some, these thought processes may become unhelpfully habitual [ 71 ]. Furthermore, knowledge and experience stored in the long-term memory can influence how information is processed [ 72 ]. Adverse experiences can stimulate negative biases, which can lead to thinking biases and disordered cognition [ 73 ]. Experiencing a severe season of bushfires, for example, may lead to cognitive styles characterized by catastrophizing (e.g., “humanity is doomed”) or excessive preoccupation with past or anticipated losses. Conversely, beliefs and experiences held in long-term memory could motivate constructive thinking. One study, for example, found associations between habitual worrying about climate change (repetitive, automatic thinking) and pro-ecological worldviews, pro-environmental values, a ‘green’ identity, and pro-environmental behavior, suggesting a more constructive cognitive style [ 71 ].

A person’s beliefs about their own thoughts may also impact and maintain their anxiety [ 74 ]. According to metacognitive theory, one’s awareness, knowledge and perception of their thoughts can guide which coping strategies they select [ 74 ]. For example, an individual who believes they struggle to control their thoughts about climate change may unsuccessfully try to suppress their emotions or thoughts, leading to greater anxiety. For further consideration is whether the experience of climate anxiety is in general a direct and proportionate response to climate change related threats (e.g., ‘state anxiety’), or an extension of an individual’s tendency to experience anxiety or worry-based thinking styles (e.g., ‘trait anxiety’) [ 75 , 76 ]. While some research has found that climate anxiety is associated with generalized anxiety and trait pathological worry [ 71 ], another study found that approximately 60% of participants scoring highly on state climate anxiety were absent in high trait anxiety [ 76 ]. While further research is needed to explore the role of cognitive styles and processes in managing and processing climate anxiety (e.g., metacognitive beliefs, knowledge, tendency to use specific thinking styles), existing literature points to a range of adaptive to maladaptive cognitive responses [ 29 ]. It is important to note that while unhelpful cognitions may play a role in climate anxiety, concerns about climate change reflect a natural response to an existential threat. There is an emerging body of work that seeks to understand the existential nature of climate anxiety.

1.3.2 The existential perspective

Existentialists regard humans as reflective and meaning-making beings, who are expected to naturally confront and reconcile shared existential concerns considered core to human life [ 77 ]. Awareness of existential concerns can elicit apprehension, angst, anxiety, grief, and dread [ 11 , 78 ], threatening the core self and tasking one to make the change necessary to move forward in life with greater meaning and authenticity [ 11 ]. Death, meaning, guilt and isolation are among the common existential concerns that arise during the lifetime [ 77 , 78 , 79 , 80 ].

While limited empirical evidence has linked climate anxiety with existential concerns, several authors propose that climate change raises the salience of existential concerns such as mortality, thereby evoking climate anxiety [ 11 , 29 , 79 ]. One study conducted a thematic analysis to ascertain whether existential themes were present in interviews with psychotherapy patients describing their experiences of climate anxiety [ 11 ]. Within these interviews, patients described the salience of mortality, fearing the “death of humanity,” and the meaninglessness of existence, among other existential themes. It has also been suggested that feelings of vulnerability that arise when confronted with existential concerns may prompt the use of defense strategies (e.g., denial and apathy) as a means of restoring psychological equilibrium [ 68 ]. The proposed theoretical model thus considers climate anxiety as a manifestation of the existential conflict evoked by climate change, whereby one’s accompanying cognitive and behavioral strategies attempt to mitigate this conflict.

1.3.3 Systemic influences

How climate anxiety is experienced and coped with can be influenced by a range of factors outside of an individual’s cognitive, emotional, and behavioral characteristics. There is accumulating evidence that suggests specific populations are at greater risk of climate anxiety. Research has linked an increased risk of climate anxiety or climate change-related distress to females [ 12 , 23 , 71 , 81 ], young people [ 24 , 33 , 82 ], and individuals with pro-environmental identity [ 23 , 71 ], left-leaning political values [ 83 ], and those with pre-existing anxiety or stress [ 9 , 35 , 76 ]. First responders, health care providers, activists, and scientists, who are more exposed to or have greater knowledge of the direct impacts of climate change, may be more likely to experience higher levels of climate anxiety [ 18 , 29 , 84 ]. Unique vulnerability to specific climate-related events may also foster heightened anxiety. For example, an individual may experience greater climate anxiety if damage brought by natural disasters (e.g., flooding, fires) presents a risk to their homes, livelihoods, and environment, particularly for those with strong cultural or spiritual connections to land [ 12 , 85 ]. This may be especially the case for populations residing in the Global South, where climate change exacerbates pre-existing vulnerabilities such as extreme weather, scarcity of resources, forced migration, and poverty [ 86 ]. What is clear is that as climate change stressors (e.g., extreme weather events) fluctuate in salience for different groups across time, psychological and emotional responses are likely to be similarly dynamic [ 87 ].

Psychological responses to climate change should not be viewed in isolation, but rather as existing within layers of social, community, cultural, and political systems [ 86 , 88 , 89 ]. This has been conceptualized within a social-ecological framework, which illustrates how various nested contextual ‘systems’ within which an individual is embedded (e.g., family, peers, work or school, community, culture, the government) may shape whether and how that person experiences climate anxiety [ 86 ]. At the individual level, potential influences include temperament, biology/neurology, coping styles, any pre-existing mental health conditions, knowledge about climate change, as well as unique experience and vulnerability to climate change in their immediate context. At the microsystemic level, influences include the attitudes and experiences of family and friends, as well as how climate change is discussed or communicated in close relationships. Factors in the mesosystem may include community resources, community responses to climate change, as well as shared communal stress resulting from these changes. Exosystemic factors include governmental attitudes, collaboration or conflict between nations, the selection and implementation (or lack) of policies aimed to mitigate climate change, as well as how climate change is communicated in media. Additionally, overarching cultural influences in the macrosystem include cultural knowledge and attitudes, spiritual or religious connections to land, and potential loss of culture or cultural places due to climate change. While the conceptual model proposed in the current paper highlights affective, cognitive, behavioral, and existential dimensions of climate anxiety and coping at the individual level, it is important for researchers and practitioners to consider how these domains interact with an individual’s wider social-ecological contexts (for further detail, refer to Crandon, Scott [ 86 ]).

1.4 Model development

In the current paper, the authors constructed a model of climate anxiety and coping by drawing together the theoretical concepts previously described using a ‘top-down’ approach. Based on social-ecological theory and its application to climate change (see Crandon et al. [ 86 ]), environmental factors were considered as shaping all climate-related triggers and therefore how someone responds to those triggers. For this reason, systemic and contextual factors are depicted at the top of the model. From here, the model shows that acute and chronic triggers can then evoke climate anxiety. Existential theories were considered and ultimately included in the model to highlight that climate anxiety is an existential conflict that can be minimized or strengthened depending on the subsequent process of coping. The existential conflict (i.e., climate anxiety) then establishes an affective experience which has emotional and physiological components. The authors then applied the literature on coping to illustrate how climate anxiety can prompt a process of coping, which encompasses ongoing cognitive and behavioral efforts/strategies to reduce or mitigate the existential conflict of climate change and its associated experienced affect. Well-established evidence-based cognitive and behavioral theories were acknowledged in the model by showing how affect, cognitive appraisals and behavioral responses are bidirectionally influenced, and impact on overall functioning. Finally, the ongoing coping process informs the degree of adaptivity to the existential conflict caused by climate change.

2 Introduction of a theoretical model of climate anxiety and coping

The current conceptual model proposes that even after acknowledging systemic influences [ 86 ], climate anxiety is an existential conflict that leads to affective/emotional experiences. Individuals manage and respond to these experiences using cognitive and behavioral coping processes (see Fig.  2 ), which can be adaptive (when reinforcing functioning) or maladaptive (when interfering with functioning). Cognitive and behavioral coping may separately or simultaneously focus on solving or mitigating the problems of climate change, as well as soothing or removing the emotions evoked by it. We propose that individuals are not fixed to one process but can engage in more than one at the same time and over time, thereby oscillating on a continuum between low and high degrees of adaptive coping. Importantly, the affective (felt emotion/s), cognitive (thought content and process), and behavioral responses (actions and impacts) will be unique for an individual, as influenced by intrapersonal psychological factors, as well as the external social-ecological systems surrounding them.

2.1 Adaptive coping

When faced with triggers of the climate crisis, processing of climate change as a significant, overwhelming challenge may lead to existential conflict. As part of this conflict, autonomic arousal (e.g., discomfort, unease, shakiness, impaired concentration, increased heart rate, muscular tension, tight chest) and emotional experiences (e.g., angst, anxiety, fear, dread, anger, helplessness) act as a cue, whereby cognitive appraisal determines a course of action to reduce the threat [ 90 ]. This appraisal involves specific thoughts (e.g., what an individual thinks about climate change) and thought process (e.g., the mechanics of thinking). Adaptive thought content may be meaning-focused or hope inducing, be influenced by strongly held beliefs or values, involve interpretations about the greater historical context of climate change, or considerations of different climate solutions being developed and implemented [ 66 ]. For adaptive thought processes, an individual may engage in problem solving/solutions-focused thinking or cultivate acceptance of uncertainty and negative emotions [ 49 ].

These adaptive cognitive modes interact to identify behaviors that can help connect an individual to respond in ways that are consistent with their values. Responses might include practical strategies such as pro-environmental behavior, activism, or emotion-focused strategies such as engaging with social support and activities in nature [ 49 , 66 , 91 ]. While this does not remove the threat, the individual integrates the conflict in a way that allows them to function and move forward with life in a meaningful way [ 91 ] so as to manage the threat as adaptively as possible. However, with the likely continued exposure of climate change related triggers in the future, the individual may continue to undergo an ongoing cycle of direct and indirect exposure to climate change triggers, making subsequent attempts to resolve or alleviate distress an ongoing process.

2.2 Maladaptive coping

Humans have the innate capacity to manage and resolve existential conflicts in personally meaningful ways [ 92 ]. However, there is potential for this process to be challenged when complicated by internal (e.g., pre-existing mental illness, a tendency for ruminative thought patterns or unhelpful coping strategies) and external (e.g., unexpected loss, migration, death) factors. When this occurs, an individual’s thoughts about climate change may be negatively biased (e.g., catastrophizing) or they may use unhelpful thought processes (e.g., ruminative, or excessive preoccupation styles of thinking) [ 49 , 66 ]. Individuals may struggle to identify or implement strategies that could help mitigate their existential conflict, or they may succumb to habitual maladaptive behavior to avoid or alleviate negative feelings in the short term (e.g., excessive suppression, substance use, risk-taking behaviors) [ 18 , 93 , 94 ].

Alternatively, those who engage strategies to address climate change may do so to an unhelpful degree, making significant lifestyle changes that negatively impact their well-being in the long term by devoting much of their personal resources (e.g., time, energy) to climate action and experiencing ‘burnout’ or disillusionment as a result [ 18 ]. The loss of control ensued from unhelpful cognitive and behavioral patterns may then impair personal, social, and occupational domains. In turn, the feelings of climate anxiety and existential conflict are perpetuated and the individual may be less equipped to cope with future climate change triggers [ 95 ].

3 Discussion

3.1 using the theoretical model of climate anxiety and coping in measurement.

Developing a measure of psychological phenomena that is reliable, valid, and operational, is difficult without a consistent and comprehensive theoretical underpinning [ 96 ]. The theoretical model of climate anxiety and coping presented in the current paper draws together existing theories and measures to highlight climate anxiety as an affective construct, with potential correlates or sub-domains of (1) cognitive coping; (2) behavioral coping; and (3) functional impact. Existing measures may help to inform the development and selection of items that may assess these constructs, as well as any potential lower order constructs (see Table  2 for an example).

It is important for a climate anxiety measure to include both adaptive and maladaptive dimensions of cognitive and behavioral coping. The Measure of Affect Regulation (MARS) provides a useful example of a scale that measures frequency of 13 coping strategies, which differ based on whether the strategy is cognitive or behavioral, and whether the strategy focuses on resolving the situation or one’s mood [ 97 ]. Some examples of coping strategies include cognitive reappraisal (finding meaning or considering alternative perspectives), suppression (not allowing the expression of emotion), problem solving action (planning or acting to solve the problem), socializing or seeking help, and withdrawal or self-isolation. One study extended the MARS by including environmental strategies (e.g., going to favorite natural places). A climate anxiety measure might similarly assess coping across three dimensions: (1) cognitive vs. behavioral, (2) adaptive vs. maladaptive, and (3) focusing on resolving climate change, or the existential conflict/anxious feelings.

3.2 Identifying potential areas to intervene

Addressing the drivers of climate change will most significantly alleviate the negative implications for mental health and well-being. Yet, there is also increasing demand for interventions to support those who experience climate anxiety and the unmitigated impacts that climate change is having on mental health. Using a multiple needs framework, Bingley, Tran [ 36 ] identified that climate anxiety interventions can and do focus on meeting one or a combination of individual (e.g., improving individual well-being), social (e.g., fostering social connection), and environmental needs (e.g., pro-environmental attitude or behavior). As a starting platform, the theoretical model of climate anxiety and coping could be used to identify where to intervene in order to meet these needs or outcomes. More specifically, targeting cognitive or behavioral coping may be the mechanism for shifting levels of functioning across personal, social, and occupational domains. Interventions addressing cognitive coping may, for example, aim to support one to manage dysfunctional/unhelpful styles of thinking (individual needs), identify their shared values (social needs), or explore their role as it relates to climate change (environmental needs). Behaviorally focused interventions may, for example, focus on developing relaxation strategies (individual needs), fostering peer interaction or community building (social needs) or target climate mitigation through project engagement or decreasing one’s carbon footprint (environmental needs). These are few of the many ideas that can be developed based on the premise that coping will impact functioning, rather than emotion.

3.2.1 Ideas for interventions for maladaptive climate anxiety

Given the potential for maladaptive coping responses to climate anxiety, some individuals may need more comprehensive individual support. It is important, however, to note that little evidence exists for the efficacy of existing therapeutic interventions in supporting those who specifically experience climate anxiety. Potential interventions that could be drawn on to target cognitive or behavioral coping could include cognitive behavior therapy [ 66 ], acceptance and commitment therapy (accepting ecological emotions such as ecological grief or climate anxiety, connecting one to their values and committing to action) [ 7 , 95 ], and interventions which may be existentially-focused, self-care focused [ 7 , 31 ], emotion-focused [ 21 ], nature-based [ 6 ], as well as peer or group-based [ 21 , 100 ]. As mentioned, research is needed to evaluate the effectiveness of these approaches in helping to strengthen adaptive coping and minimize impairments to functioning. Furthermore, such support should also consider the social and ecological influences that may shape adaptivity (e.g., geography, political landscape, culture) [ 29 , 86 ].

As climate change impacts the world, there is an urgent need for intervention to be delivered beyond an individual receiving one-to-one support. Systemic interventions that aim to support public mental health can aim to promote adaptive cognitive and behavioral coping. For example, public health campaigns might consider reducing guilt, fear, and shame messaging, and instead communicating that climate anxiety is a shared experience that encompasses a range of different emotions that are understandable and can be responded to adaptively. Alternatively, media outlets that disseminate information on organizations, policies and initiatives that are working to address climate change could help to promote hope-based thinking and positive re-appraisals. Tangible strategies for coping could be given alongside these messages, particularly as they relate to meeting individual, social and environmental needs (e.g., online self-help tools for managing emotions, promoting community projects, funding climate mitigation projects) [ 7 ]. As with individual interventions, the focus of public-health level strategies is not to eliminate climate anxiety feelings, but to support planetary and human health and well-being.

3.3 Limitations and ideas for future research

The proposed theoretical model draws on the current state of evidence on climate anxiety along with well-established psychological theories of emotion and coping. It was developed based on a wide-ranging narrative review of existing research which included assessment of previous systematic reviews, and psychological theory brought together through clinical expertise of the contributing authors. Given the study was not a systematic review, this may have introduced a source of bias as to the way psychological concepts reviewed in the paper were used to construct the model presented. It must also be acknowledged that the theoretical model is untested, and empirical validation studies are greatly needed. Importantly, the model should be further informed and refined through future research and practice. Pathway analyses could help to evaluate potential associations between emotions about climate change, how individuals cognitively and behaviorally cope, and their relationship with functioning. Investigating how systemic factors influence climate anxiety and the capacity for coping will also help to determine how best to strengthen adaptive coping and over time, psychological resilience. Despite these limitations and the need for future research, this paper importantly responded to recommendations made by previous systematic reviews [ 12 , 13 , 30 ]. Specifically, the theoretical model of climate anxiety and coping helps to refine the conceptual understanding of climate anxiety and coping. From here, its application provides a way to assess psychological responses to climate change using measurement tools, which may in turn help in developing ways to support well-being as the climate crisis continues.

4 Conclusions

Within the theoretical model of climate anxiety and coping, competing viewpoints on the nature of climate anxiety converge. Specifically, climate anxiety may vary in adaptivity, intensity and severity. While existing measures capture maladaptive dimensions of climate anxiety, there is need for continued focus on developing a measure that can fully capture the spectrum of coping responses. Development of such a measure would (1) contribute to a more comprehensive understanding of how climate anxiety is experienced, (2) reduce potential inappropriate pathologizing of individuals who experience significant anxiety, yet who are responding to that anxiety in helpful ways; (3) identify those individuals who may be most in need of targeted mental health intervention; and (4) be used in future research to explore which factors may be associated with more or less adaptive responses. For interventions to be most effective, the range of experiences across cognitive, emotional, behavioral, existential, and systemic domains must be considered. Crucially, whether an intervention is delivered with the individual or at the public health level, focus should not be on eliminating climate anxiety, but in supporting the ability to channel that anxiety using cognitive and behavioral strategies to best meet the needs of the individual. With a more theoretically driven and robust conceptualization of climate anxiety, further research on climate anxiety may be able to better identify ways in which to support those adversely affected.

Data availability

Not applicable.

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T.C. is supported by the Child and Youth Mental Health Research Group PhD Scholarship. H.T. and F.C. are supported by the Queensland Centre for Mental Health Research which is funded by the Queensland Department of Health.

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Crandon, T.J., Scott, J.G., Charlson, F.J. et al. A theoretical model of climate anxiety and coping. Discov Psychol 4 , 94 (2024). https://doi.org/10.1007/s44202-024-00212-8

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Climate change and infectious disease: a review of evidence and research trends

Paige van de vuurst.

1 Virginia Tech Graduate School, Translational Biology, Medicine, and Health Program, Blacksburg, VA USA

2 Department of Fish and Wildlife Conservation, Virginia Tech, Blacksburg, VA USA

3 Center for Emerging Zoonotic and Arthropod-Borne Pathogens, Virginia Tech, Blacksburg, VA USA

Luis E. Escobar

4 Global Change Center, Virginia Tech, Blacksburg, VA USA

5 Facultad de Ciencias Agropecuarias, Universidad de La Salle, Bogotá, Colombia

Associated Data

Not applicable.

Climate change presents an imminent threat to almost all biological systems across the globe. In recent years there have been a series of studies showing how changes in climate can impact infectious disease transmission. Many of these publications focus on simulations based on in silico data, shadowing empirical research based on field and laboratory data. A synthesis work of empirical climate change and infectious disease research is still lacking.

We conducted a systemic review of research from 2015 to 2020 period on climate change and infectious diseases to identify major trends and current gaps of research. Literature was sourced from Web of Science and PubMed literary repositories using a key word search, and was reviewed using a delineated inclusion criteria by a team of reviewers.

Our review revealed that both taxonomic and geographic biases are present in climate and infectious disease research, specifically with regard to types of disease transmission and localities studied. Empirical investigations on vector-borne diseases associated with mosquitoes comprised the majority of research on the climate change and infectious disease literature. Furthermore, demographic trends in the institutions and individuals published revealed research bias towards research conducted across temperate, high-income countries. We also identified key trends in funding sources for most resent literature and a discrepancy in the gender identities of publishing authors which may reflect current systemic inequities in the scientific field.

Conclusions

Future research lines on climate change and infectious diseases should considered diseases of direct transmission (non-vector-borne) and more research effort in the tropics. Inclusion of local research in low- and middle-income countries was generally neglected. Research on climate change and infectious disease has failed to be socially inclusive, geographically balanced, and broad in terms of the disease systems studied, limiting our capacities to better understand the actual effects of climate change on health.

Graphical abstract

Supplementary Information

The online version contains supplementary material available at 10.1186/s40249-023-01102-2.

The Intergovernmental Panel on Climate Change has anticipated, with high confidence, that climate change will amplify health threats worldwide [ 1 , 2 ], which is supported by the fact that the life cycles of many infectious agents are inextricably linked to climate [ 1 , 3 – 6 ]. Multiple studies have shown that variation in temperature, precipitation, and humidity affects the transmission and distribution of infectious diseases [ 7 – 10 ]. Nevertheless, the magnitude, direction, and strength of the impact of climate change upon infectious disease transmission remains unclear [ 3 , 5 , 7 ]. To determine what further research is needed to advance a given field in scientific research it is often necessary to synthesize previous work [ 11 ]. This type of retrospective, systematic analysis of literature in a specific topic or field is referred to as a systematic review. Systematic reviews are a popular and effective method commonly utilized to identify trends and gaps in ongoing research [ 12 ]. Results from systematic reviews and scoping studies, which are often used to map the availability of literature on an specific topic [ 13 , 14 ], can be used to guide future research lines, future policy decisions, and can be particularly useful in scientific fields with emerging evidences, such as epidemiology [ 12 , 13 , 15 , 16 ].

Despite their effectiveness, systematic reviews are noticeably lacking in the literary landscape of anthropogenic climate change research, especially with regard to its impacts on infectious diseases. There is, therefore, a need for a systematic synthesis of recent empirical research assessing disease impacts of climate change. Here, we provide a synthesis of scientific literature on climate change and infectious diseases from recent history. The overall objective of this study was to determine the trends of recent empirical research regarding climate change impacts on infectious diseases and to identify geographic, topical, or taxonomic trends of research. We sought to assess the geographic regions where climate change and disease transmission have been under studied, accounting for both study area and first author affiliation to identify geographic and bibliometric signals. In addition, we assessed the taxa of hosts and transmission types of pathogens studied. Finally, we sought to inform future research avenues, policy, and practices via the trends and impacts identified herein.

Search strategy, inclusion criteria, exclusion criteria

Our search strategy included recovering articles from Web of Science (Clarivate™) [ 17 ] and PubMed™ [ 18 ] literary repositories using a key word search. Keywords included "climate change", "global warming", “greenhouse gas*” (*asterisk used to incorporate all forms of the word. i.e., gas, gases, gaseous), “world warming”, “disease”, “infectious”, “pathogen”, “waterborne”, “water borne”, “food borne”, “vector borne”, “parasite”, and “non-vector borne”. Time range restrictions were set from January of 2015 to December of 2020 to incorporate all publications from the most recent, pre-pandemic five-year period of empirical climate change research. This key word search was limited to journal manuscripts, as the purpose of this study was to analyze original peer-reviewed research. Other literature types such as book chapters, review articles, proceedings papers, or conference abstracts were excluded. Articles were then imported into Endnote citation software, where redundant articles were removed.

After collection we conducted an initial screening of both article titles and abstracts. This initial review allowed for the identification of articles which did not fit within the review criteria. Inclusion criteria were: (1) The manuscript was peer-reviewed and published without retraction, (2) the primary goal of the research was centered on assessing climate change and its repercussions, impacts, effects, association, or influences on disease, infection, transmission, infestation, or illness, (3) the research was original and not a review, (4) the research was descriptive, retrospective, and based on real world systems using non-simulated future-climate data (i.e., present-day and past climate only), (5) the manuscript utilized primary data and (6) the pathogen, parasite, vector, or disease of focus impacted either humans, non-human animals, or both. Each article was reviewed by at least two independent reviewers and was confirmed for inclusion or exclusion based on the inclusion criteria. If the independent reviewers were in disagreement on whether or not the article fit the inclusion criteria, the article was reviewed by a third reviewer. Studies which did not fit this inclusion criteria were flagged and maintained in a separate databased. Studies on plant diseases were not within the scope of this study and therefore were excluded.

Evidence extraction and analysis

We then reviewed the remaining publications in full and conducted evidence extraction of each article to conduct our gap analysis of bibliometric, subject, taxonomic, and geographic trends in research and publication. We gathered descriptive metadata from each article to assess when, where, and by whom the articles were published (e.g., year or publication, journal name, title, authors, etc.). To assess authorship demographics, we recorded the lead author and senior author’s names, pronouns, and institutional affiliation for each publication. Authors’ pronouns were recorded based upon the personal distinctions of each individual author, and the pronouns they chose to use (e.g., she/her, he/him, they/them, em/eir, xem/xyr, etc.) on their institutional or research affiliated websites. We implemented this method to be inclusive of all authors’ identities while maintaining personal privacy [ 19 , 20 ]. If the author did not denote their pronouns in any public way, we recorded their pronouns as “unknown”. We also collected descriptive metadata on the study methods and locations or each article including: (1) study location at the country and continent level, (2) disease host, vector, or pathogen studied, (3) transmission method of each disease studied, (4) primary taxa or taxon of interest (i.e., the taxonomic group of the host or infectious organism or organisms being studied), and (5) spatial scale (e.g., local or inferior to country level, regional, country level, or global). To assess the quality of the included literature, we also recorded and synthesized the conclusions of the sampled articles, and reported these findings based upon the author’s interpretation of their results. We also collected descriptive information on the publication funding or support for each article published in the most recent year included in the review (i.e., 2020) to ascertain current funding sources for the most recent climate change and disease publications. We then compared funding sources with current estimates of country gross domestic product (GDP) from the World Bank World Development Indicators Dataset [ 21 ].

To assess the distribution of the categorical topics of the literature we used a Pearson’s chi-squared ( χ 2 ) test. It has been estimated that approximately 60% of known infectious diseases are zoonotic (i.e., originating in non-human animals) [ 16 , 22 ]. We compared this value (60%) with the proportion of literature which assessed zoonotic diseases to identify if the literature followed this expected proportion. We also used the χ 2 test to identify if the proportion of host species categories studied (humans, wildlife, and livestock) were equal. To assess the geographic distribution of publication demographics, the lead authors’ institutional affiliations were recorded for each publication and assigned to their corresponding countries of origin. Demographic data of study locations and author affiliations were summarized and visualized to detect spatial and temporal patterns of these data using ArcGISpro version 2.9.3 and R version 4.1 [ 23 – 25 ]. We utilized population data from the United Nations Population Division [ 26 ] for the year 2020 to assess the per-capita research effort by country.

Literature demographics

Our initial key word search resulted in 10,461 articles from both PubMed and Web of Science. A total of 621 research articles (5.9%) fit the inclusion criteria for the 2015–2020 period and were retained for evidence extraction and gap analysis. Within these publications, 109 distinct infectious diseases were identified in relation to climate change research. A small portion of publications ( n  = 127) assessed multiple diseases within the same study. Authors of the reviewed articles reported that climate change impacted the disease system being assessed in 59% of the articles. Most of the articles (83.9%) which described climate change impacts reported that climate change increased the prevalence, transmission, or suitability for the disease being studied, while 11.5% of studies reported that climate change decreased the prevalence, transmission, or suitability. Only 7.7% of the assessed articles reported no effect of climate change on the disease system being studied. The review revealed that 32.7% of the articles concluded that climate change could “possibly” or “potentially” impact the disease system being assessed (i.e., the authors did not report a definitive pattern).

Research trends

Infectious diseases which originate from cross-species pathogen transmission of animals to humans (i.e., zoonotic diseases) accounted for most of the studies ( n  = 288, 46.4%), significantly more than diseases which do not originate from animal to human cross species transmission ( n  = 253, 40.7%), ( χ 2  = 9.97, P  = 0.002). Infectious diseases which impact humans were well represented within the literature ( n  = 406) ( χ 2 = 114.3, P  = 0.0001), while infectious diseases affecting livestock were less represented ( n  = 152). Only 116 publications assessed diseases affecting wildlife.

The specific conditions most frequently studied from this sample included vector-borne diseases (Fig.  1 ), such as malaria ( n  = 58), dengue fever ( n  = 37), and Lyme disease ( n  = 22) (Fig.  1 ). Vectors most frequently studied were mosquitoes ( n  = 174), ticks ( n  = 51), and flies ( n  = 14) (Fig.  1 ). Frequently studied environmentally transmitted conditions included food and water-borne diseases, such as diarrheal diseases ( n  = 18) and chytridiomycosis ( n  = 10) (Fig.  1 ). Studies also focused on diseases hosted by arthropods ( n  = 189) and humans ( n  = 185) (Fig.  1 ). The third most studied host taxonomic group was non-human mammals ( n  = 47), followed by amphibians ( n  = 19) and birds ( n  = 17) (Fig.  1 ). In terms of study scale, research was conducted at the local, regional, or country levels, with less effort for global-level studies (Fig.  2 ).

Trends in climate change and disease research. Number of publications ( x -axis) from 2015–2020 according to A taxa of host species studied, B transmission type of diseases studied, C vector species studied, and D top 20 most studied diseases from over 100 different diseases studied. Multiple: multiple diseases with multiple transmission types studied in a single article

Bibliometric demographics. A Number of publications ( x -axis) from 2015–2020 when delimited by scale of study. N/A: Studies for which a spatial scale was not applicable (e.g., laboratory-based studies) or for which scale was not specified. B Percentile breakdown of lead author affiliations collated into categories based on the institution’s description (i.e., college or university, governmental organizations or research organization). Other: lead author affiliation institutions which do not fit one of these categories including non-governmental organizations, independent researchers, or private companies not otherwise specified

Publication trends

Bibliometric analysis revealed a greater usage of he/him pronouns for both first and senior authors (Fig.  3 ). We recorded no instances of they/them or other non-binary pronouns by first or senior authors from the articles revised. We also found that study areas and affiliation of lead authors most frequently occurred in the United States, China, the United Kingdom, Canada, and Australia (Figs.  4 , ​ ,5). 5 ). Research effort accounting for the country’s population size showed that countries such as Norway, Australia, and Canada have a higher comparative research effort than other countries (Fig.  4 ). Most lead author affiliations were linked to higher education institutions (i.e., universities or colleges), with fewer publications originating from governmental organizations or independent research institutions (Fig.  2 ). University affiliations were frequently located in the United States (e.g., the University of California, Colorado State University, University of Florida), and in China (e.g., Shandong University) (Fig.  5 ). Funding for papers published in 2020 was largely sourced from federal or national institutions (53.3% of articles) or a combination of federal and academic institutions (26.7% of articles), with most of this funding originating in high income countries such as the United States, Canada, Germany, and the United Kingdom (Supplementary Fig. 1). Information of funding sources from lower income countries was limited, with only one country (Greece) having a GDP below the top 50 of reported counties based on World Bank estimates [ 21 ]. Non-governmental organizations and local agencies made up a modest proportion of funding sources for the total of articles published (20%).

Author pronouns on climate change and infectious disease research. The self-identified pronouns of A first authors and B last (senior) authors of articles on climate change and disease from 2015 to 2020. The disparity between he/him pronoun usage over other pronouns was pronounced for senior authors. Authors’ pronoun usage in public settings may vary from their gender identities

Map of study locations by country. A The geographic representation of where studies were conducted (i.e., country where the data analyzed in the study originated) from 2015–2020 on climate change and infectious disease and B publications that fit the inclusion criteria as a proportion of human population in 2020 (per one million individuals). Population data were collected from the United Nations Population Division [ 26 ]. Darker color represents more publications conducted in or on the corresponding country. Grey indicates that no studies which fit the inclusion criteria were conducted in or on the corresponding countries. Shape file for map creation sourced from DIVA-GIS [ 84 , 85 ]

Map of lead author affiliation origins. The geographic representation of lead author affiliation origins for research on climate change and disease from 2015 to 2020. Darker color represents more publications originating from the corresponding country. Grey indicates that no studies which fit the inclusion criteria were conducted by authors affiliated with the corresponding countries. Blue points indicate the top ten publishing institutions globally for climate change and disease. Shape file for map creation sourced from DIVA-GIS [ 84 , 85 ]

Through this study we have revised the major trends in the current literature on climate change and infectious diseases. Our assessment identified both topical and geographic biases in the climate change and disease research arena. More specifically, we found that there was a notable focus on diseases which impact humans and upon arthropod-borne pathogens. Taxonomic bias, or the emphasis of study on specific organisms [ 27 ], has previously been identified in biodiversity and conservation science research [ 28 – 30 ]. Our results have identified taxonomic biases toward mammalian hosts and arthropod-borne pathogens and in climate change and infectious disease research. When certain taxa are over-represented in various scientific fields it is possible for them to draw both attention and funds away from less understood taxa [ 28 ]. It is possible that taxonomic bias has impacted the study of climate change and infectious disease by skewing research toward specific disease systems, suggesting an anthropocentric research approach potentially influenced by external forces, such as public health funding and disease burden [ 31 , 32 ]. Vector-borne diseases have considerable burden on human health, killing approximately 700,000 people annually [ 33 ]. A research emphasis on diseases affecting humans is, therefore, potentially unsurprising as human health is a driving force behind many research efforts and encompasses a large proportion of research and development funding [ 34 , 35 ]. Other research has shown that societal pressures correlate with taxonomic bias [ 28 ], which could explain why human-only and zoonotic diseases were so heavily studied as well.

Despite the anthropocentric nature of our results, many understudied taxa, such as amphibians, birds, and aquatic invertebrates, have higher risks of extinction due to infectious diseases than humans or other mammals [ 36 – 38 ]. Taxonomic bias in the study of infectious disease is concerning, as a lack of research effort could limit the understanding of diseases systems for threatened or endangered taxa. This in turn limits our capacities to understand how, where, and why diseases emerge in the wild. Risks of climate change impacts on lesser studied groups, such as wildlife and livestock, could still have public health effects due to spillover transmission of unknown pathogens [ 22 , 39 ]. The dearth of research on wildlife diseases could also lead to gaps of knowledge. Infectious diseases may harm ecological balance by reducing wildlife populations and decreasing overall biodiversity [ 40 – 42 ]. A large body of literature shows that ecological imbalances and biodiversity loss have detrimental effects on human health as well [ 39 , 43 – 45 ]. For instance, decreases in diversity of wildlife has been associated with increases risk of hantavirus spillover transmission from rodents to humans [ 46 – 49 ]. Public health efforts to study climate change and human health should consider biodiversity dimensions of spillover transmission for a more holistic ecosystem health approach.

We found that most lead authors were linked to higher-education institutions (i.e., universities or colleges), with fewer publications originating from governmental organizations or independent research institutions (Fig.  2 ). This bias towards academic-based research is not surprising considering that higher-education institutions often focus efforts on research and disseminating knowledge [ 50 ]. This result also indicates a poor active participation of stakeholders in governing bodies on climate change and health research, which could explain the slow progress of international policy on climate change and disease research. It is important to note, however, that most funding for the support of recent research publications originated from federal or national institutions (Additional file 1 : Fig. S1). While funding agencies constitute important stakeholders in the scientific publication process, agendas from funding sources may bias the research topics and discoveries reported [ 51 , 52 ]. For instance, publications with corporate funding are more likely to contribute to the polarization or politicization (i.e., contributing to the tension between political ideologies or identities) of climate change related topics [ 53 ]. We found that most articles reviewed for funding sources did not receive funding from corporate or industry agencies. Government funding is the main driver of science and provides research directions for non-government funding sources [ 52 ]. As such, an increase in government funding for climate change and infectious disease research accounting for environmental justice could transform the landscape of public and private research funding opportunities to reduce the inequities presented here. An increase in funding in the social science aspects of climate change may also facilitate the framing of climate change as a global social challenge, rather than a purely scientific endeavor with limited social legitimacy [ 54 ].

We also found that there was greater usage of he/him pronouns by lead and senior authors across the articles revised, suggesting that more male or male identified authors were present than female or female identified authors (Fig.  3 ). Gender discrepancies in authorship were more notable for senior authorship than for first authorship, which appears to be a general pattern in academic authorship inequity [ 55 ], even with increased authorship by women in recent decades [ 56 ]. Until recently, women or female-identified authors comprise a minority of researchers and trainees in science in general, which has resulted in authorship inequities that are expected to persist for some time [ 56 ]. Gender persistant inequity in authorship is specifically conerning within the field of climate change and infectious disease research due to its cross cutting social implications. Women are expected to experience greater climate change and health impacts as a result of their social and economic positions, and cultural discrimination [ 57 ]. As such it is important that women’s viewpoints and experiences are represented within the scientific literature to develop more effective and inclusive policies for climate change adaptation and mitigation.

In terms of geographic scale and location, we found that most climate change and infectious disease research was conducted at the regional and local scales (Fig.  2 ), suggesting that fine-scale studies dominate the field and our understanding of climate change impacts on human and animal health. Climate change and disease research also occurred principally in temperate areas (e.g., North America, Europe) rather than in tropical areas (e.g., sub-Saharan Africa, Latin America, and Pacific Southeast Asia) (Figs.  4 , ​ ,5). 5 ). This spatial bias is present even when publications were corrected for country population. The research effort discrepancy between temperate vs tropical regions is concerning considering that tropical areas are the most at risk for emerging infectious diseases impacts [ 58 , 59 ]. Tropical areas are also experiencing drastic climate change effects, including reductions in food availability in short periods [ 60 ]. Tropical areas having limited to no climate change and disease research included Latin America, Northern and West Africa, and the Indo-pacific (Figs.  3 , ​ ,4). 4 ). Furthermore, climate change is expected to increase the areas suitable for infectious agents in land and aquatic ecosystems [ 10 , 61 ]. For instance, the aquatic pathogen Vibrio cholerae , the causative agent of cholera, is expected to increase in regions where we found limited research effort [ 61 , 62 ]. Other areas which did not receive substantive research effort include extremely cold Arctic or Subarctic areas of Eurasia (Fig.  4 ). Permafrost regions such as these have recently experienced outbreaks of avian influenza (H5N1) [ 63 ], and previous reviews have identified melting permafrost as a reservoir of potentially viable and uncharacterized pathogens [ 64 ]. As such, a constituted effort to elucidated emerging infectious diseases in these regions should be undertaken to mitigate the risks of disease emergence. The confluence of susceptibility to both climate change impacts and infectious disease suggests a need for research in underrepresented areas reported here. Furthermore, underrepresentation of countries and human communities already disenfranchised and at greater risk for encountering infectious disease amplifies social inequity [ 7 ].

One caveat of our assessment is that publications from lower income or developing countries may not have been indexed in the publication data repositories accessed (i.e., Web of Science and PubMed) due to publication barriers such as language, publication fees, or lack of equitable partnerships or collaborative networks [ 65 – 69 ]. The potential misrepresentation of science from low-income countries highlights a possible equity issues within the dissemination of research which, in turn, could lead to the exclusion of relevant discoveries in the global health agenda [ 68 – 70 ]. A confirmation or publication bias could also be present in our results, as seen by the high number of papers which positively identified a climate change impact on infectious diseases. Previous research has commented on the scientific culture and potential dangers associated with the current emphasis on publishing only “significant” or “positive” results [ 71 – 74 ]. It is possible that researchers were reluctant or unable to publish negative or inconclusive results, thus skewing the conclusions of this sample. Furthermore, while we found that many articles either found a definitive climate change impact, or concluded that climate change could “possibly” or “potentially” impact the disease system being assessed, these findings were based upon the author’s interpretation of their results and may be an exaggerated interpretation of the data. Finally, while we sought to identify the distribution of authorship via author pronoun usage, there could be discrepancies present between the pronouns publicly available for the authors and the gender identities they have privately. This discrepancy is to be expected considering the discriminatory practices in academia against lesbian, gay, bisexual, transgender, and queer (LGBTQ+) scientists [ 75 – 77 ].

We found that both geographic and taxonomic trends were present in recent studies assessing climate change and the burden of infectious disease. The majority of research was focused on vector-borne pathogens and was conducted in well-developed, high-income countries with temperate climates, neglecting directly-transmitted diseases in tropical regions. The anthropocentric signal in research effort may contribute to a lack of understanding of climate change effects on wildlife systems. The underrepresentation of some taxonomic groups of pathogens and hosts, pathogen transmission types, and geographic areas should be of global health concern, as areas and diseases neglected may become sources of emerging zoonotic diseases. An ecosystem-based framework to study disease responses to climate change could mitigate topical and taxonomic biases identified here. Viral zoonoses outbreaks at the local level in underrepresented countries such as Madagascar, Saudi Arabia, and Indonesia have led to prolific human epidemics of plague, Middle East respiratory syndrome, and cholera in recent years [ 78 ], highlighting the need for more research in regions underrepresented in the literature. The recent coronavirus disease pandemic also highlights the need for more research on directly transmitted pathogens circulating in wildlife [ 79 ]. Furthermore, research is still needed to understand the linkages between patterns of research funding with climate change and infectious disease studies. Understanding the funding landscape (e.g., agencies prioritizing certain regions, diseases, and topics) could further elucidate the relationship between research bias, research equity, and funding allocation.

The impact of climate change research on intergovernmental policy and vice versa is both tractable and increasingly important [ 80 , 81 ]. Policy changes to address the biases presented here, including the diseases studied, areas, and identities of leading authors, should be prioritized by both funding agencies and the scientific community. Policy change could include, for example, the prioritization of infectious disease research and surveillance at the human-wildlife interface within the context of climate change, funding prioritizing scientists from minority groups, and neglected geographic regions. Addressing research inequity will help build human capacity, surveillance, and scientific infrastructure to better prepare and strengthen the global health response to climate change threats [ 82 ]. Furthermore, research foundations in high-income countries should implement and maintain inclusive-collaboration practices to value contributions by local scientists in countries underrepresented in this review to advance research equity as a means towards effective prevention of future emerging diseases from their sources. Building political and social support behind climate change and infectious disease research will be essential under the expected rates of climatic variation in the near future [ 83 ]. In conclusion, there is an urgent need to increase research effort for neglected disease systems and geographies, and there is a need to re-examine aspects of environmental justice from the scientists leading these studies to the local beneficiaries for the advancement of infectious diseases research in the context of climate change.

Acknowledgements

Authors thank Sarah M. Karpanty, Mark Ford, Steven N. Winter, Mariana Castaneda-Guzman, Diego Soler-Tovar, Caroline Ilse, Abigail Parch, Tabatha Gentry, David Treanor, Alma Talcott, and Victor Jose Catalan who contributed greatly to the completion of this work.

Abbreviation

Author contributions

Both authors designed and wrote the first draft of this commentary. All authors contributed to the development, review, and approval of the last version of this article. All authors read and approved the final manuscript.

This study was supported by the National Science Foundation award: Human–Environment and Geographical Sciences Program (2116748), the Institute for Critical Technology and Applied Science, Virginia Tech: ICTAS-JFP-2022-2023 program, and the Virginia Tech College of Natural Resources and Environment Environmental Security Grant program.

Availability of data and materials

Declarations.

Consent was obtained from Luis E. Escobar for the publication of any data of images herein.

The authors declare that there are no competing interests.

Article  

• Volume 20, issue 8
• CP, 20, 1817–1836, 2024
• Peer review
• Related articles

South Asian summer monsoon enhanced by the uplift of the Iranian Plateau in Middle Miocene

Gilles ramstein, tianjun zhou.

• Final revised paper (published on 13 Aug 2024)
• Supplement to the final revised paper
• Preprint (discussion started on 26 Feb 2024)
• Supplement to the preprint

Interactive discussion

Status : closed

This manuscript is well written and tires to clarify the role of the Himalaya uplift, Iranian Plateau (IP) uplift and atmospheric CO2 on SASM evolution in the mid-Miocene. They suggest IP uplift to be the main factor causing enhancement of SASM. Overall, I do recommend this study for publication after some revisions. Some suggestions and comments are listed below.

• There are several uncertainties in the Middle Miocene paleogeographic boundary conditions (Frigola et al., 2018) used in the simulation, such as the eastern Tethys seaway and Greenland-Scotland Ridge are deep water gateways, and the Bohai Bay and Yellow Sea basins in East Asia are shallow sea environments, which are inconsistent with many geological records (e.g., Sun J.M. et al., 2021, Paleo-3; Tan M.X. et al., 2020, Marine and Petroleum Geology; Stoker M.S. et al., 2005, Marine and Petroleum Geology). Some uncertainties of the boundary conditions are discussed in Section 5.3.
• In this study, authors lumped together all the mountain ranges west of the Himalayan, including the Hindu Kush and Pamir as the IP. The uplift history of the Iranian plateau, Hindu Kush, Pamir and East Africa remains controversial. Some studies suggested that the IP and East Africa began to uplift in the late Oligocene–early Miocene and rapidly uplifted in the middle–late Miocene (e.g., Macgregor, 2015, Journal of African Earth Sciences; Mouthereau et al., 2012). Uncertainties of topographic uplift can be appropriately added to the discussion.
• Table 2: there are some errors and inappropriate references. For example, Zhuang et al. (2017) interpreted the late Miocene (11–10 Ma) ocean cooling as representing the establishment of monsoonal upwelling in the western Arabian Sea, which may not be suitable as evidence for the enhancement of SASM in the Middle Miocene. Betzler et al. (2016): “deposit” changes to “sedimentary and geochemical record”. Bialik et al. (2020): “Precip” changes to “wind”; Ai et al. (2021): “Precip” changes to “wind”. In these papers, authors mainly talked about wind/monsoonal upwelling, not precipitation.
• Table 2: “sample” changes to “proxies”.
• Lines 507 and 523: “geography” changes to “land-sea distribution”.

Dear Referee,

Thank you very much for your positive recommendation of our manuscript. We truly appreciate your time and effort in reviewing it. Your comments help us to improve  the quality of this paper. The responses point by point to your comments are in the attached document.

Best regards,

Yan Zhao on behalf of AC

  This manuscript discusses the enhancement of the South Asian summer monsoon during the Miocene and explores the drivers of that change. By using an ocean-atmosphere global climate model, the response of the South Asian summer monsoon to the uplift of the Iranian Plateau coincides with observed precipitation and wind speeds compared to reconstructions. The uplift of the Iranian Plateau is found to play a dominant role in the enhancement of the South Asian summer monsoon, especially in north-west India. The research work carries out a large number of simulation experiments, a large amount of analysis and simulation, the article is readable, and the findings are important for understanding the long-term evolution of the South Asian monsoon since the Miocene. It is recommended for publication after detailed revision of the following comments.

• The authors have emphasised that the time period of the study is MMIO, 17-12 Ma, and from the authors' very limited collection of record sites, it appears that the age of all the records is concentrated in the 14-12 Ma range, and the trend of the state of the South Asian monsoon indicated by these sites is "increasing".

Here, the authors need to be more explicit about the motivation for the Iranian Plateau, Himalayan and CO 2 modelling. The reasons are as follows. Firstly, according to the general concept, the atmospheric CO 2 concentration peaked around 15 Ma in the Miocene and then declined (e.g., Toward a Cenozoic history of atmospheric CO2, THE CENOZOIC CO 2 PROXY INTEGRATION PROJECT (CENCO2PIP) CONSORTIUM 2023). Therefore, it is unlikely that CO 2 is responsible for the intensification of the monsoon during this period from 14 to 12 Ma. Secondly, the authors have cited and elaborated that the Himalayas have reached their present height at 15 Ma, which also seems unlikely to be a factor in the 14~12 Ma monsoon intensification, and thus seems to be excluded. Finally, the authors mention that the Iranian Plateau uplifted at 15~12 Ma, but do not give clearer paleo-height constraints, and there is a lack of geographically reconstructed paleo-height evidence for the study.

The authors need to explicitly give the above information. This relates to the design rationale for the height of the Iranian Plateau in the authors' experimental design, as well as the attribution of monsoon intensification in the geological record.

• The authors excessively cite previous research findings in the experimental analysis section, e.g., P9L227~L228, P11L256~L257, and P14L318~319. which tends to confuse the reader: is this the result of your experiment or the result of previous work? It may even lead to the misunderstanding: your experiment is exactly the same model and experimental design as the previous work? It needs to be revised.

Specific issues:

P4L79~82 Therefore, it is worthy to revisit the response of the SASM to the IP and HM uplift under Miocene boundary conditions with a fully coupled Ocean-Atmosphere Global Climate Model (OAGCM) and investigate the underlying physical processes.

The authors emphasise the coupled experiments in the introduction, but they do not mention the advantages of the coupled ocean-air experiments throughout the analysis and discussion. In addition, considering that each experiment only runs for 200 years and that thousands of years of credits are generally required to carry out a coupled experiment simulation, 200 years is too short a credit for a coupled experiment simulation. Considering the high horizontal resolution used in all experiments, 200 years seems to be acceptable. However, whether the authors have considered biases due to SST disequilibrium or uncertainties in the conclusions of the study due to additional feedbacks would be best discussed briefly in the Discussion section.

P6L136~138 Is the topographic palaeoheight design of the Iranian Plateau supported by relevant cited literature?

P7L182~183 (2) Webster-Yang Index (WYI; Webster and Yang, et al., 1992): meridional wind stress 183 shear between 850 hPa and 200 hPa averaged over 40-110°E, 0-20°N during June-August.

Did the authors use the WY index with the same selected area as in the original work? Did you take into account the uncertainty associated with the index's indication of monsoon circulation due to the inconsistency of the land and sea distribution in the Middle Miocene with the modern era, and did you correct the computed area? Please provide a brief description.

P2L22: Global Climate Model 22 CESM1.2 through a series of 12 sensitivity experiments, the authors stated 12 sets of experiments, while in Table 1 (P32L845) only 10 sets are shown. Please change!

P17L367 Fig7 extra experiment 560ppm 800ppm, but the experiment description clearly states that.

P7L182: Webster and Yang, et al., 1992 is incorrectly cited; it should be Webster and Yang, 1992.

P12L269: 722B, monsoonal signal is absent in IPHM0 (Fig.3d). What is IPHM0? Is it a writing error?

P16L6 The figure is labelled IPHM0 as well?

P18L399~400 north Africa to North Africa

P18L402 2 Medina et al., 2010?The literature is not cited.

P19L414 Regarding to change to Regarding or Regard to.

P21L463 bewteen to between. Words are spelled incorrectly, please double-check the entire text

Thank you very much for your positive recommendation of our manuscript. We truly appreciate your time and effort in reviewing it. Your comments and valuable inputs help us to improve  the quality of this paper. The point-by-point responses to your comments are in the attached document.

The manuscript uses climate modeling to compare the effect from the uplift of the Himalaya (HM) and Iranian Plateau (IP) and the increase of atmospheric CO2 to the intensified SASM during the Middle Miocene (17-12 Ma) with coupled atmosphere-ocean global climate model CESM. The results indicate the IP uplift plays a dominant role in the intensification of the SASM, and the effect of the HM uplift is confined to the range of the HM and its vicinity. In the case of extremely atmospheric CO2 variation, the effects of two factors are comparable in the SASM region. Although some results are similar to previse modeling studies, this study compares the effect from topographic forcing and atmospheric CO2 variation, which are also interesting and important. However, there are still several limitations. Particularly, because the main purpose of this study is to compare the effect from topographic forcing and atmospheric CO2 variation, the uncertainties in used topographic change and CO2 variation should be mentioned, these uncertainties may affect the main conclusions of this study.

Lines 60-67, Can you give an estimate of the raised height of the IP during the Middle Miocene? Lines 85-87, during mid- to late Miocene, the CO2 decreases according to the reconstruction, why increased CO2 is considered here? Line 111, is the ice sheet model active during the simulation? Lines 154 and 175, it’s better to show the times series of the surface temperature and net top of the atmosphere radiation imbalance in these experiments. Lines 159-160, why the reference height is different between HM and IP? Lines160-164, the experimental design for the uplift of HM and IP from flat to 100% is too idealized compared to the geological evidence (Lines 53-56, 60-67) during the Middle Miocene. Lines 180-181, annual or seasonal precipitation? Figure 1, in the experimental design, how do the authors determine the extent of the HM and IP? The extent of the HM looks larger in Fig. S2. Lines 228-229, it’s better to point out the inconsistencies between model results and records. How about the ODP 359 and 758? Line 279, where is the ‘core’ region? Line 307, “to its west” should be “to its east”? Line 399, “southeasterly” should be “southwesterly”? Line 404, from Figure 9d, LCL is increased over the IP. Line 468, where is “American region”? Lines 484-486, the different used extent of the HM between these studies can explain the disagreement the author mentioned. Line 506, the uncertainties in used topographic change and CO2 variation should be discussed. Line 539, Zhang et al., 2017 is not a modeling study. Table 2 No 3, the change in ODP 722 at 11 Ma is out of the Middle Miocene (17-12 Ma).

Thank you very much for your positive recommendation of our manuscript. We truly appreciate your time and effort in reviewing it. Your comments and valuable inputs help us to improve  the quality of this paper. The responses point by point to your comments are in the attached document.

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Average count of the number of days per year in which the highest maximum temperature within each county of the UK has exceeded 28°C – indicating a ‘hot’ day – covering the periods 1961-1990, 1991-2020, 2014-2023 and actual counts for year 2023. The scale extends to 20 days. Counts are based on 1km resolution gridded climate data from the HadUK-Grid dataset.

Furthermore, the proportional increase across all counties over time is much more pronounced as the temperature threshold gets higher. The number of ‘pleasant’ days (daily maximum 20°C) has increased by 41% for the most recent decade (2014-2023) compared to 1961-1990. The number of ‘warm’ days (25°C) has increased by 63%, ‘hot’ days (28°C) have more than doubled and ‘very hot’ days (30°C) have more than trebled over the same period.

Although rainfall has a much higher natural variability than temperature, it is still possible to identify an increasing frequency of the wettest days over time too. By taking the top 5% of wettest days during the 1961-1990 averaging period it is possible to see how frequent these very wet days have been in the most recent decade (2014-2023).

The most recent decade has had around 20% more days of exceptional rainfall compared to the 1961-1990 averaging period. While there is no significant signal for this change being more pronounced in a specific area of the UK, overall, this analysis clearly shows an increase in the number of very wet days in the UK’s climate in recent years compared to what was observed just a few decades ago.

Average number of days per year for 1961-1990, 1991-2020 and 2014-2023 and actual number of days for 2023 in which the daily rainfall total for each county of the UK has exceeded the 95th percentile daily rainfall for that county based on the period 1961-1990. The 95th percentile corresponds to 1 in 20 days or 18.3 days per year, by definition – as shown on the map for 1961-1990. The legend scale extends to 35 days. Daily totals are based on the average value across each county.

Lead author and Met Office climate scientist, Mike Kendon, said: “Our new analysis of these observations really shines a light on the fastest changing aspects of our weather as a consequence of climate change. Long term averages can be difficult for people to relate to, but what we are showing here is the notable change in frequencies of extreme weather that can have a real impact on people’s lives.

“2023 was another year of interesting and at times significant weather. From the UK’s record warmest June by a wide margin, to a significant September heatwave and the most active start to the storm naming season culminating in serious flooding problems in the autumn, it was another year of typically varied weather. But underlying this natural variability is a continuing and increasing influence of climate change which is influencing the weather we experience.”

Attributing our changing climate

A number of climate attribution studies were completed by Met Office scientists through 2023. These studies examine the influence of human activity on our climate by using computer models to compare the likelihood of the same event happening in a ‘natural’ environment (without the effects of man-made greenhouse gas emissions) against the likelihood in our current climate.

Attribution studies were conducted on the record breaking June monthly temperature , the joint warmest September on record and the year as a whole being the second warmest on record for the UK. All of these studies found that human induced climate change had made them much more likely to happen than they would have been in a natural climate.

Professor Liz Bentley, Chief Executive of the Royal Meteorological Society, said: “This report is the authoritative annual summary of the UK climate published as a special supplement in our International Journal of Climatology. It not only helps to highlight the latest knowledge on our changing climate but also enables us to understand the trends, risks and impacts to help inform how we will need to adapt, now and in the future.

“The new analysis of days that are classified as ‘hot’ or having ‘exceptional rainfall’ highlights the increased frequency in high impact extremes we are already experiencing in the UK, and the attribution studies help to understand how human activities, such as burning fossil fuels, are making these extreme events much more likely to happen as our climate continues to change.”

Year in review

The report gives a comprehensive assessment of the UK climate through 2023 and uses recent and past climate averaging periods to put the months, seasons and year as a whole into context.

2023 was the UK’s second warmest, seventh wettest and 22nd sunniest year in records dating back to 1884, 1836 and 1910 respectively. There was of course regional variability, with Wales and Northern Ireland recording their warmest years on record for example.

March, July, October and December 2023 were all top-ten wettest months in the UK monthly rainfall series from 1836; the first year this has happened for four separate months in the same calendar year. February, May, June and September 2023 were all ranked in the top-ten warmest months for the UK in the monthly series from 1884.

The report shows a huge increase in top-ten warmest monthly, seasonal and annual records for counties of the UK in the most recent decade 2014-2023, compared to virtually no top-ten coldest records. For the UK overall, the most recent record warmest (or equal warmest) months for UK average monthly temperature have been May 2024, September 2023, June 2023, December 2015 and April 2011, whereas the last record cold month was December 2010.

Although changes in rainfall are less pronounced, they also indicate a recent increase in top-ten wettest monthly, seasonal and annual records but no obvious trend in top-ten driest records.

The most recent decade (2014-2023) has been on average 0.42°C warmer than the 1991-2020 average and 1.25°C warmer than 1961-1990. The change in UK annual mean temperature is broadly in line with global temperature changes over land. UK winters for the most recent decade (2014-2023) have been 9% wetter than 1991-2020 and 24% wetter than 1961-1990, with smaller increases in summer and autumn and none in spring.

Significant weather events in 2023

Significant weather events through 2023 include the record warm June, coinciding with a significant marine heatwave. 30°C was recorded in September in the UK on seven consecutive days for the first time on record, and unusually, the hottest day of the year was recorded in September (33.5°C on 10 September).

Scotland had its wettest 2-day period on record on 6 to 7 October in a daily series from 1891, 65.9mm, 39% of the 1991-2020 October whole-month average.

The 2023-2024 storm season had its most active start with respect to the number of named storms since storm naming was introduced in 2015, with seven named storms (Agnes to Gerrit) from September to December. Storm Babet brought widespread prolonged and heavy rainfall and was the UK’s most impactful weather event of the year. Eastern Scotland – where a red warning for rain was issued – was particularly badly affected due to an unusual south-easterly flow with increased rainfall across high ground. Winds from storm Ciarán on 2 November had the potential to be as severe as from the ‘Great Storm’ of 16 October 1987, but the strongest winds missed the UK to the south.

The UK recorded its wettest September to December period since 2000 due to persistently wet and unsettled weather, including the sequence of named storms from Agnes to Gerrit.

Sea level change

A section of the report authored by the National Oceanography Centre (NOC) assesses sea level change around the UK.

Data from the tide gauge at Newlyn, one of the longest available records around the UK, continues to show that sea level is rising, with 2023 the highest year on record for annual mean sea level since records began. Ongoing problems with observations mean an accurate assessment for the whole of the UK cannot be produced, but other sites around the UK also had their highest or second highest year on record.

The rate of sea level rise at Newlyn also continues to increase, with most recent trends estimating a rise of 4.6 ± 0.9 mm per year (1993-2023).

Dr Svetlana Jevrejeva is a sea level scientist at NOC, she said: “ Tide gauge records provide robust observational evidence that sea level around the UK continues to rise due to increased rate of ice loss from the Greenland and Antarctic ice sheets, as well as continued glacier mass loss and warming of the ocean. The sea level record from Newlyn, one of our longest records starting in 1915, showed exceptionally high periods in 2023 especially in the second half of the year, which could lead to the greater impacts from storm surges observed during Autumn/Winter. In 2023 there were 16 extreme storm surge events, affecting coastal communities and infrastructure. ”

The report also includes a section on phenology, the study of seasonal changes in plants and animals from year to year, authored by the Woodland Trust . It summarises the wider citizen science project run by the Woodland Trust called ‘Nature’s Calendar’.

Biological indicators for spring 2023 were generally near-average or later compared to the 1999–2022 baseline. Insect activity, in particular, appeared later. However, Hazel had its earliest flowering date in a series from 1999.

Bare tree dates in autumn were a few days later than the 1999–2022 baseline due to warm September temperatures and a generally mild autumn.

Overall, the 2023 leaf-on season was slightly longer than the 1999–2022 baseline, although the shorter lawn cutting season might be attributed to a complex mixture of low temperatures in early March inhibiting growth and wet grass in autumn discouraging late cutting.

Citizen Science Officer at the Woodland Trust, Dr Judith Garforth, said: “In the UK, phenology data are provided by volunteers who observe their local surroundings and record the first occurrence of key seasonal indicators across different wildlife species.

“2023 was a near average or late year for most events, with the exception of hazel flowering, which was 12 days ahead of the baseline, and elder first leafing. This illustrates how the effect of weather on UK wildlife is complex – the impact is unique for each species and seasonal event, and of course weather can be very localised too. That's why it's so important that we have volunteers all over the UK monitoring wildlife on their doorsteps - without their help we wouldn't have this valuable insight.” 

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Where the world’s largest companies stand on nature

Nature’s health, like climate change, is now recognized as an urgent global risk. 1 The global risks report 2022, 17th edition , World Economic Forum, January 11, 2022. In purely economic terms, half of all economic activity is moderately or highly dependent on natural capital —the world’s stock of natural assets. 2 Nature risk rising: Why the crisis engulfing nature matters for business and the economy , World Economic Forum, January 19, 2020. Governments and intergovernmental organizations are increasingly calling attention to the nature crisis, 3 “Nature positive” language was included during the most recent G7 and G20 meetings, at the 2021 United Nations Climate Change Conference (COP26), and by the Network for Greening the Financial System (NGFS), representing 114 central banks and financial supervisors. while a growing number of businesses are making pledges related to biodiversity or becoming “nature positive.” 4 Under the Finance for Biodiversity Pledge, 103 financial institutions have committed to set targets on their impacts on nature and periodically report on progress. At the same time as COP26, nearly 100 high-profile UK companies committed to becoming “nature positive,” joining companies such as GSK and Holcim. See also, “A Global Goal for Nature: Nature Positive by 2030,” Nature Positive, accessed August 2022. Industry-led organizations, such as the Taskforce on Nature-related Financial Disclosures (TNFD) , are setting the framework for how businesses report and act on nature-related risks and opportunities. 5 Others, such as the Science Based Targets Network (SBTN), which created the gold standard for target setting for carbon, are developing guidelines to help companies set science-based targets for nature.

Nature-related commitments remain low

About the authors.

This article is a collaborative effort by Julien Claes, Ivo Erben, Duko Hopman , Kartik Jayaram , Joshua Katz , and Tucker Van Aken, representing views from McKinsey’s Sustainability Practice.

Companies are in the early stages of committing to a broad set of nature-related goals (Exhibit 1). A high-level review of the Fortune Global 500 companies shows that most companies have climate-related targets (83 percent) or at least acknowledge climate change (an additional 15 percent). 6 This review includes 460 of the Fortune Global 500 companies, as there was not sufficient public information to determine the goals of 40 companies. Across other dimensions of nature, however, targets and acknowledgements are far lower (see sidebar, “Our methodology”).

Our methodology

Several studies have looked at the consistency and quality of company commitments to protect against biodiversity loss, 1 Integrating biodiversity into a risk assessment framework , Moody’s, May 26, 2021; Prue Addison et al., “Are corporate biodiversity commitments consistent with delivering ‘nature-positive’ outcomes? A review of ‘nature-positive’ definitions, company progress and challenges,” preprint, SocArXiv, July 23, 2022. but this review sought to understand how leading companies around the world are considering nature across multiple dimensions. This review used the planetary boundaries framework, developed by the Stockholm Resilience Centre, as the basis of the dimensions of nature used. 2 “For sustainable business, ‘planetary boundaries’ define the new rules,” Global Commons Alliance, November 18, 2020.

To identify commitments for each company, our team conducted an open-ended press search, reviewed publicly available statements, and leveraged company filings. Search terms included the words outlined in the chart above as the starting point but also included close synonyms (for example, for biodiversity loss, “habitat,” “ecosystem,” and other terms), as well as individual judgment. For each company, we categorized each dimension of nature based on whether our review revealed the presence of a target and the company’s acknowledgment of its importance, an acknowledgement of importance alone, or no target or meaningful acknowledgment at all, as further described below. Forty companies were excluded due to a lack of data.

• Target. The company has set a quantified, time-bound, and outcome-oriented target across the entire organization. A commitment to spend a certain dollar amount without a target outcome and/or time period did not count as a target. The quality and materiality of the targets were outside the scope of this review.
• Acknowledgement. The company refers to that dimension of nature and either acknowledges its importance or reports ad hoc steps or initiatives it has taken to mitigate nature loss, without specifying a concrete goal.
• None. The company does not meaningfully mention the dimension at the corporate level.

This analysis should be considered directionally, as not all companies adhered to clear reporting standards, and data availability were often sparse. It is also possible that the press review missed targets or acknowledgements.

For instance, although 51 percent of companies acknowledge biodiversity loss in some way, only 5 percent have set quantified targets in addition to that acknowledgment. Meanwhile, some dimensions of nature, such as soil nutrient pollution, show up much less frequently in public acknowledgements. This may not be surprising—while decades of experience have helped companies understand how to address climate change, corporate understanding of nature is still nascent.

There is no standardized approach to measuring natural capital and ecosystem services, 7 The TNFD nature-related risk and opportunity management and disclosure framework: Beta v0.2 , Taskforce on Nature-related Financial Disclosures, June 2, 2022. and many companies may not know what steps to take beyond simply acknowledging the challenge. This potential explanation is echoed by our own experience working with clients globally on sustainability topics: while corporate leaders increasingly acknowledge the importance of nature, limited understanding of how to structurally and responsibly engage on the topic of nature degradation prevents many from making quantified commitments.

Considering all dimensions of nature

Among companies that have nature-related targets, most are only considering one dimension of nature—most often climate.

Another cut of the same data highlights the fact that, among companies that have nature-related targets, most are only considering one dimension of nature—most often climate (in a context of natural climate solutions). Sixteen percent of the Fortune Global 500 have set targets against three or more dimensions of nature, and no companies have targets against the six dimensions we looked at in this analysis (Exhibit 2). While one explanation for this could be that companies focus on what matters most in relation to their activities, expectations are rising: for example, the initial guidance of the Science-Based Targets for Nature (SBTN) initiative suggests that companies have “a comprehensive understanding of [their] impacts and dependencies on nature.” 8 “Science-Based Targets for Nature: Initial Guidance for Business,” Science-Based Targets Network, September 2020.

Some sectors are ahead of others in setting targets

A sector-level cut of the data reveals that, as a proportion of the overall sector, transportation leads on overall target setting (Exhibit 3). This is likely due to a combination of the sector facing climate transition risks , regulatory focus on transportation sector carbon emissions, 9 For instance, 75 percent of countries that have submitted nationally determined contributions (NDCs) as part of their Paris Agreement commitments have transportation sector targets; Cornie Huizenga and Karl Peet, “Transport and climate change: How nationally determined contributions can accelerate transport decarbonization,” NDC Partnership, accessed August 2022. and a shift to renewable energy , among other factors. And although the sample is small, agriculture leads on setting three or more targets, likely due to increased attention to water and nutrient pollution concerns, in addition to climate , compared with other sectors.

Looking ahead to this year’s UN Biodiversity Conference (COP 15), governments will agree to a new set of goals for nature to ensure that “the shared vision of living in harmony with nature is fulfilled.” 10 Biodiversity Conference (COP 15) Overview, United Nations Environment Programme, accessed August 2022. Now is the time to consider what will be needed to spur broad and effective nature-based action among companies. Corporate leaders will need to understand the shape of the challenge ahead, risks to their operations and opportunities for business building, what the key targets are, and what actions their companies can take.

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