literature review on climate change pdf

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A review of the global climate change impacts, adaptation, and sustainable mitigation measures

Kashif abbass.

1 School of Economics and Management, Nanjing University of Science and Technology, Nanjing, 210094 People’s Republic of China

Muhammad Zeeshan Qasim

2 Jiangsu Key Laboratory of Chemical Pollution Control and Resources Reuse, School of Environmental and Biological Engineering, Nanjing University of Science and Technology, Xiaolingwei 200, Nanjing, 210094 People’s Republic of China

Huaming Song

Muntasir murshed.

3 School of Business and Economics, North South University, Dhaka, 1229 Bangladesh

4 Department of Journalism, Media and Communications, Daffodil International University, Dhaka, Bangladesh

Haider Mahmood

5 Department of Finance, College of Business Administration, Prince Sattam Bin Abdulaziz University, 173, Alkharj, 11942 Saudi Arabia

Ijaz Younis

Associated data.

Data sources and relevant links are provided in the paper to access data.

Climate change is a long-lasting change in the weather arrays across tropics to polls. It is a global threat that has embarked on to put stress on various sectors. This study is aimed to conceptually engineer how climate variability is deteriorating the sustainability of diverse sectors worldwide. Specifically, the agricultural sector’s vulnerability is a globally concerning scenario, as sufficient production and food supplies are threatened due to irreversible weather fluctuations. In turn, it is challenging the global feeding patterns, particularly in countries with agriculture as an integral part of their economy and total productivity. Climate change has also put the integrity and survival of many species at stake due to shifts in optimum temperature ranges, thereby accelerating biodiversity loss by progressively changing the ecosystem structures. Climate variations increase the likelihood of particular food and waterborne and vector-borne diseases, and a recent example is a coronavirus pandemic. Climate change also accelerates the enigma of antimicrobial resistance, another threat to human health due to the increasing incidence of resistant pathogenic infections. Besides, the global tourism industry is devastated as climate change impacts unfavorable tourism spots. The methodology investigates hypothetical scenarios of climate variability and attempts to describe the quality of evidence to facilitate readers’ careful, critical engagement. Secondary data is used to identify sustainability issues such as environmental, social, and economic viability. To better understand the problem, gathered the information in this report from various media outlets, research agencies, policy papers, newspapers, and other sources. This review is a sectorial assessment of climate change mitigation and adaptation approaches worldwide in the aforementioned sectors and the associated economic costs. According to the findings, government involvement is necessary for the country’s long-term development through strict accountability of resources and regulations implemented in the past to generate cutting-edge climate policy. Therefore, mitigating the impacts of climate change must be of the utmost importance, and hence, this global threat requires global commitment to address its dreadful implications to ensure global sustenance.

Introduction

Worldwide observed and anticipated climatic changes for the twenty-first century and global warming are significant global changes that have been encountered during the past 65 years. Climate change (CC) is an inter-governmental complex challenge globally with its influence over various components of the ecological, environmental, socio-political, and socio-economic disciplines (Adger et al.  2005 ; Leal Filho et al.  2021 ; Feliciano et al.  2022 ). Climate change involves heightened temperatures across numerous worlds (Battisti and Naylor  2009 ; Schuurmans  2021 ; Weisheimer and Palmer  2005 ; Yadav et al.  2015 ). With the onset of the industrial revolution, the problem of earth climate was amplified manifold (Leppänen et al.  2014 ). It is reported that the immediate attention and due steps might increase the probability of overcoming its devastating impacts. It is not plausible to interpret the exact consequences of climate change (CC) on a sectoral basis (Izaguirre et al.  2021 ; Jurgilevich et al.  2017 ), which is evident by the emerging level of recognition plus the inclusion of climatic uncertainties at both local and national level of policymaking (Ayers et al.  2014 ).

Climate change is characterized based on the comprehensive long-haul temperature and precipitation trends and other components such as pressure and humidity level in the surrounding environment. Besides, the irregular weather patterns, retreating of global ice sheets, and the corresponding elevated sea level rise are among the most renowned international and domestic effects of climate change (Lipczynska-Kochany  2018 ; Michel et al.  2021 ; Murshed and Dao 2020 ). Before the industrial revolution, natural sources, including volcanoes, forest fires, and seismic activities, were regarded as the distinct sources of greenhouse gases (GHGs) such as CO 2 , CH 4 , N 2 O, and H 2 O into the atmosphere (Murshed et al. 2020 ; Hussain et al.  2020 ; Sovacool et al.  2021 ; Usman and Balsalobre-Lorente 2022 ; Murshed 2022 ). United Nations Framework Convention on Climate Change (UNFCCC) struck a major agreement to tackle climate change and accelerate and intensify the actions and investments required for a sustainable low-carbon future at Conference of the Parties (COP-21) in Paris on December 12, 2015. The Paris Agreement expands on the Convention by bringing all nations together for the first time in a single cause to undertake ambitious measures to prevent climate change and adapt to its impacts, with increased funding to assist developing countries in doing so. As so, it marks a turning point in the global climate fight. The core goal of the Paris Agreement is to improve the global response to the threat of climate change by keeping the global temperature rise this century well below 2 °C over pre-industrial levels and to pursue efforts to limit the temperature increase to 1.5° C (Sharma et al. 2020 ; Sharif et al. 2020 ; Chien et al. 2021 .

Furthermore, the agreement aspires to strengthen nations’ ability to deal with the effects of climate change and align financing flows with low GHG emissions and climate-resilient paths (Shahbaz et al. 2019 ; Anwar et al. 2021 ; Usman et al. 2022a ). To achieve these lofty goals, adequate financial resources must be mobilized and provided, as well as a new technology framework and expanded capacity building, allowing developing countries and the most vulnerable countries to act under their respective national objectives. The agreement also establishes a more transparent action and support mechanism. All Parties are required by the Paris Agreement to do their best through “nationally determined contributions” (NDCs) and to strengthen these efforts in the coming years (Balsalobre-Lorente et al. 2020 ). It includes obligations that all Parties regularly report on their emissions and implementation activities. A global stock-take will be conducted every five years to review collective progress toward the agreement’s goal and inform the Parties’ future individual actions. The Paris Agreement became available for signature on April 22, 2016, Earth Day, at the United Nations Headquarters in New York. On November 4, 2016, it went into effect 30 days after the so-called double threshold was met (ratification by 55 nations accounting for at least 55% of world emissions). More countries have ratified and continue to ratify the agreement since then, bringing 125 Parties in early 2017. To fully operationalize the Paris Agreement, a work program was initiated in Paris to define mechanisms, processes, and recommendations on a wide range of concerns (Murshed et al. 2021 ). Since 2016, Parties have collaborated in subsidiary bodies (APA, SBSTA, and SBI) and numerous formed entities. The Conference of the Parties functioning as the meeting of the Parties to the Paris Agreement (CMA) convened for the first time in November 2016 in Marrakesh in conjunction with COP22 and made its first two resolutions. The work plan is scheduled to be finished by 2018. Some mitigation and adaptation strategies to reduce the emission in the prospective of Paris agreement are following firstly, a long-term goal of keeping the increase in global average temperature to well below 2 °C above pre-industrial levels, secondly, to aim to limit the rise to 1.5 °C, since this would significantly reduce risks and the impacts of climate change, thirdly, on the need for global emissions to peak as soon as possible, recognizing that this will take longer for developing countries, lastly, to undertake rapid reductions after that under the best available science, to achieve a balance between emissions and removals in the second half of the century. On the other side, some adaptation strategies are; strengthening societies’ ability to deal with the effects of climate change and to continue & expand international assistance for developing nations’ adaptation.

However, anthropogenic activities are currently regarded as most accountable for CC (Murshed et al. 2022 ). Apart from the industrial revolution, other anthropogenic activities include excessive agricultural operations, which further involve the high use of fuel-based mechanization, burning of agricultural residues, burning fossil fuels, deforestation, national and domestic transportation sectors, etc. (Huang et al.  2016 ). Consequently, these anthropogenic activities lead to climatic catastrophes, damaging local and global infrastructure, human health, and total productivity. Energy consumption has mounted GHGs levels concerning warming temperatures as most of the energy production in developing countries comes from fossil fuels (Balsalobre-Lorente et al. 2022 ; Usman et al. 2022b ; Abbass et al. 2021a ; Ishikawa-Ishiwata and Furuya  2022 ).

This review aims to highlight the effects of climate change in a socio-scientific aspect by analyzing the existing literature on various sectorial pieces of evidence globally that influence the environment. Although this review provides a thorough examination of climate change and its severe affected sectors that pose a grave danger for global agriculture, biodiversity, health, economy, forestry, and tourism, and to purpose some practical prophylactic measures and mitigation strategies to be adapted as sound substitutes to survive from climate change (CC) impacts. The societal implications of irregular weather patterns and other effects of climate changes are discussed in detail. Some numerous sustainable mitigation measures and adaptation practices and techniques at the global level are discussed in this review with an in-depth focus on its economic, social, and environmental aspects. Methods of data collection section are included in the supplementary information.

Review methodology

Related study and its objectives.

Today, we live an ordinary life in the beautiful digital, globalized world where climate change has a decisive role. What happens in one country has a massive influence on geographically far apart countries, which points to the current crisis known as COVID-19 (Sarkar et al.  2021 ). The most dangerous disease like COVID-19 has affected the world’s climate changes and economic conditions (Abbass et al. 2022 ; Pirasteh-Anosheh et al.  2021 ). The purpose of the present study is to review the status of research on the subject, which is based on “Global Climate Change Impacts, adaptation, and sustainable mitigation measures” by systematically reviewing past published and unpublished research work. Furthermore, the current study seeks to comment on research on the same topic and suggest future research on the same topic. Specifically, the present study aims: The first one is, organize publications to make them easy and quick to find. Secondly, to explore issues in this area, propose an outline of research for future work. The third aim of the study is to synthesize the previous literature on climate change, various sectors, and their mitigation measurement. Lastly , classify the articles according to the different methods and procedures that have been adopted.

Review methodology for reviewers

This review-based article followed systematic literature review techniques that have proved the literature review as a rigorous framework (Benita  2021 ; Tranfield et al.  2003 ). Moreover, we illustrate in Fig.  1 the search method that we have started for this research. First, finalized the research theme to search literature (Cooper et al.  2018 ). Second, used numerous research databases to search related articles and download from the database (Web of Science, Google Scholar, Scopus Index Journals, Emerald, Elsevier Science Direct, Springer, and Sciverse). We focused on various articles, with research articles, feedback pieces, short notes, debates, and review articles published in scholarly journals. Reports used to search for multiple keywords such as “Climate Change,” “Mitigation and Adaptation,” “Department of Agriculture and Human Health,” “Department of Biodiversity and Forestry,” etc.; in summary, keyword list and full text have been made. Initially, the search for keywords yielded a large amount of literature.

Methodology search for finalized articles for investigations.

Source : constructed by authors

Since 2020, it has been impossible to review all the articles found; some restrictions have been set for the literature exhibition. The study searched 95 articles on a different database mentioned above based on the nature of the study. It excluded 40 irrelevant papers due to copied from a previous search after readings tiles, abstract and full pieces. The criteria for inclusion were: (i) articles focused on “Global Climate Change Impacts, adaptation, and sustainable mitigation measures,” and (ii) the search key terms related to study requirements. The complete procedure yielded 55 articles for our study. We repeat our search on the “Web of Science and Google Scholars” database to enhance the search results and check the referenced articles.

In this study, 55 articles are reviewed systematically and analyzed for research topics and other aspects, such as the methods, contexts, and theories used in these studies. Furthermore, this study analyzes closely related areas to provide unique research opportunities in the future. The study also discussed future direction opportunities and research questions by understanding the research findings climate changes and other affected sectors. The reviewed paper framework analysis process is outlined in Fig.  2 .

Framework of the analysis Process.

Natural disasters and climate change’s socio-economic consequences

Natural and environmental disasters can be highly variable from year to year; some years pass with very few deaths before a significant disaster event claims many lives (Symanski et al.  2021 ). Approximately 60,000 people globally died from natural disasters each year on average over the past decade (Ritchie and Roser  2014 ; Wiranata and Simbolon  2021 ). So, according to the report, around 0.1% of global deaths. Annual variability in the number and share of deaths from natural disasters in recent decades are shown in Fig.  3 . The number of fatalities can be meager—sometimes less than 10,000, and as few as 0.01% of all deaths. But shock events have a devastating impact: the 1983–1985 famine and drought in Ethiopia; the 2004 Indian Ocean earthquake and tsunami; Cyclone Nargis, which struck Myanmar in 2008; and the 2010 Port-au-Prince earthquake in Haiti and now recent example is COVID-19 pandemic (Erman et al.  2021 ). These events pushed global disaster deaths to over 200,000—more than 0.4% of deaths in these years. Low-frequency, high-impact events such as earthquakes and tsunamis are not preventable, but such high losses of human life are. Historical evidence shows that earlier disaster detection, more robust infrastructure, emergency preparedness, and response programmers have substantially reduced disaster deaths worldwide. Low-income is also the most vulnerable to disasters; improving living conditions, facilities, and response services in these areas would be critical in reducing natural disaster deaths in the coming decades.

Global deaths from natural disasters, 1978 to 2020.

Source EMDAT ( 2020 )

The interior regions of the continent are likely to be impacted by rising temperatures (Dimri et al.  2018 ; Goes et al.  2020 ; Mannig et al.  2018 ; Schuurmans  2021 ). Weather patterns change due to the shortage of natural resources (water), increase in glacier melting, and rising mercury are likely to cause extinction to many planted species (Gampe et al.  2016 ; Mihiretu et al.  2021 ; Shaffril et al.  2018 ).On the other hand, the coastal ecosystem is on the verge of devastation (Perera et al.  2018 ; Phillips  2018 ). The temperature rises, insect disease outbreaks, health-related problems, and seasonal and lifestyle changes are persistent, with a strong probability of these patterns continuing in the future (Abbass et al. 2021c ; Hussain et al.  2018 ). At the global level, a shortage of good infrastructure and insufficient adaptive capacity are hammering the most (IPCC  2013 ). In addition to the above concerns, a lack of environmental education and knowledge, outdated consumer behavior, a scarcity of incentives, a lack of legislation, and the government’s lack of commitment to climate change contribute to the general public’s concerns. By 2050, a 2 to 3% rise in mercury and a drastic shift in rainfall patterns may have serious consequences (Huang et al. 2022 ; Gorst et al.  2018 ). Natural and environmental calamities caused huge losses globally, such as decreased agriculture outputs, rehabilitation of the system, and rebuilding necessary technologies (Ali and Erenstein  2017 ; Ramankutty et al.  2018 ; Yu et al.  2021 ) (Table ​ (Table1). 1 ). Furthermore, in the last 3 or 4 years, the world has been plagued by smog-related eye and skin diseases, as well as a rise in road accidents due to poor visibility.

Main natural danger statistics for 1985–2020 at the global level

Source: EM-DAT ( 2020 )

Climate change and agriculture

Global agriculture is the ultimate sector responsible for 30–40% of all greenhouse emissions, which makes it a leading industry predominantly contributing to climate warming and significantly impacted by it (Grieg; Mishra et al.  2021 ; Ortiz et al.  2021 ; Thornton and Lipper  2014 ). Numerous agro-environmental and climatic factors that have a dominant influence on agriculture productivity (Pautasso et al.  2012 ) are significantly impacted in response to precipitation extremes including floods, forest fires, and droughts (Huang  2004 ). Besides, the immense dependency on exhaustible resources also fuels the fire and leads global agriculture to become prone to devastation. Godfray et al. ( 2010 ) mentioned that decline in agriculture challenges the farmer’s quality of life and thus a significant factor to poverty as the food and water supplies are critically impacted by CC (Ortiz et al.  2021 ; Rosenzweig et al.  2014 ). As an essential part of the economic systems, especially in developing countries, agricultural systems affect the overall economy and potentially the well-being of households (Schlenker and Roberts  2009 ). According to the report published by the Intergovernmental Panel on Climate Change (IPCC), atmospheric concentrations of greenhouse gases, i.e., CH 4, CO 2 , and N 2 O, are increased in the air to extraordinary levels over the last few centuries (Usman and Makhdum 2021 ; Stocker et al.  2013 ). Climate change is the composite outcome of two different factors. The first is the natural causes, and the second is the anthropogenic actions (Karami 2012 ). It is also forecasted that the world may experience a typical rise in temperature stretching from 1 to 3.7 °C at the end of this century (Pachauri et al. 2014 ). The world’s crop production is also highly vulnerable to these global temperature-changing trends as raised temperatures will pose severe negative impacts on crop growth (Reidsma et al. 2009 ). Some of the recent modeling about the fate of global agriculture is briefly described below.

Decline in cereal productivity

Crop productivity will also be affected dramatically in the next few decades due to variations in integral abiotic factors such as temperature, solar radiation, precipitation, and CO 2 . These all factors are included in various regulatory instruments like progress and growth, weather-tempted changes, pest invasions (Cammell and Knight 1992 ), accompanying disease snags (Fand et al. 2012 ), water supplies (Panda et al. 2003 ), high prices of agro-products in world’s agriculture industry, and preeminent quantity of fertilizer consumption. Lobell and field ( 2007 ) claimed that from 1962 to 2002, wheat crop output had condensed significantly due to rising temperatures. Therefore, during 1980–2011, the common wheat productivity trends endorsed extreme temperature events confirmed by Gourdji et al. ( 2013 ) around South Asia, South America, and Central Asia. Various other studies (Asseng, Cao, Zhang, and Ludwig 2009 ; Asseng et al. 2013 ; García et al. 2015 ; Ortiz et al. 2021 ) also proved that wheat output is negatively affected by the rising temperatures and also caused adverse effects on biomass productivity (Calderini et al. 1999 ; Sadras and Slafer 2012 ). Hereafter, the rice crop is also influenced by the high temperatures at night. These difficulties will worsen because the temperature will be rising further in the future owing to CC (Tebaldi et al. 2006 ). Another research conducted in China revealed that a 4.6% of rice production per 1 °C has happened connected with the advancement in night temperatures (Tao et al. 2006 ). Moreover, the average night temperature growth also affected rice indicia cultivar’s output pragmatically during 25 years in the Philippines (Peng et al. 2004 ). It is anticipated that the increase in world average temperature will also cause a substantial reduction in yield (Hatfield et al. 2011 ; Lobell and Gourdji 2012 ). In the southern hemisphere, Parry et al. ( 2007 ) noted a rise of 1–4 °C in average daily temperatures at the end of spring season unti the middle of summers, and this raised temperature reduced crop output by cutting down the time length for phenophases eventually reduce the yield (Hatfield and Prueger 2015 ; R. Ortiz 2008 ). Also, world climate models have recommended that humid and subtropical regions expect to be plentiful prey to the upcoming heat strokes (Battisti and Naylor 2009 ). Grain production is the amalgamation of two constituents: the average weight and the grain output/m 2 , however, in crop production. Crop output is mainly accredited to the grain quantity (Araus et al. 2008 ; Gambín and Borrás 2010 ). In the times of grain set, yield resources are mainly strewn between hitherto defined components, i.e., grain usual weight and grain output, which presents a trade-off between them (Gambín and Borrás 2010 ) beside disparities in per grain integration (B. L. Gambín et al. 2006 ). In addition to this, the maize crop is also susceptible to raised temperatures, principally in the flowering stage (Edreira and Otegui 2013 ). In reality, the lower grain number is associated with insufficient acclimatization due to intense photosynthesis and higher respiration and the high-temperature effect on the reproduction phenomena (Edreira and Otegui 2013 ). During the flowering phase, maize visible to heat (30–36 °C) seemed less anthesis-silking intermissions (Edreira et al. 2011 ). Another research by Dupuis and Dumas ( 1990 ) proved that a drop in spikelet when directly visible to high temperatures above 35 °C in vitro pollination. Abnormalities in kernel number claimed by Vega et al. ( 2001 ) is related to conceded plant development during a flowering phase that is linked with the active ear growth phase and categorized as a critical phase for approximation of kernel number during silking (Otegui and Bonhomme 1998 ).

The retort of rice output to high temperature presents disparities in flowering patterns, and seed set lessens and lessens grain weight (Qasim et al. 2020 ; Qasim, Hammad, Maqsood, Tariq, & Chawla). During the daytime, heat directly impacts flowers which lessens the thesis period and quickens the earlier peak flowering (Tao et al. 2006 ). Antagonistic effect of higher daytime temperature d on pollen sprouting proposed seed set decay, whereas, seed set was lengthily reduced than could be explicated by pollen growing at high temperatures 40◦C (Matsui et al. 2001 ).

The decline in wheat output is linked with higher temperatures, confirmed in numerous studies (Semenov 2009 ; Stone and Nicolas 1994 ). High temperatures fast-track the arrangements of plant expansion (Blum et al. 2001 ), diminution photosynthetic process (Salvucci and Crafts‐Brandner 2004 ), and also considerably affect the reproductive operations (Farooq et al. 2011 ).

The destructive impacts of CC induced weather extremes to deteriorate the integrity of crops (Chaudhary et al. 2011 ), e.g., Spartan cold and extreme fog cause falling and discoloration of betel leaves (Rosenzweig et al. 2001 ), giving them a somehow reddish appearance, squeezing of lemon leaves (Pautasso et al. 2012 ), as well as root rot of pineapple, have reported (Vedwan and Rhoades 2001 ). Henceforth, in tackling the disruptive effects of CC, several short-term and long-term management approaches are the crucial need of time (Fig.  4 ). Moreover, various studies (Chaudhary et al. 2011 ; Patz et al. 2005 ; Pautasso et al. 2012 ) have demonstrated adapting trends such as ameliorating crop diversity can yield better adaptability towards CC.

Schematic description of potential impacts of climate change on the agriculture sector and the appropriate mitigation and adaptation measures to overcome its impact.

Climate change impacts on biodiversity

Global biodiversity is among the severe victims of CC because it is the fastest emerging cause of species loss. Studies demonstrated that the massive scale species dynamics are considerably associated with diverse climatic events (Abraham and Chain 1988 ; Manes et al. 2021 ; A. M. D. Ortiz et al. 2021 ). Both the pace and magnitude of CC are altering the compatible habitat ranges for living entities of marine, freshwater, and terrestrial regions. Alterations in general climate regimes influence the integrity of ecosystems in numerous ways, such as variation in the relative abundance of species, range shifts, changes in activity timing, and microhabitat use (Bates et al. 2014 ). The geographic distribution of any species often depends upon its ability to tolerate environmental stresses, biological interactions, and dispersal constraints. Hence, instead of the CC, the local species must only accept, adapt, move, or face extinction (Berg et al. 2010 ). So, the best performer species have a better survival capacity for adjusting to new ecosystems or a decreased perseverance to survive where they are already situated (Bates et al. 2014 ). An important aspect here is the inadequate habitat connectivity and access to microclimates, also crucial in raising the exposure to climate warming and extreme heatwave episodes. For example, the carbon sequestration rates are undergoing fluctuations due to climate-driven expansion in the range of global mangroves (Cavanaugh et al. 2014 ).

Similarly, the loss of kelp-forest ecosystems in various regions and its occupancy by the seaweed turfs has set the track for elevated herbivory by the high influx of tropical fish populations. Not only this, the increased water temperatures have exacerbated the conditions far away from the physiological tolerance level of the kelp communities (Vergés et al. 2016 ; Wernberg et al. 2016 ). Another pertinent danger is the devastation of keystone species, which even has more pervasive effects on the entire communities in that habitat (Zarnetske et al. 2012 ). It is particularly important as CC does not specify specific populations or communities. Eventually, this CC-induced redistribution of species may deteriorate carbon storage and the net ecosystem productivity (Weed et al. 2013 ). Among the typical disruptions, the prominent ones include impacts on marine and terrestrial productivity, marine community assembly, and the extended invasion of toxic cyanobacteria bloom (Fossheim et al. 2015 ).

The CC-impacted species extinction is widely reported in the literature (Beesley et al. 2019 ; Urban 2015 ), and the predictions of demise until the twenty-first century are dreadful (Abbass et al. 2019 ; Pereira et al. 2013 ). In a few cases, northward shifting of species may not be formidable as it allows mountain-dwelling species to find optimum climates. However, the migrant species may be trapped in isolated and incompatible habitats due to losing topography and range (Dullinger et al. 2012 ). For example, a study indicated that the American pika has been extirpated or intensely diminished in some regions, primarily attributed to the CC-impacted extinction or at least local extirpation (Stewart et al. 2015 ). Besides, the anticipation of persistent responses to the impacts of CC often requires data records of several decades to rigorously analyze the critical pre and post CC patterns at species and ecosystem levels (Manes et al. 2021 ; Testa et al. 2018 ).

Nonetheless, the availability of such long-term data records is rare; hence, attempts are needed to focus on these profound aspects. Biodiversity is also vulnerable to the other associated impacts of CC, such as rising temperatures, droughts, and certain invasive pest species. For instance, a study revealed the changes in the composition of plankton communities attributed to rising temperatures. Henceforth, alterations in such aquatic producer communities, i.e., diatoms and calcareous plants, can ultimately lead to variation in the recycling of biological carbon. Moreover, such changes are characterized as a potential contributor to CO 2 differences between the Pleistocene glacial and interglacial periods (Kohfeld et al. 2005 ).

Climate change implications on human health

It is an understood corporality that human health is a significant victim of CC (Costello et al. 2009 ). According to the WHO, CC might be responsible for 250,000 additional deaths per year during 2030–2050 (Watts et al. 2015 ). These deaths are attributed to extreme weather-induced mortality and morbidity and the global expansion of vector-borne diseases (Lemery et al. 2021; Yang and Usman 2021 ; Meierrieks 2021 ; UNEP 2017 ). Here, some of the emerging health issues pertinent to this global problem are briefly described.

Climate change and antimicrobial resistance with corresponding economic costs

Antimicrobial resistance (AMR) is an up-surging complex global health challenge (Garner et al. 2019 ; Lemery et al. 2021 ). Health professionals across the globe are extremely worried due to this phenomenon that has critical potential to reverse almost all the progress that has been achieved so far in the health discipline (Gosling and Arnell 2016 ). A massive amount of antibiotics is produced by many pharmaceutical industries worldwide, and the pathogenic microorganisms are gradually developing resistance to them, which can be comprehended how strongly this aspect can shake the foundations of national and global economies (UNEP 2017 ). This statement is supported by the fact that AMR is not developing in a particular region or country. Instead, it is flourishing in every continent of the world (WHO 2018 ). This plague is heavily pushing humanity to the post-antibiotic era, in which currently antibiotic-susceptible pathogens will once again lead to certain endemics and pandemics after being resistant(WHO 2018 ). Undesirably, if this statement would become a factuality, there might emerge certain risks in undertaking sophisticated interventions such as chemotherapy, joint replacement cases, and organ transplantation (Su et al. 2018 ). Presently, the amplification of drug resistance cases has made common illnesses like pneumonia, post-surgical infections, HIV/AIDS, tuberculosis, malaria, etc., too difficult and costly to be treated or cure well (WHO 2018 ). From a simple example, it can be assumed how easily antibiotic-resistant strains can be transmitted from one person to another and ultimately travel across the boundaries (Berendonk et al. 2015 ). Talking about the second- and third-generation classes of antibiotics, e.g., most renowned generations of cephalosporin antibiotics that are more expensive, broad-spectrum, more toxic, and usually require more extended periods whenever prescribed to patients (Lemery et al. 2021 ; Pärnänen et al. 2019 ). This scenario has also revealed that the abundance of resistant strains of pathogens was also higher in the Southern part (WHO 2018 ). As southern parts are generally warmer than their counterparts, it is evident from this example how CC-induced global warming can augment the spread of antibiotic-resistant strains within the biosphere, eventually putting additional economic burden in the face of developing new and costlier antibiotics. The ARG exchange to susceptible bacteria through one of the potential mechanisms, transformation, transduction, and conjugation; Selection pressure can be caused by certain antibiotics, metals or pesticides, etc., as shown in Fig.  5 .

A typical interaction between the susceptible and resistant strains.

Source: Elsayed et al. ( 2021 ); Karkman et al. ( 2018 )

Certain studies highlighted that conventional urban wastewater treatment plants are typical hotspots where most bacterial strains exchange genetic material through horizontal gene transfer (Fig.  5 ). Although at present, the extent of risks associated with the antibiotic resistance found in wastewater is complicated; environmental scientists and engineers have particular concerns about the potential impacts of these antibiotic resistance genes on human health (Ashbolt 2015 ). At most undesirable and worst case, these antibiotic-resistant genes containing bacteria can make their way to enter into the environment (Pruden et al. 2013 ), irrigation water used for crops and public water supplies and ultimately become a part of food chains and food webs (Ma et al. 2019 ; D. Wu et al. 2019 ). This problem has been reported manifold in several countries (Hendriksen et al. 2019 ), where wastewater as a means of irrigated water is quite common.

Climate change and vector borne-diseases

Temperature is a fundamental factor for the sustenance of living entities regardless of an ecosystem. So, a specific living being, especially a pathogen, requires a sophisticated temperature range to exist on earth. The second essential component of CC is precipitation, which also impacts numerous infectious agents’ transport and dissemination patterns. Global rising temperature is a significant cause of many species extinction. On the one hand, this changing environmental temperature may be causing species extinction, and on the other, this warming temperature might favor the thriving of some new organisms. Here, it was evident that some pathogens may also upraise once non-evident or reported (Patz et al. 2000 ). This concept can be exemplified through certain pathogenic strains of microorganisms that how the likelihood of various diseases increases in response to climate warming-induced environmental changes (Table ​ (Table2 2 ).

Examples of how various environmental changes affect various infectious diseases in humans

Source: Aron and Patz ( 2001 )

A recent example is an outburst of coronavirus (COVID-19) in the Republic of China, causing pneumonia and severe acute respiratory complications (Cui et al. 2021 ; Song et al. 2021 ). The large family of viruses is harbored in numerous animals, bats, and snakes in particular (livescience.com) with the subsequent transfer into human beings. Hence, it is worth noting that the thriving of numerous vectors involved in spreading various diseases is influenced by Climate change (Ogden 2018 ; Santos et al. 2021 ).

Psychological impacts of climate change

Climate change (CC) is responsible for the rapid dissemination and exaggeration of certain epidemics and pandemics. In addition to the vast apparent impacts of climate change on health, forestry, agriculture, etc., it may also have psychological implications on vulnerable societies. It can be exemplified through the recent outburst of (COVID-19) in various countries around the world (Pal 2021 ). Besides, the victims of this viral infection have made healthy beings scarier and terrified. In the wake of such epidemics, people with common colds or fever are also frightened and must pass specific regulatory protocols. Living in such situations continuously terrifies the public and makes the stress familiar, which eventually makes them psychologically weak (npr.org).

CC boosts the extent of anxiety, distress, and other issues in public, pushing them to develop various mental-related problems. Besides, frequent exposure to extreme climatic catastrophes such as geological disasters also imprints post-traumatic disorder, and their ubiquitous occurrence paves the way to developing chronic psychological dysfunction. Moreover, repetitive listening from media also causes an increase in the person’s stress level (Association 2020 ). Similarly, communities living in flood-prone areas constantly live in extreme fear of drowning and die by floods. In addition to human lives, the flood-induced destruction of physical infrastructure is a specific reason for putting pressure on these communities (Ogden 2018 ). For instance, Ogden ( 2018 ) comprehensively denoted that Katrina’s Hurricane augmented the mental health issues in the victim communities.

Climate change impacts on the forestry sector

Forests are the global regulators of the world’s climate (FAO 2018 ) and have an indispensable role in regulating global carbon and nitrogen cycles (Rehman et al. 2021 ; Reichstein and Carvalhais 2019 ). Hence, disturbances in forest ecology affect the micro and macro-climates (Ellison et al. 2017 ). Climate warming, in return, has profound impacts on the growth and productivity of transboundary forests by influencing the temperature and precipitation patterns, etc. As CC induces specific changes in the typical structure and functions of ecosystems (Zhang et al. 2017 ) as well impacts forest health, climate change also has several devastating consequences such as forest fires, droughts, pest outbreaks (EPA 2018 ), and last but not the least is the livelihoods of forest-dependent communities. The rising frequency and intensity of another CC product, i.e., droughts, pose plenty of challenges to the well-being of global forests (Diffenbaugh et al. 2017 ), which is further projected to increase soon (Hartmann et al. 2018 ; Lehner et al. 2017 ; Rehman et al. 2021 ). Hence, CC induces storms, with more significant impacts also put extra pressure on the survival of the global forests (Martínez-Alvarado et al. 2018 ), significantly since their influences are augmented during higher winter precipitations with corresponding wetter soils causing weak root anchorage of trees (Brázdil et al. 2018 ). Surging temperature regimes causes alterations in usual precipitation patterns, which is a significant hurdle for the survival of temperate forests (Allen et al. 2010 ; Flannigan et al. 2013 ), letting them encounter severe stress and disturbances which adversely affects the local tree species (Hubbart et al. 2016 ; Millar and Stephenson 2015 ; Rehman et al. 2021 ).

Climate change impacts on forest-dependent communities

Forests are the fundamental livelihood resource for about 1.6 billion people worldwide; out of them, 350 million are distinguished with relatively higher reliance (Bank 2008 ). Agro-forestry-dependent communities comprise 1.2 billion, and 60 million indigenous people solely rely on forests and their products to sustain their lives (Sunderlin et al. 2005 ). For example, in the entire African continent, more than 2/3rd of inhabitants depend on forest resources and woodlands for their alimonies, e.g., food, fuelwood and grazing (Wasiq and Ahmad 2004 ). The livings of these people are more intensely affected by the climatic disruptions making their lives harder (Brown et al. 2014 ). On the one hand, forest communities are incredibly vulnerable to CC due to their livelihoods, cultural and spiritual ties as well as socio-ecological connections, and on the other, they are not familiar with the term “climate change.” (Rahman and Alam 2016 ). Among the destructive impacts of temperature and rainfall, disruption of the agroforestry crops with resultant downscale growth and yield (Macchi et al. 2008 ). Cruz ( 2015 ) ascribed that forest-dependent smallholder farmers in the Philippines face the enigma of delayed fruiting, more severe damages by insect and pest incidences due to unfavorable temperature regimes, and changed rainfall patterns.

Among these series of challenges to forest communities, their well-being is also distinctly vulnerable to CC. Though the detailed climate change impacts on human health have been comprehensively mentioned in the previous section, some studies have listed a few more devastating effects on the prosperity of forest-dependent communities. For instance, the Himalayan people have been experiencing frequent skin-borne diseases such as malaria and other skin diseases due to increasing mosquitoes, wild boar as well, and new wasps species, particularly in higher altitudes that were almost non-existent before last 5–10 years (Xu et al. 2008 ). Similarly, people living at high altitudes in Bangladesh have experienced frequent mosquito-borne calamities (Fardous; Sharma 2012 ). In addition, the pace of other waterborne diseases such as infectious diarrhea, cholera, pathogenic induced abdominal complications and dengue has also been boosted in other distinguished regions of Bangladesh (Cell 2009 ; Gunter et al. 2008 ).

Pest outbreak

Upscaling hotter climate may positively affect the mobile organisms with shorter generation times because they can scurry from harsh conditions than the immobile species (Fettig et al. 2013 ; Schoene and Bernier 2012 ) and are also relatively more capable of adapting to new environments (Jactel et al. 2019 ). It reveals that insects adapt quickly to global warming due to their mobility advantages. Due to past outbreaks, the trees (forests) are relatively more susceptible victims (Kurz et al. 2008 ). Before CC, the influence of factors mentioned earlier, i.e., droughts and storms, was existent and made the forests susceptible to insect pest interventions; however, the global forests remain steadfast, assiduous, and green (Jactel et al. 2019 ). The typical reasons could be the insect herbivores were regulated by several tree defenses and pressures of predation (Wilkinson and Sherratt 2016 ). As climate greatly influences these phenomena, the global forests cannot be so sedulous against such challenges (Jactel et al. 2019 ). Table ​ Table3 3 demonstrates some of the particular considerations with practical examples that are essential while mitigating the impacts of CC in the forestry sector.

Essential considerations while mitigating the climate change impacts on the forestry sector

Source : Fischer ( 2019 )

Climate change impacts on tourism

Tourism is a commercial activity that has roots in multi-dimensions and an efficient tool with adequate job generation potential, revenue creation, earning of spectacular foreign exchange, enhancement in cross-cultural promulgation and cooperation, a business tool for entrepreneurs and eventually for the country’s national development (Arshad et al. 2018 ; Scott 2021 ). Among a plethora of other disciplines, the tourism industry is also a distinct victim of climate warming (Gössling et al. 2012 ; Hall et al. 2015 ) as the climate is among the essential resources that enable tourism in particular regions as most preferred locations. Different places at different times of the year attract tourists both within and across the countries depending upon the feasibility and compatibility of particular weather patterns. Hence, the massive variations in these weather patterns resulting from CC will eventually lead to monumental challenges to the local economy in that specific area’s particular and national economy (Bujosa et al. 2015 ). For instance, the Intergovernmental Panel on Climate Change (IPCC) report demonstrated that the global tourism industry had faced a considerable decline in the duration of ski season, including the loss of some ski areas and the dramatic shifts in tourist destinations’ climate warming.

Furthermore, different studies (Neuvonen et al. 2015 ; Scott et al. 2004 ) indicated that various currently perfect tourist spots, e.g., coastal areas, splendid islands, and ski resorts, will suffer consequences of CC. It is also worth noting that the quality and potential of administrative management potential to cope with the influence of CC on the tourism industry is of crucial significance, which renders specific strengths of resiliency to numerous destinations to withstand against it (Füssel and Hildén 2014 ). Similarly, in the partial or complete absence of adequate socio-economic and socio-political capital, the high-demanding tourist sites scurry towards the verge of vulnerability. The susceptibility of tourism is based on different components such as the extent of exposure, sensitivity, life-supporting sectors, and capacity assessment factors (Füssel and Hildén 2014 ). It is obvious corporality that sectors such as health, food, ecosystems, human habitat, infrastructure, water availability, and the accessibility of a particular region are prone to CC. Henceforth, the sensitivity of these critical sectors to CC and, in return, the adaptive measures are a hallmark in determining the composite vulnerability of climate warming (Ionescu et al. 2009 ).

Moreover, the dependence on imported food items, poor hygienic conditions, and inadequate health professionals are dominant aspects affecting the local terrestrial and aquatic biodiversity. Meanwhile, the greater dependency on ecosystem services and its products also makes a destination more fragile to become a prey of CC (Rizvi et al. 2015 ). Some significant non-climatic factors are important indicators of a particular ecosystem’s typical health and functioning, e.g., resource richness and abundance portray the picture of ecosystem stability. Similarly, the species abundance is also a productive tool that ensures that the ecosystem has a higher buffering capacity, which is terrific in terms of resiliency (Roscher et al. 2013 ).

Climate change impacts on the economic sector

Climate plays a significant role in overall productivity and economic growth. Due to its increasingly global existence and its effect on economic growth, CC has become one of the major concerns of both local and international environmental policymakers (Ferreira et al. 2020 ; Gleditsch 2021 ; Abbass et al. 2021b ; Lamperti et al. 2021 ). The adverse effects of CC on the overall productivity factor of the agricultural sector are therefore significant for understanding the creation of local adaptation policies and the composition of productive climate policy contracts. Previous studies on CC in the world have already forecasted its effects on the agricultural sector. Researchers have found that global CC will impact the agricultural sector in different world regions. The study of the impacts of CC on various agrarian activities in other demographic areas and the development of relative strategies to respond to effects has become a focal point for researchers (Chandioet al. 2020 ; Gleditsch 2021 ; Mosavi et al. 2020 ).

With the rapid growth of global warming since the 1980s, the temperature has started increasing globally, which resulted in the incredible transformation of rain and evaporation in the countries. The agricultural development of many countries has been reliant, delicate, and susceptible to CC for a long time, and it is on the development of agriculture total factor productivity (ATFP) influence different crops and yields of farmers (Alhassan 2021 ; Wu  2020 ).

Food security and natural disasters are increasing rapidly in the world. Several major climatic/natural disasters have impacted local crop production in the countries concerned. The effects of these natural disasters have been poorly controlled by the development of the economies and populations and may affect human life as well. One example is China, which is among the world’s most affected countries, vulnerable to natural disasters due to its large population, harsh environmental conditions, rapid CC, low environmental stability, and disaster power. According to the January 2016 statistical survey, China experienced an economic loss of 298.3 billion Yuan, and about 137 million Chinese people were severely affected by various natural disasters (Xie et al. 2018 ).

Mitigation and adaptation strategies of climate changes

Adaptation and mitigation are the crucial factors to address the response to CC (Jahanzad et al. 2020 ). Researchers define mitigation on climate changes, and on the other hand, adaptation directly impacts climate changes like floods. To some extent, mitigation reduces or moderates greenhouse gas emission, and it becomes a critical issue both economically and environmentally (Botzen et al. 2021 ; Jahanzad et al. 2020 ; Kongsager 2018 ; Smit et al. 2000 ; Vale et al. 2021 ; Usman et al. 2021 ; Verheyen 2005 ).

Researchers have deep concern about the adaptation and mitigation methodologies in sectoral and geographical contexts. Agriculture, industry, forestry, transport, and land use are the main sectors to adapt and mitigate policies(Kärkkäinen et al. 2020 ; Waheed et al. 2021 ). Adaptation and mitigation require particular concern both at the national and international levels. The world has faced a significant problem of climate change in the last decades, and adaptation to these effects is compulsory for economic and social development. To adapt and mitigate against CC, one should develop policies and strategies at the international level (Hussain et al. 2020 ). Figure  6 depicts the list of current studies on sectoral impacts of CC with adaptation and mitigation measures globally.

Sectoral impacts of climate change with adaptation and mitigation measures.

Conclusion and future perspectives

Specific socio-agricultural, socio-economic, and physical systems are the cornerstone of psychological well-being, and the alteration in these systems by CC will have disastrous impacts. Climate variability, alongside other anthropogenic and natural stressors, influences human and environmental health sustainability. Food security is another concerning scenario that may lead to compromised food quality, higher food prices, and inadequate food distribution systems. Global forests are challenged by different climatic factors such as storms, droughts, flash floods, and intense precipitation. On the other hand, their anthropogenic wiping is aggrandizing their existence. Undoubtedly, the vulnerability scale of the world’s regions differs; however, appropriate mitigation and adaptation measures can aid the decision-making bodies in developing effective policies to tackle its impacts. Presently, modern life on earth has tailored to consistent climatic patterns, and accordingly, adapting to such considerable variations is of paramount importance. Because the faster changes in climate will make it harder to survive and adjust, this globally-raising enigma calls for immediate attention at every scale ranging from elementary community level to international level. Still, much effort, research, and dedication are required, which is the most critical time. Some policy implications can help us to mitigate the consequences of climate change, especially the most affected sectors like the agriculture sector;

Warming might lengthen the season in frost-prone growing regions (temperate and arctic zones), allowing for longer-maturing seasonal cultivars with better yields (Pfadenhauer 2020 ; Bonacci 2019 ). Extending the planting season may allow additional crops each year; when warming leads to frequent warmer months highs over critical thresholds, a split season with a brief summer fallow may be conceivable for short-period crops such as wheat barley, cereals, and many other vegetable crops. The capacity to prolong the planting season in tropical and subtropical places where the harvest season is constrained by precipitation or agriculture farming occurs after the year may be more limited and dependent on how precipitation patterns vary (Wu et al. 2017 ).

The genetic component is comprehensive for many yields, but it is restricted like kiwi fruit for a few. Ali et al. ( 2017 ) investigated how new crops will react to climatic changes (also stated in Mall et al. 2017 ). Hot temperature, drought, insect resistance; salt tolerance; and overall crop production and product quality increases would all be advantageous (Akkari 2016 ). Genetic mapping and engineering can introduce a greater spectrum of features. The adoption of genetically altered cultivars has been slowed, particularly in the early forecasts owing to the complexity in ensuring features are expediently expressed throughout the entire plant, customer concerns, economic profitability, and regulatory impediments (Wirehn 2018 ; Davidson et al. 2016 ).

To get the full benefit of the CO 2 would certainly require additional nitrogen and other fertilizers. Nitrogen not consumed by the plants may be excreted into groundwater, discharged into water surface, or emitted from the land, soil nitrous oxide when large doses of fertilizer are sprayed. Increased nitrogen levels in groundwater sources have been related to human chronic illnesses and impact marine ecosystems. Cultivation, grain drying, and other field activities have all been examined in depth in the studies (Barua et al. 2018 ).

• The technological and socio-economic adaptation

The policy consequence of the causative conclusion is that as a source of alternative energy, biofuel production is one of the routes that explain oil price volatility separate from international macroeconomic factors. Even though biofuel production has just begun in a few sample nations, there is still a tremendous worldwide need for feedstock to satisfy industrial expansion in China and the USA, which explains the food price relationship to the global oil price. Essentially, oil-exporting countries may create incentives in their economies to increase food production. It may accomplish by giving farmers financing, seedlings, fertilizers, and farming equipment. Because of the declining global oil price and, as a result, their earnings from oil export, oil-producing nations may be unable to subsidize food imports even in the near term. As a result, these countries can boost the agricultural value chain for export. It may be accomplished through R&D and adding value to their food products to increase income by correcting exchange rate misalignment and adverse trade terms. These nations may also diversify their economies away from oil, as dependence on oil exports alone is no longer economically viable given the extreme volatility of global oil prices. Finally, resource-rich and oil-exporting countries can convert to non-food renewable energy sources such as solar, hydro, coal, wind, wave, and tidal energy. By doing so, both world food and oil supplies would be maintained rather than harmed.

IRENA’s modeling work shows that, if a comprehensive policy framework is in place, efforts toward decarbonizing the energy future will benefit economic activity, jobs (outweighing losses in the fossil fuel industry), and welfare. Countries with weak domestic supply chains and a large reliance on fossil fuel income, in particular, must undertake structural reforms to capitalize on the opportunities inherent in the energy transition. Governments continue to give major policy assistance to extract fossil fuels, including tax incentives, financing, direct infrastructure expenditures, exemptions from environmental regulations, and other measures. The majority of major oil and gas producing countries intend to increase output. Some countries intend to cut coal output, while others plan to maintain or expand it. While some nations are beginning to explore and execute policies aimed at a just and equitable transition away from fossil fuel production, these efforts have yet to impact major producing countries’ plans and goals. Verifiable and comparable data on fossil fuel output and assistance from governments and industries are critical to closing the production gap. Governments could increase openness by declaring their production intentions in their climate obligations under the Paris Agreement.

It is firmly believed that achieving the Paris Agreement commitments is doubtlful without undergoing renewable energy transition across the globe (Murshed 2020 ; Zhao et al. 2022 ). Policy instruments play the most important role in determining the degree of investment in renewable energy technology. This study examines the efficacy of various policy strategies in the renewable energy industry of multiple nations. Although its impact is more visible in established renewable energy markets, a renewable portfolio standard is also a useful policy instrument. The cost of producing renewable energy is still greater than other traditional energy sources. Furthermore, government incentives in the R&D sector can foster innovation in this field, resulting in cost reductions in the renewable energy industry. These nations may export their technologies and share their policy experiences by forming networks among their renewable energy-focused organizations. All policy measures aim to reduce production costs while increasing the proportion of renewables to a country’s energy system. Meanwhile, long-term contracts with renewable energy providers, government commitment and control, and the establishment of long-term goals can assist developing nations in deploying renewable energy technology in their energy sector.

Author contribution

KA: Writing the original manuscript, data collection, data analysis, Study design, Formal analysis, Visualization, Revised draft, Writing-review, and editing. MZQ: Writing the original manuscript, data collection, data analysis, Writing-review, and editing. HS: Contribution to the contextualization of the theme, Conceptualization, Validation, Supervision, literature review, Revised drapt, and writing review and editing. MM: Writing review and editing, compiling the literature review, language editing. HM: Writing review and editing, compiling the literature review, language editing. IY: Contribution to the contextualization of the theme, literature review, and writing review and editing.

Availability of data and material

Declarations.

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The authors declare no competing interests.

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Contributor Information

Kashif Abbass, Email: nc.ude.tsujn@ssabbafihsak .

Muhammad Zeeshan Qasim, Email: moc.kooltuo@888misaqnahseez .

Huaming Song, Email: nc.ude.tsujn@gnimauh .

Muntasir Murshed, Email: [email protected] .

Haider Mahmood, Email: moc.liamtoh@doomhamrediah .

Ijaz Younis, Email: nc.ude.tsujn@sinuoyzaji .

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• Open access
• 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

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

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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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03 Apr 2009

Climate change and sexual and reproductive health and rights research in low-income and middle-income countries: a scoping review

María Barreix ,

Doris Chou ,

Caron Rahn Kim ,

https://doi.org/ 10.1136/bmjph-2024-001090

Introduction This study aimed to provide an overview of the research landscape and to identify research gaps linking climate change events and sexual and reproductive health and rights (SRHR) in low-income and middle-income countries (LMICs), where the negative impacts of climate change are most severe.

Methods We conducted a scoping review to map research studies that link climate change events or factors and SRHR aspects in LMICs. We performed a structured literature search across six databases to identify relevant peer-reviewed publications between January 1994 and 6 September 2023. The literature search yielded 14 674 peer-reviewed articles. After screening, 75 articles were included, spanning 99 countries across the globe.

Results Climate change events such as extreme temperatures, drought, rainfall shocks, cyclones and floods were found to be associated with negative maternal and newborn health outcomes ranging from reduced or low birth weight, preterm births and low Apgar scores, to lack of pregnancy care, pregnancy complications, stillbirths, and newborn and maternal deaths. Associations were also found between climate-related events and increased gender-based violence and HIV prevalence, as well as fertility decisions and harmful practices such as female genital mutilations and early and forced marriages. About two-thirds (48/75) of the articles were from the African or Western Pacific regions. The main research gaps on climate change-related events and SRHR included abortion, reproductive cancers and contraception use.

Conclusion Complementing existing evidence with targeted research to fill these knowledge gaps could enhance mitigation programmes and policies.

What is already known on this topic

Earlier systematic, scoping and narrative reviews have examined the impact of climate change or specific climate change phenomena such as extreme heat on general or specific health aspects such as mental health, or HIV, and pregnancy outcomes including preterm birth, or on specific groups such as children. However, there is a notable absence of review studies that map the existing research body concerning the impact of climate change on broader sexual and reproductive health and rights (SRHR) in low-income and middle-income countries (LMICs).

What this study adds

Our study contributes a distinctive and extensive overview of existing research on the interconnections between various climate change phenomena and all major SRHR domains, highlighting existing evidence and specific knowledge gaps to guide future research and mitigation efforts in LMICs, where populations in the most vulnerable situations to the effects of climate change live.

How this study might affect research, practice or policy

The review reveals under-researched or unexplored areas to guide future scientific investigations on climate change phenomena and SRHR such as abortion, contraception and reproductive cancers. It also highlights how methodologies and research collaborations may be expanded moving forward to enable a more comprehensive understanding of SRHR and climate to guide future policies and intervention programmes addressing critical climate change-related threats.

• Introduction

Long-term shifts in temperatures and changing weather patterns (ie, climate change) pose a major challenge to public health in the 21st century. 1 Rising temperatures, rainfall shocks and an increase in the intensity and frequency of extreme weather events such as cyclones, directly and indirectly, threaten the health and well-being of populations worldwide, particularly those that already face risks and vulnerabilities in low-income settings. 2 Climate change affects the entire planet, but its effects are often more dramatic around the equator, and the negative impacts are more severe in low-income and middle-income countries (LMICs) with less financial, infrastructural and geographical resources to mitigate the consequences. 3 LMICs are also often heavily reliant on climate-sensitive sectors for income and survival, such as agriculture, fishing/aquaculture and tourism and may have less resources and adaptive capacity to address the impacts of extreme weather changes than high-income countries. 3

Climate change may further aggravate pre-existing disparities in health, related to factors such as age, socioeconomic status, ethnicity, race, disability, indigeneity, as well as sex and gender differences. 2 The impacts of climate change on sexual and reproductive health and rights (SRHR) may be exacerbated due to gender inequalities. 4 As a result, women and children, particularly girls, as well as other vulnerable populations, face additional challenges when it comes to mitigating climate-related poor health consequences. 4–6 For instance, drought conditions can cause food insecurity which disproportionately impacts women and children. 6 7 Situations of food insecurity can exacerbate existing nutritional vulnerabilities (eg, iron deficiency) among pregnant or breastfeeding women. 5 Studies also show that climate change-induced floods contribute to population displacement and disrupt the provision of healthcare services, including life-saving sexual and reproductive health services such as facility-based childbirth, HIV prevention and contraception. 5 8 Furthermore, experimental studies and reviews reveal that extreme temperatures, floods and droughts directly impact SRHR through several mechanisms. For instance, Hnat et al found that among pregnant women, extreme temperatures can lead to increased sweating due to thermoregulation, which can cause dehydration and trigger early labour. 9 Heat stress also causes a rise in cortisol levels, potentially leading to decreased blood flow to the placenta as blood is diverted for other immediate bodily needs. This can consequently affect fetal growth due to reduced oxygen levels in the fetus. 10

While the evidence base for gender, health and climate change interlinkages is growing, considerable research gaps remain at the intersection of climate change and SRHR which to date has received inadequate attention. 2 Previous systematic, scoping and narrative reviews of climate change in LMICs have focused on overall health, specific health areas such as child health, mental health, chronic illnesses and nutritional health or health systems of specific populations (eg, children). 1 6–8 Yet, to the best of our knowledge, none has documented existing published literature on SRHR and climate change in LMICs. In order to bridge this gap, the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), housed at the WHO, through its HRP Alliance for research capacity strengthening convened a group of experts to scope existing evidence at this intersection. 11 The goal is to provide an exploratory mapping of research that links climate change factors or events and SRHR aspects in LMICs and to identify existing research gaps. By highlighting research gaps particular to sexual and reproductive health, we aim to advance evidence-based interventions, mitigation, adaptation and policy improvements. This review charts existing research and thereby can guide the direction of future research in this space.

We conducted a scoping review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis—scoping reviews extension (PRISMA-ScR, https://www.prisma-statement.org/scoping —see online supplemental file 1 , pages 25–27). The protocol was registered in the Open Science Framework available at https://osf.io/a4wm5/

Search strategy

A structured literature search was conducted in the following databases: Medline, Embase, Web of Science Core Collection, CINAHL, Google Scholar and World Health Organization (WHO) Global Index Medicus in December 2022 and repeated on 6 September 2023, to identify relevant peer-reviewed publications between January 1994 and 6 September 2023. The search strategy was developed on Medline (Ovid) in collaboration with librarians at the Karolinska Institutet University Library. For each search concept, relevant Medical Subject Headings (MeSH terms) and free-text terms were identified. The search was then translated, in part using Polyglot Search Translator, 12 into the other databases.

The search strategy focused on identifying articles that explored the intersections of climate change and SRHR. Distinct keywords and MeSH terms specific to SRHR (eg, “maternal health” or “abortion”) and climate change (eg, “drought” or “floods”) were cross-combined and searched with search terms specific to LMICs (eg, “Philippines” or “Sierra Leone”). The detailed search strategy, including how deduplication and additional steps for comparing DOIs were done, can be found in online supplemental file 1 (pages 27–50).

We adopted the 2018 definition of SRHR by the Guttmacher-Lancet Commission as ‘a state of physical, emotional, mental and social well-being in relation to all aspects of sexuality and reproduction, not merely the absence of disease, dysfunction or infirmity’, relying on the ‘realisation of sexual and reproductive rights’ that builds on globally established human rights conventions such as the Universal Declaration of Human Rights, the right to health, the rights of the child, the Convention on the Elimination of All Forms of Discrimination against Women and the Sustainable Development Goals (SDGs). 13 In this review, our understanding of climate change events, such as heat waves, droughts and floods, is based on the Intergovernmental Panel on Climate Change (IPCC) 2022 report. 14

Selection criteria

Peer-reviewed articles in any language were considered for inclusion if they empirically measured or explicitly analysed the intersection of climate change and SRHR. We limited the search to publications from January 1994 to reflect when the United Nations Framework Convention on Climate Change was ratified, and when the United Nations International Conference on Population and Development in Cairo adopted a human rights approach to sexual and reproductive health. The final database search and inclusion date was 6 September 2023.

We included only original research articles based on quantitative (eg, cohort-based, cross-sectional and time-series), qualitative and mixed-methods study designs. We included all articles that explored SRHR and climate change in LMICs affecting all populations regardless of age, sex or gender. Since there is no standardised classification of SRHR factors with respect to climate change, we adapted the Guttmacher-Lancet Commission framework together with specific SDG targets focusing on broad sexual and reproductive health domains and related essential services. 13 Based on this framework, we divided included articles into the following categories: maternal and newborn health, abortion, HIV and other sexually transmitted infections (STIs), contraception, fertility care (including pregnancy intentions and timing, family size, and infertility), reproductive cancers, gender-based violence (GBV), harmful practices (including early/forced marriage and female genital mutilation (FGM), and multiple (a few studies researched several SRHR aspects including maternal and newborn health, GBV, harmful practices and fertility care).

Similarly, due to the absence of a standardised classification for climate change phenomena, we categorised climate change events based on those identified as detrimental to health and well-being by the IPCC. 14 Articles were included if they (1) explicitly measured how climatic/weather events changed over time by increasing in frequency or intensity or duration in the study context and/or (2) used reference measures to denote how those events were ‘extreme’ (eg, temperature ≥95th percentile or ≤5th percentile) and/or (3) defined that the phenomena analysed were anomalies. If articles did not use the term ‘climate change’ but used the above description, they were still included. Thus, the following major climate change events were considered: extreme temperature (including the subcategories of increasing/extreme heat and decreasing temperature/cold spells), rainfall shocks (including positive and negative shocks), drought, floods, cyclone/typhoons and multiple climate change events (a few studies researched several of the included events such as drought, abnormal temperatures and precipitation, floods and cyclones). 14

We excluded articles focusing on predictions or projections of future scenarios. Systematic reviews, scoping and literature reviews, meta-analyses, conceptual frameworks, book reviews, news reports, editorials, letters, commentaries, viewpoints, theoretical articles, mathematical models and non-peer-reviewed reports were excluded. Articles that did not report their methodology or focused on populations living in high-income countries were excluded. Articles on child health beyond the perinatal period were also excluded, except if the article(s) related to SRHR outcomes such as in early/forced marriage FGM or GBV. We excluded studies on natural disasters unrelated to anthropogenic climate change (eg, earthquakes and tsunamis), dust storms and air pollution (including those related to volcanic eruptions and wildfires) since their connection to climate change is complex and less direct. Specific to air pollution, the complexity can be seen in how several reviews have examined the impact of air pollution on SRHR including in LMICs without mentioning climate change, 15 while a most recent review only examined the impacts of air pollution and climate change separately on SRHR. 16 Further, studies that focused on interventions related to climate change adaptation, mitigation, resilience and coping were excluded unless they were directly linked to SRHR outcomes.

Study selection

The search results were first imported into an EndNote Library and then uploaded to Rayyan, a web-based software platform for conducting reviews (available from: https://www.rayyan.ai ) from where identified duplicates were removed. Three authors (MOA, RS and APFC) screened the articles by titles and abstracts for inclusion and removed any remaining duplicates. This was followed by full-text extraction of relevant articles by two reviewers (RS and APFC) to create a literature database; a third reviewer (MOA) verified all final inclusion decisions and was the tiebreaker in cases of conflict.

Data abstraction and charting

For all included articles, we extracted information regarding title, year of publication, study country and income level following the World Bank classification, study setting (urban, rural, mixed), study design (quantitative, qualitative or both), sample and data source, SRHR domain, climate change event, climate data source and key findings. Additionally, we categorised all study countries by WHO regional classification. 17 We also reported the first and corresponding authors’ affiliated institution, country and income classification, and affiliations of any other author. Complete details are presented in online supplemental file 1 .

We identified a total of 23 338 records and after removal of 8573 duplicates, 14 674 were screened for eligibility by title and abstract. 262 records were retrieved for full text review and 75 articles were finally included in this scoping review. Figure 1 displays the PRISMA flow diagram showing a summary of the article selection process for the scoping review.

PRISMA diagram showing the study selection process of articles. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses; SRHR, sexual and reproductive health and rights.

Characteristics of included articles

Table 1 and online supplemental file 2 present an overview of the characteristics of the 75 articles included. 18–92 The search yielded articles across 99 LMICs, with over 80% published between 2018 and 2023. Figure 2 shows that the majority of the articles focused exclusively on African (26), Western Pacific (22) and South-East Asian regions (15) constituting 84% of the total articles. A detailed synthesis of the 75 studies and a list of study countries can be found in online supplemental file 1 (tables A (p 27–50) and B (p 51–52), respectively). 47 (63%) articles had at least one author affiliated with institutions in LMICs, the majority of whom were from the countries where the studies were conducted.

Distribution of 75 articles on climate change and sexual and reproductive health and rights, published 1994–2023 in low-income and middle-income countries by WHO regions.

Populations studied, sample size and study design

Figure 3 displays the distribution of populations studied by a number of articles, with newborns and women of reproductive age accounting for 28 and 20 articles, respectively, constituting more than half (55%) of all the articles. Four (5%) articles focused on men and women living with HIV, aged 15+ years. Quantitative studies constituted three-quarters (57 out of 75) of the articles, with the sample sizes ranging from 105 to 5.44 million and were mainly cross-sectional and retrospective designs. 13 (17%) articles employed qualitative approaches, mainly key informant interviews and focus group discussion, and five (7%) were mixed-methods studies.

Populations studied by 75 articles on climate change and sexual and reproductive health and rights, published 1994–2023 in low-income and middle-income countries.

Climate change exposures

The impact of extreme temperatures on SRHR was the most extensively studied area including 33 articles (44.0%) encompassing factors such as heat waves, cold spells and increasing ambient temperatures. This was followed by articles on drought (18), rainfall shocks (14), floods (10) and cyclones/typhoons (4), with a few articles examining more than 2 climate change events. Six articles examining the impact of three or more climate change events on SRHR.

SRHR outcomes and key findings

Figure 4 is a matrix showing SRHR domains studied with respect to specific climate change events.

A matrix of climate change events and SRHR categories, studied by 75 articles, published between 1994 and September 2023 in LMICs. LMICs, low-income and middle-income countries.

Maternal and newborn health

This was the most studied SRHR domain with 37 (49%) out of 75 articles across various climate change events. Among these, 73% (27/37) focused on the impact of extreme temperatures 36 37 40–45 48–51 53–57 61–69 92 on maternal and newborn health, with 21 out of the 27 from the Western Pacific region, primarily China. There were no articles on extreme temperatures from South-East Asian, European and Eastern Mediterranean regions in this SRHR domain. Other studies of climate change factors with respect to maternal/newborn health included drought, 35 rainfall shocks, 37 46 47 58 92 floods 34 38 52 60 and cyclones/typhoons. 59 One study looked at multiple climatic events. 39 Generally, the studies reported associations between climate change events such as extreme temperatures (hot or cold), prolonged drought and neonatal outcomes such as reduced or low birth weight, 35–37 41 42 45–48 51 54 58 63 65 92 increased preterm birth, 43 44 50 53 56 57 62 64 66 68 low Apgar scores, 36 40 shorter length at birth, 36 congenital heart defects, 67 69 macrosomia 49 and stillbirth. 52 55 Studies also found associations between flooding, cyclones and typhoons with lack of appropriate pregnancy care, pregnancy complications and maternal death. 34 38 52 59 60 Further, rainfall shocks were associated with shorter gestational periods, infant mortality 58 and large birth weights. 37 92

Gender-based violence

Nine articles studied GBV or violence against women and girls in relation to climate change events. Five out of the nine articles were exclusively from the African region. Climate change phenomena researched in this domain included drought, 20–22 24 25 floods, 19 cyclones and typhoons, 26 rainfall shocks 23 and multiple climate change events including extreme temperatures. 18 Studies reported associations between floods, drought, cyclones and GBV including sexual violence, 19 24 26 psychological 26 and physical violence. 19 23 24 26 However, no study reported on sex trafficking or sex work in the context of the climate crisis.

HIV and other STIs

Nine articles studied climate change and HIV, seven of which were exclusively from the African region. Drought was the predominant climate factor examined with respect to HIV. Others included floods and rainfall shocks. The studies reported associations between extreme climatic events particularly droughts, floods, rainfall shocks and increased HIV prevalence. 70 73 75–78 Studies also found these climate-related events and HIV risk factors such as multiple sexual partners, 77 condomless sex 72 and other risky sexual behaviours, 71 78 as well as decreased antiretroviral therapy adherence and retention in care. 74 There were few to no studies on the climate change events in this study and other STIs and certain aspects of HIV, including coinfections, discrimination and stigma.

Fertility care

Fertility care, encompassing pregnancy intentions and timing, family size and infertility, was studied by eight articles from across all regions. Fertility was studied in the context of extreme temperatures, floods and rainfall shocks. 79–85 89 Decreases in total fertility rates 79 and reduced semen quality 80 were reported to be associated with extreme temperatures. Increased birth rates were reported during below-average temperatures and above-average rainfall, 83 but ideal family size lowered with exposure to higher temperatures in Africa. 81

Harmful practices

Seven articles examined harmful practices such as forced marriages, and FGM and climate change. All the articles in this domain were from South-East Asian and African regions. Negative impacts were reported between extreme weather events such as storms, 27 28 32 extreme temperatures, 29 33 and drought 30 31 and forced marriages and FGM. 27–33 Of note, while most studies showed a greater risk of early and forced marriages and FGM, one study reported a 3% decrease in the risk of marriage between ages 12 and 17 in sub-Saharan Africa and a 4% decrease in India due to drought. 30

Contraception

Only one article addressed contraception in this review, reporting associations between rainfall shocks and increased demand for modern and traditional contraceptives. 91 No studies addressed associations between modern contraception preferences, whether long-acting or short-acting, or permanent as well as access, costs or user satisfaction.

Multiple SRHR domains

Five articles studied the interplay of climate change events and multiple SRHR domains. Three studies examined how fertility care, family planning and harmful practices are impacted by drought 86 88 and extreme temperatures. 90 One article analysed how floods impact SRHR services, fertility care including unwanted pregnancies, GBV, and maternal and newborn health through the lens of maternal death. 87 Lastly, one article examined how more than three climatic events combined influence fertility care and contraception use. 89

Main research gaps

Notably, no studies were conducted within the SRHR areas of induced abortion and reproductive cancers in the context of climate change, indicating research gaps that could be explored by future studies.

This scoping review is among the first to map peer-reviewed publications over the past three decades at the intersection of climate change and SRHR in LMICs across WHO regions worldwide. We identified 75 articles investigating the impact of climate change on SRHR. Most of these articles were published in 2018 and were conducted on populations in African, Western Pacific and South-East Asian regions. Most studies employed quantitative methodologies and targeted newborns and women of reproductive age. Maternal and newborn health was the most researched aspect of SRHR in the context of climate change; meanwhile, we did not find any studies exploring the impact of climate change on induced abortion or reproductive cancers. Extreme temperatures and drought were the most studied climate change phenomena, especially as they relate to maternal and newborn health.

The exponential increase in the articles published since 2018 indicates a growing recognition of the need to understand the impact of climate change on SRHR. This aligns with the growing attention on climate change and health as a global research priority, as demonstrated by the 2017/2018 WHO surveys conducted among national health services on health and climate change, involving 101 countries. These highlighted the profiled countries’ expected health impacts of climate change with the aim to raise awareness of health and climate linkages. 93 The fact that most articles relied on data from cross-sectional surveys implies that the captured climate impacts are either from ongoing or past extreme weather events. This poses challenges in ascertaining some impact associations found due to the risk of recall or social desirability biases and other systematic errors, for example, regarding identifying links between forced marriage and floods in a community where early and forced marriage are already highly prevalent. Using health records from registries on maternal/newborn health, HIV, abortion or reproductive cancers could allow for longitudinal analysis and impact comparisons of extreme climatic events at different times with higher validity.

While the intersection of climate change and maternal and newborn health has received significant attention in published articles, including a recent call to action by several UN actors, 5 a substantial amount (73%) of these articles focused on the impact of extreme temperatures. Moreover, most of these articles were from the Western Pacific region, particularly China. Conversely, there is limited literature on the impact of floods, rainfall shocks, drought and cyclones on maternal and newborn health in regions prone to these climate change events and where the risk of maternal and newborn morbidity and mortality due to climate change is higher such as in African and South-East Asian regions. 94 Filling such research gaps in these regions is critical to inform tailored interventions and policies. Further, certain climate change and SRHR areas are predominantly studied in certain regions, perhaps due to heightened vulnerabilities in those regions and subsequent investments for research. For instance, floods and cyclones are well studied in South-East Asia, mainly Bangladesh, likely owing to their susceptibility to such events. 84 Articles on HIV, GBV and drought from the African region reflect the substantial challenges related to HIV and drought in this region. 73–76 A recent review by Logie et al 95 revealed an association between extreme weather events—such as hurricanes, floods, drought and storms—and adverse HIV outcomes attributable to limited access to antiretroviral treatment and deteriorating mental health. Notably, very few articles focused on Latin America and the Caribbean, although many communities in this region are highly vulnerable to weather extremes and are dependent on weather-sensitive activities such as agriculture and tourism. 96

This scarcity of studies looking at climate change events and contraception, abortion or reproductive cancers revealed in this review could be partly due to a lack of reliable data across LMICs. 97 Addressing these data gaps is crucial in the context of climate change. Furthermore, despite only one article that exclusively studied climate change and harmful practices in Kenya, 31 reliable organisational reports have continued to highlight the implications of climate change on early and forced marriages and FGM across the African region. 98 While FGM is a practice deeply embedded in culture and social norms, it is also a requirement for marriage in many settings, therefore, an increase in FGM can be a precursor to early marriage in response to existential and livelihood threats posed by climate change. 31 Certain SRHR domains such as abortion, GBV and harmful practices may require a special long-term framework to study in the context of climate change in LMICs given that reporting and documentation of such incidences may be hindered due to sociocultural limitations in certain communities. Longitudinal research and greater involvement of local researchers and local stakeholders could improve measurement.

In all regions, the predominant study populations were newborns and women of reproductive age. Subsequent studies could endeavour to broaden the scope of research at the intersection of climate change and SRHR in LMICs to include other demographics such as boys, men and individuals with diverse sexual orientations, gender identities/expressions and sex characteristics. Additionally, studies could explore these associations among migrant and indigenous populations. Across all populations, more attention could be given to the ‘rights’ aspect of SRHR. 99 In essence, the achievement of SRHR relies on adopting a rights-based approach to health; a perspective that emphasises that all individuals have a right to make decisions regarding their bodies and should have access to services that uphold and support that right. 99

Implications for future research

Regarding the methods, several studies highlighted limitations related to the available health data for climate change research. 32 36 37 This emphasises the need for improved climate-related routine health data collection. There were relatively very few articles that employed mixed quantitative and qualitative approaches where findings were merged and triangulated. Researchers could harness the power of both methods for a better understanding of climate change-related and SRHR-related topics. More registry-based data and longitudinal studies could also be helpful for studying rare impacts of climate change events on SRHR in LMICs, including those related to changes in air quality.

Over one-third of the articles were authored exclusively by authors from institutions in high-income countries, with limited involvement of institutions in LMICs. This may be due to imbalances of power and funding resources skewed towards high-income countries and, perhaps, an underappreciation of prioritising indigenous, context-specific knowledge in research. 100 Considering that climate change disproportionately impacts LMICs, collaborating with local researchers in affected areas can be vital, especially when employing mixed methods and qualitative approaches. Moving forward, fostering cross-institutional collaborations between high-income countries and LMICs, as well as South-South partnerships, would not only enhance research capabilities and the validity, credibility and transferability of findings but also address ethical considerations 100 and equitable partnerships in this critical field.

Limitations

There are limitations to this review. First, given the lack of standard classification of climate change factors, there is a possibility that the search may have left out other potential intersection areas, for instance, climate change and SRHR-related infectious diseases and social conflicts. Relatedly, our categorisation of SRHR domains and climate change phenomena is but one way to classify these issues, there could be others. For example, we did not find studies on broader sexual or menstrual health which could alter this categorisation in the future. Second, we excluded studies on projections and predictions which could have provided valuable insights concerning the future impacts of climate change on SRHR. Similarly, we also excluded one important factor related to climate change: air pollution. Given the broad range of air pollution factors, including the confounding or mediating effects, it is complicated to determine the impact of air pollution attributable to climate change. These factors are outside the scope of this review and best placed as a separate standalone review. Third, since this is a scoping review, we leave it to future systematic reviews to conduct critical appraisals to assess the quality of extant research. Fourth, by focusing on studies in LMICs, we excluded studies on forcibly displaced people, asylum seekers, refugees and other migrants originating from LMICs but located in high-income countries.

The findings of this scoping review underscore the growing, but still emerging, field of research that links climate change and SRHR in LMICs. We mapped existing studies and identified knowledge gaps that could guide future research priorities. In the context of climate change, maternal and newborn health was the most studied while potential climate change links to abortion, reproductive cancers and contraception were the least researched SRHR domains. The review underscores the urgent need to complement existing evidence with targeted research to fill knowledge gaps and strengthen the evidence base to guide interventions and policy development on SRHR and climate change.

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How Climate Change Impacts Mountains

• First Online: 08 August 2024

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• Erlijn van Genuchten 2  

Climate change has a significant impact on landscapes, including mountains. As global temperatures rise, snow, glaciers, and permafrost melt, which further disrupts the regional heat balance. This disruption increases the number of geohazards and risks, such as landslides, rock slope failures, and falling rocks. Also, mountain ecosystems and services change, for example affecting plant growth, water quality, and food web structures. This in turn strongly impacts mountain communities and infrastructure, as they rely on mountains for water, food, agriculture, and tourism. This shows that higher global temperatures have far-reaching consequences in mountain areas.

Credit: This chapter is based on the scientific article “Scientists’ warning of the impacts of climate change on mountains” by Jasper Knight. (Full citation is available at the end of the chapter)

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Knight J. (2022). Scientists’ warning of the impacts of climate change on mountains. PeerJ , 10 , e14253.

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van Genuchten, E. (2024). How Climate Change Impacts Mountains. In: A Guide to a Healthier Planet, Volume 2. Springer, Cham. https://doi.org/10.1007/978-3-031-60128-6_2

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