The effects on public health of climate change adaptation responses: a systematic review of evidence from low- and middle-income countries.

Climate change adaptation responses are being developed and delivered in many parts of the world in the absence of detailed knowledge of their effects on public health. Here we present the results of a systematic review of peer-reviewed literature reporting the effects on health of climate change adaptation responses in low- and middle-income countries (LMICs). The review used the 'Global Adaptation Mapping Initiative' database (comprising 1682 publications related to climate change adaptation responses) that was constructed through systematic literature searches in Scopus, Web of Science and Google Scholar (2013-2020). For this study, further screening was performed to identify studies from LMICs reporting the effects on human health of climate change adaptation responses. Studies were categorised by study design and data were extracted on geographic region, population under investigation, type of adaptation response and reported health effects. The review identified 99 studies (1117 reported outcomes), reporting evidence from 66 LMICs. Only two studies were ex ante formal evaluations of climate change adaptation responses. Papers reported adaptation responses related to flooding, rainfall, drought and extreme heat, predominantly through behaviour change, and infrastructural and technological improvements. Reported (direct and intermediate) health outcomes included reduction in infectious disease incidence, improved access to water/sanitation and improved food security. All-cause mortality was rarely reported, and no papers were identified reporting on maternal and child health. Reported maladaptations were predominantly related to widening of inequalities and unforeseen co-harms. Reporting and publication-bias seems likely with only 3.5% of all 1117 health outcomes reported to be negative. Our review identified some evidence that climate change adaptation responses may have benefits for human health but the overall paucity of evidence is concerning and represents a major missed opportunity for learning. There is an urgent need for greater focus on the funding, design, evaluation and standardised reporting of the effects on health of climate change adaptation responses to enable evidence-based policy action.

Systematic mapping of global research on climate and health: a machine learning review.

BACKGROUND: The global literature on the links between climate change and human health is large, increasing exponentially, and it is no longer feasible to collate and synthesise using traditional systematic evidence mapping approaches. We aimed to use machine learning methods to systematically synthesise an evidence base on climate change and human health. METHODS: We used supervised machine learning and other natural language processing methods (topic modelling and geoparsing) to systematically identify and map the scientific literature on climate change and health published between Jan 1, 2013, and April 9, 2020. Only literature indexed in English were included. We searched Web of Science Core Collection, Scopus, and PubMed using title, abstract, and keywords only. We searched for papers including both a health component and an explicit mention of either climate change, climate variability, or climate change-relevant weather phenomena. We classified relevant publications according to the fields of climate research, climate drivers, health impact, date, and geography. We used supervised and unsupervised machine learning to identify and classify relevant articles in the field of climate and health, with outputs including evidence heat maps, geographical maps, and narrative synthesis of trends in climate health-related publications. We included empirical literature of any study design that reported on health pathways associated with climate impacts, mitigation, or adaptation. FINDINGS: We predict that there are 15 963 studies in the field of climate and health published between 2013 and 2019. Climate health literature is dominated by impact studies, with mitigation and adaptation responses and their co-benefits and co-risks remaining niche topics. Air quality and heat stress are the most frequently studied exposures, with all-cause mortality and infectious disease incidence being the most frequently studied health outcomes. Seasonality, extreme weather events, heat, and weather variability are the most frequently studied climate-related hazards. We found major gaps in evidence on climate health research for mental health, undernutrition, and maternal and child health. Geographically, the evidence base is dominated by studies from high-income countries and China, with scant evidence from low-income counties, which often suffer most from the health consequences of climate change. INTERPRETATION: Our findings show the importance and feasibility of using automated machine learning to comprehensively map the science on climate change and human health in the age of big literature. These can provide key inputs into global climate and health assessments. The scant evidence on climate change response options is concerning and could significantly hamper the design of evidence-based pathways to reduce the effects on health of climate change. In the post-2015 Paris Agreement era of climate solutions, we believe much more attention should be given to climate adaptation and mitigation options and their effects on human health. FUNDING: Foreign, Commonwealth & Development Office.

Mapping global research on climate and health using machine learning (a systematic evidence map).

Climate change is already affecting health in populations around the world, threatening to undermine the past 50 years of global gains in public health. Health is not only affected by climate change via many causal pathways, but also by the emissions that drive climate change and their co-pollutants. Yet there has been relatively limited synthesis of key insights and trends at a global scale across fragmented disciplines. Compounding this, an exponentially increasing literature means that conventional evidence synthesis methods are no longer sufficient or feasible. Here, we outline a protocol using machine learning approaches to systematically synthesize global evidence on the relationship between climate change, climate variability, and weather (CCVW) and human health. We will use supervised machine learning to screen over 300,000 scientific articles, combining terms related to CCVW and human health. Our inclusion criteria comprise articles published between 2013 and 2020 that focus on empirical assessment of: CCVW impacts on human health or health-related outcomes or health systems; relate to the health impacts of mitigation strategies; or focus on adaptation strategies to the health impacts of climate change. We will use supervised machine learning (topic modeling) to categorize included articles as relevant to impacts, mitigation, and/or adaptation, and extract geographical location of studies. Unsupervised machine learning using topic modeling will be used to identify and map key topics in the literature on climate and health, with outputs including evidence heat maps, geographic maps, and narrative synthesis of trends in climate-health publishing. To our knowledge, this will represent the first comprehensive, semi-automated, systematic evidence synthesis of the scientific literature on climate and health.