Refugee settlements are highly exposed to extreme weather conditions.

Involuntary displacement from conflict and other causes leads to clustering of refugees and internally displaced people, often in long-term settlements. Within refugee-hosting countries, refugee settlements are frequently located in isolated and remote areas, characterized by poor-quality land and harsh climatic conditions. Yet, the exposure of refugee settlements to climatic events is underresearched. In this article, we study the exposure of the 20 largest refugee settlements worldwide to extreme variations in climatic conditions. The analysis integrates exposure of camp locations compared to the national trends for both slow- and rapid-onset events and includes descriptive statistics, signal-to-noise analyses, and trend analyses. Our findings show that most refugee settlements included face relatively high exposure to slow-onset events, including high temperatures (for settlements in Kenya, Ethiopia, Rwanda, Sudan, and Uganda), low temperatures (in the case of Jordan and Pakistan), and low levels of rainfall (in Ethiopia, Rwanda, Kenya, and Uganda) compared to national averages. Our findings for rapid-onset events-heatwaves, coldwaves, and extreme rainfall-are less conclusive compared to country trends, although we find relatively high exposure to extreme rainfall in Cox's Bazar, Bangladesh. Our analyses confirm that refugee populations are exposed to extreme weather conditions postdisplacement, which, in combination with their sociopolitical exclusion, poses a threat to well-being and increased marginalization. Our findings call for an inclusive and integrated approach, including refugees and their host communities, in designing climate adaptation and sustainable development policies, in order to promote equitable sustainable development pathways in refugee-hosting countries.

Trends of extreme US weather events in the changing climate.

Trends in extreme 100-y events of temperature and rainfall amounts in the continental United States are estimated, to see effects of climate change. This is a nontrivial statistical problem because climate change effects have to be extracted from "noisy" weather data within a limited time range. We use nonparametric Bayesian methods to estimate the trends of extreme events that have occurred between 1979 and 2019, based on data for temperature and rainfall. We focus on 100-y events for each month in [Formula: see text] geographical areas looking at hourly temperature and 5-d cumulative rainfall. Distribution tail models are constructed using extreme value theory (EVT) and data on 33-y events. This work shows it is possible to aggregate data from spatial points in diverse climate zones for a given month and fit an EVT model with the same parameters. This surprising result means there are enough extreme event data to see the trends in the 41-y record for each calendar month. The yearly trends of the risk of a 100-y high-temperature event show an average 2.1-fold increase over the last 41 y of data across all months, with a 2.6-fold increase for the months of July through October. The risk of high rainfall extremes increases in December and January 1.4-fold, but declines by 22% for the spring and summer months.

Integrated causal-predictive machine learning models for tropical cyclone epidemiology.

Strategic preparedness reduces the adverse health impacts of hurricanes and tropical storms, referred to collectively as tropical cyclones (TCs), but its protective impact could be enhanced by a more comprehensive and rigorous characterization of TC epidemiology. To generate the insights and tools necessary for high-precision TC preparedness, we introduce a machine learning approach that standardizes estimation of historic TC health impacts, discovers common patterns and sources of heterogeneity in those health impacts, and enables identification of communities at highest health risk for future TCs. The model integrates (i) a causal inference component to quantify the immediate health impacts of recent historic TCs at high spatial resolution and (ii) a predictive component that captures how TC meteorological features and socioeconomic/demographic characteristics of impacted communities are associated with health impacts. We apply it to a rich data platform containing detailed historic TC exposure information and records of all-cause mortality and cardiovascular- and respiratory-related hospitalization among Medicare recipients. We report a high degree of heterogeneity in the acute health impacts of historic TCs, both within and across TCs, and, on average, substantial TC-attributable increases in respiratory hospitalizations. TC-sustained windspeeds are found to be the primary driver of mortality and respiratory risks.

Extreme Humid-Heat Exposure and Mortality Among Patients Receiving Dialysis.

RATIONALE & OBJECTIVE: Exposure to extreme heat events has been linked to increased morbidity and mortality in the general population. Patients receiving maintenance dialysis may be vulnerable to greater risks from these events, but this is not well understood. We sought to characterize the association of extreme heat events and the risk of death among patients receiving dialysis in the United States. STUDY DESIGN: Retrospective cohort study. SETTING & PARTICIPANTS: Data from the United States Renal Data System were used to identify adults living in US urban settlements prone to extreme heat who initiated maintenance dialysis between 1997 and 2016. EXPOSURE: An extreme heat event was defined as a time-updated heat index (a humid-heat metric) exceeding 40.6°C for ≥2 days or 46.1°C for ≥1 day. OUTCOME: Death. ANALYTICAL APPROACH: Cox proportional hazards regression to estimate the elevation in risk of death during a humid-heat event adjusted for age, sex, year of dialysis initiation, dialysis modality, poverty level, and climate region. Interactions between humid-heat and these same factors were explored. RESULTS: Among 945,251 adults in 245 urban settlements, the mean age was 63 years and 44% were female. During a median follow-up of 3.6 years, 498,049 adults were exposed to at least one of 7,154 extreme humid-heat events, and 500,025 deaths occurred. In adjusted models, there was an increased risk of death (hazard ratio 1.18; 95% confidence interval 1.15-1.20) during extreme humid-heat exposure. Relative mortality risk was higher among patients living in the Southeast (P<0.001) compared with the Southwest. LIMITATIONS: Possibility of exposure misclassification, did not account for land use and air pollution co-exposures. CONCLUSIONS: This study suggests that patients receiving dialysis face an increased risk of death during extreme humid-heat exposure.

Zoonotic spillover and extreme weather events drive the global outbreaks of airborne viral emerging infectious diseases.

Outbreaks of airborne viral emerging infectious diseases (EIDs) cause an increasing burden on global public health, particularly with a backdrop of intensified climate change. However, infection sources and drivers for outbreaks of airborne viral EIDs remain unknown. Here, we aim to explore the driving mechanisms of outbreaks based on the one health perspective. Outbreak information for 20 types of airborne viral EIDs was collected from the Global Infectious Disease and Epidemiology Network database and a systematic literature review. Four statistically significant and high-risk spatiotemporal clusters for airborne viral EID outbreaks were identified globally using multivariate scan statistic tests. There were 112 outbreaks with clear infection sources, and zoonotic spillover was the most common source (95.54%, 107/112). Since 1970, the majority of outbreaks occurred in healthcare facilities (24.82%), followed by schools (17.93%) and animal-related settings (15.93%). Significant associations were detected between the number of earthquakes, storms, duration of floods, and airborne viral EIDs' outbreaks using a case-crossover study design and multivariable conditional logistic regression. These findings implied that zoonotic spillover and extreme weather events are driving global outbreaks of airborne viral EIDs, and targeted prevention and control measures should be made to reduce the airborne viral EIDs burden.

Unravelling the role of tropical cyclones in shaping present species distributions.

Driven by climate change, tropical cyclones (TCs) are predicted to change in intensity and frequency through time. Given these forecasted changes, developing an understanding of how TCs impact insular wildlife is of heightened importance. Previous work has shown that extreme weather events may shape species distributions more strongly than climatic averages; however, given the coarse spatial and temporal scales at which TC data are often reported, the influence of TCs on species distributions has yet to be explored. Using TC data from the National Hurricane Center, we developed spatially and temporally explicit species distribution models (SDMs) to examine the role of TCs in shaping present-day distributions of Puerto Rico's 10 Anolis lizard species. We created six predictor variables to represent the intensity and frequency of TCs. For each occurrence of a species, we calculated these variables for TCs that came within 500 km of the center of Puerto Rico and occurred within the 1-year window prior to when that occurrence was recorded. We also included predictor variables related to landcover, climate, topography, canopy cover and geology. We used random forests to assess model performance and variable importance in models with and without TC variables. We found that the inclusion of TC variables improved model performance for the majority of Puerto Rico's 10 anole species. The magnitude of the improvement varied by species, with generalist species that occur throughout the island experiencing the greatest improvements in model performance. Range-restricted species experienced small, almost negligible, improvements but also had more predictive models both with and without the inclusion of TC variables compared to generalist species. Our findings suggest that incorporating data on TCs into SDMs may be important for modeling insular species that are prone to experiencing these types of extreme weather events.

Subarctic winter warming promotes soil microbial resilience to freeze-thaw cycles and enhances the microbial carbon use efficiency.

Climate change is predicted to cause milder winters and thus exacerbate soil freeze-thaw perturbations in the subarctic, recasting the environmental challenges that soil microorganisms need to endure. Historical exposure to environmental stressors can facilitate the microbial resilience to new cycles of that same stress. However, whether and how such microbial memory or stress legacy can modulate microbial responses to cycles of frost remains untested. Here, we conducted an in situ field experiment in a subarctic birch forest, where winter warming resulted in a substantial increase in the number and intensity of freeze-thaw events. After one season of winter warming, which raised mean surface and soil (-8 cm) temperatures by 2.9 and 1.4°C, respectively, we investigated whether the in situ warming-induced increase in frost cycles improved soil microbial resilience to an experimental freeze-thaw perturbation. We found that the resilience of microbial growth was enhanced in the winter warmed soil, which was associated with community differences across treatments. We also found that winter warming enhanced the resilience of bacteria more than fungi. In contrast, the respiration response to freeze-thaw was not affected by a legacy of winter warming. This translated into an enhanced microbial carbon-use efficiency in the winter warming treatments, which could promote the stabilization of soil carbon during such perturbations. Together, these findings highlight the importance of climate history in shaping current and future dynamics of soil microbial functioning to perturbations associated with climate change, with important implications for understanding the potential consequences on microbial-mediated biogeochemical cycles.

Divergent ecological responses to typhoon disturbance revealed via landscape-scale acoustic monitoring.

Climate change is increasing the frequency, intensity, and duration of extreme weather events across the globe. Understanding the capacity for ecological communities to withstand and recover from such events is critical. Typhoons are extreme weather events that are expected to broadly homogenize ecological dynamics through structural damage to vegetation and longer-term effects of salinization. Given their unpredictable nature, monitoring ecological responses to typhoons is challenging, particularly for mobile animals such as birds. Here, we report spatially variable ecological responses to typhoons across terrestrial landscapes. Using a high temporal resolution passive acoustic monitoring network across 24 sites on the subtropical island of Okinawa, Japan, we found that typhoons elicit divergent ecological responses among Okinawa's diverse terrestrial habitats, as indicated by increased spatial variability of biological sound production (biophony) and individual species detections. This suggests that soniferous communities are capable of a diversity of different responses to typhoons. That is, spatial insurance effects among local ecological communities provide resilience to typhoons at the landscape scale. Even though site-level typhoon impacts on soundscapes and bird detections were not particularly strong, monitoring at scale with high temporal resolution across a broad spatial extent nevertheless enabled detection of spatial heterogeneity in typhoon responses. Further, species-level responses mirrored those of acoustic indices, underscoring the utility of such indices for revealing insight into fundamental questions concerning disturbance and stability. Our findings demonstrate the significant potential of landscape-scale acoustic sensor networks to capture the understudied ecological impacts of unpredictable extreme weather events.

Heat wave-induced microbial thermal trait adaptation and its reversal in the Subarctic.

Climate change predictions suggest that arctic and subarctic ecosystems will be particularly affected by rising temperatures and extreme weather events, including severe heat waves. Temperature is one of the most important environmental factors controlling and regulating microbial decomposition in soils; therefore, it is critical to understand its impact on soil microorganisms and their feedback to climate warming. We conducted a warming experiment in a subarctic birch forest in North Sweden to test the effects of summer heat waves on the thermal trait distributions that define the temperature dependences for microbial growth and respiration. We also determined the microbial temperature dependences 10 and 12 months after the heat wave simulation had ended to investigate the persistence of the thermal trait shifts. As a result of warming, the bacterial growth temperature dependence shifted to become warm-adapted, with a similar trend for fungal growth. For respiration, there was no shift in the temperature dependence. The shifts in thermal traits were not accompanied by changes in α- or ß-diversity of the microbial community. Warming increased the fungal-to-bacterial growth ratio by 33% and decreased the microbial carbon use efficiency by 35%, and both these effects were caused by the reduction in moisture the warming treatments caused, while there was no evidence that substrate depletion had altered microbial processes. The warm-shifted bacterial thermal traits were partially restored within one winter but only fully recovered to match ambient conditions after 1 year. To conclude, a summer heat wave in the Subarctic resulted in (i) shifts in microbial thermal trait distributions; (ii) lower microbial process rates caused by decreased moisture, not substrate depletion; and (iii) no detectable link between the microbial thermal trait shifts and community composition changes.

Cross-scale assessments of the impacts and resilience of subtropical montane cloud forests to chronic seasonal droughts and episodic typhoons.

Montane cloud forests (MCFs) are ecosystems frequently immersed in fog and are vital for the terrestrial hydrological cycle and biodiversity hotspots. However, the potential impacts of climate change, particularly intensified droughts and typhoons, on the persistence of ecosystems remain unclear. Our study conducted cross-scale assessments using 6-year (2016-2021) ground litterfall and 21-year (2001-2021) satellite greenness data (the Enhanced Vegetation Index [EVI] and the EVI anomaly change [ΔEVI% ]), gross primary productivity anomaly change (ΔGPP% ), and meteorological variables (the standardized precipitation index [SPI] and wind speed). We found a positive correlation between summer EVI and ΔGPP% with the SPI-3 (3-month time scale), while winter litterfall showed a negative correlation. Maximum typhoon daily wind speed was negatively correlated with summer and the monthly ΔEVI% and ΔGPP% . These findings suggest vegetation damage and productivity loss were related to drought and typhoon intensities. Furthermore, our analysis highlighted that chronic seasonal droughts had more pronounced impacts on MCFs than severe typhoons, implying that high precipitation and frequent fog immersion do not necessarily mitigate the ramifications of water deficit on MCFs but might render MCFs more sensitive and vulnerable to drought. A significant negative correlation between the summer and winter ΔEVI% and ΔGPP% of the same year, suggesting disturbance severity during summer may facilitate vegetation regrowth and carbon accumulation in the subsequent winter. This finding may be attributed to the ecological resilience of MCFs, which enables them to recover from the previous summer. In the long-term, our results indicated an increase in vegetation resilience over two decades in MCFs, likely driven by rising temperatures and elevated carbon dioxide levels. However, the enhancement of resilience might be overshadowed by the potential intensified droughts and typhoons in the future, potentially causing severe damage and insufficient recovery times for MCFs, thus raising concerns about uncertainties regarding their sustained resilience.

Climate change: Attitudes and concerns of, and learnings from, people with neurological conditions, carers, and health care professionals.

OBJECTIVE: Concern about climate change among the general public is acknowledged by surveys. The health care sector must play its part in reducing greenhouse gas emissions and adapting to a changing climate, which will require the support of its stakeholders including those with epilepsy, who may be especially vulnerable. It is important to understand this community's attitudes and concerns about climate change and societal responses. METHODS: A survey was made available to more than 100 000 people among a section of the neurological community (patients, carers, and clinicians), focused on epilepsy. We applied quantitative analysis of Likert scale responses supported by qualitative analyses of free-text questions with crossover analyses to identify consonance and dissonance between the two approaches. RESULTS: A small proportion of potential respondents completed the survey; of 126 respondents, 52 had epilepsy and 56 explicitly declared no illness. The survey indicated concern about the impact of climate change on health within this neurological community focused on epilepsy. More than half of respondents considered climate change to have been bad for their health, rising to 68% in a subgroup with a neurological condition; over 80% expected climate change to harm their health in future. Most (>75%) believed that action to reduce greenhouse gas emissions will lead to improved health and well-being. The crossover analysis identified cost and accessibility as significant barriers. SIGNIFICANCE: The high level of concern about climate change impacts and positive attitudes toward policies to reduce greenhouse gas emissions provide support for climate action from the epilepsy community. However, if policies are implemented without considering the needs of patients, they risk being exclusionary, worsening inequalities, and further threatening neurological health and well-being.

Thermoregulatory consequences of growing up during a heatwave or a cold snap in Japanese quail.

Changes in environmental temperature during development can affect growth, metabolism and temperature tolerance of the offspring. We know little about whether such changes remain to adulthood, which is important to understand the links between climate change, development and fitness. We investigated whether phenotypic consequences of the thermal environment in early life remained in adulthood in two studies on Japanese quail (Coturnix japonica). Birds were raised under simulated heatwave, cold snap or control conditions, from hatching until halfway through the growth period, and then in common garden conditions until reproductively mature. We measured biometric and thermoregulatory [metabolic heat production (MHP), evaporative water and heat loss (EWL, EHL) and body temperature] responses to variation in submaximal air temperature at the end of the thermal acclimation period and in adulthood. Warm birds had lower MHP than control birds at the end of the thermal acclimation period and, in the warmest temperature studied (40°C), also had higher evaporative cooling capacity compared with controls. No analogous responses were recorded in cold birds, although they had higher EWL than controls in all but the highest test temperature. None of the effects found at the end of the heatwave or cold snap period remained until adulthood. This implies that chicks exposed to higher temperatures could be more prepared to counter heat stress as juveniles but that they do not enjoy any advantages of such developmental conditions when facing high temperatures as adults. Conversely, cold temperature does not seem to confer any priming effects in adolescence.

Process-Informed Subsampling Improves Subseasonal Rainfall Forecasts in Central America.

Subseasonal rainfall forecast skill is critical to support preparedness for hydrometeorological extremes. We assess how a process-informed evaluation, which subsamples forecasting model members based on their ability to represent potential predictors of rainfall, can improve monthly rainfall forecasts within Central America in the following month, using Costa Rica and Guatemala as test cases. We generate a constrained ensemble mean by subsampling 130 members from five dynamic forecasting models in the C3S multimodel ensemble based on their representation of both (a) zonal wind direction and (b) Pacific and Atlantic sea surface temperatures (SSTs), at the time of initialization. Our results show in multiple months and locations increased mean squared error skill by 0.4 and improved detection rates of rainfall extremes. This method is transferrable to other regions driven by slowly-changing processes. Process-informed subsampling is successful because it identifies members that fail to represent the entire rainfall distribution when wind/SST error increases.

Impact of extreme weather events on mental health in South and Southeast Asia: A two decades of systematic review of observational studies.

Extreme weather events in South and Southeast Asia exert profound psychosocial impacts, amplifying the prevalence of mental illness. Despite their substantial consequences, there is a dearth of research and representation in the current literature. We conducted a systematic review of observational studies published between January 1, 2000, and January 20, 2024, to examine the impact of extreme weather events on the mental health of the South and Southeast Asian population. Quality assessment of the included studies was conducted using the Newcastle-Ottawa Scale (NOS) quality appraisal checklist. The search retrieved 70 studies that met the inclusion criteria and were included in our review. Most were from India (n = 22), and most used a cross-sectional study design (n = 55). Poor mental health outcomes were associated with six types of extreme weather events: floods, storm surges, typhoons, cyclones, extreme heat, and riverbank erosion. Most studies (n = 41) reported short-term outcome measurements. Findings included outcomes with predictable symptomatology, including post-traumatic stress disorder, depression, anxiety, general psychological distress, emotional distress and suicide. Limited studies on long-term effects showed higher mental disorders after floods and typhoons, while cyclone-exposed individuals had more short-term distress. Notably, the review identified over 50 risk factors influencing mental health outcomes, categorized into six classes: demographic, economic, health, disaster exposure, psychological, and community factors. However, the quantitative evidence linking extreme weather events to mental health was limited due to a lack of longitudinal data, lack of control groups, and the absence of objective exposure measurements. The review found some compelling evidence linking extreme weather events to adverse mental health in the South and Southeast Asia region. Future research should focus on longitudinal study design to identify the specific stressors and climatic factors influencing the relationship between climate extremes and mental health in this region.

A Germany-wide survey of caregiving professionals on climate change and mental health of children and adolescents - factors influencing their relevance rating of extreme weather event associated mental health impairments.

INTRODUCTION: Climate change presents a significant risk for the mental and physical health of young people. In order to identify and properly care for potential mental health impairments from extreme weather events, the relevance of these impairments must be assessed as high by the professional groups providing care for children and adolescents. This raises the question of which factors influence the individual relevance assessment of caretaking professionals? METHODS: Data was collected creating and conducting a Germany-wide online questionnaire via LimeSurvey. The questionnaire was addressed to professionals providing care for children and adolescents, in this case medical and therapeutic personnel as well as school and pedagogical personnel. Professional associations, chief physicians and school principals were contacted as multipliers and asked to forward the questionnaire to their members and staff. The data was analyzed using the R statistical software, and multiple linear regressions were performed to test the hypotheses. RESULTS: Overall, 648 questionnaires were taken into analysis. Approximately 70% of the participants considered climate change-induced impacts on the mental health of children and adolescents due to extreme weather events as relevant. Experiencing heat, storm, heavy precipitation, flood/flooding, and/or avalanches/mudflows made a modest yet significant contribution to explaining higher relevance assessments. In contrast, there was no evidence to suggest that an urban working environment increases the relevance assessment. CONCLUSION: The described influence of experiencing extreme weather events should not be regarded as the sole factor leading to higher relevance ratings. A more comprehensive understanding of the factors influencing relevance assessments is necessary to address key aspects of risk communication and increase risk awareness.

Insects and recent climate change.

Insects have diversified through more than 450 million y of Earth's changeable climate, yet rapidly shifting patterns of temperature and precipitation now pose novel challenges as they combine with decades of other anthropogenic stressors including the conversion and degradation of land. Here, we consider how insects are responding to recent climate change while summarizing the literature on long-term monitoring of insect populations in the context of climatic fluctuations. Results to date suggest that climate change impacts on insects have the potential to be considerable, even when compared with changes in land use. The importance of climate is illustrated with a case study from the butterflies of Northern California, where we find that population declines have been severe in high-elevation areas removed from the most immediate effects of habitat loss. These results shed light on the complexity of montane-adapted insects responding to changing abiotic conditions. We also consider methodological issues that would improve syntheses of results across long-term insect datasets and highlight directions for future empirical work.

Extreme weather events and military conflict over seven centuries in ancient Korea.

We explore the causal connection between weather and war by constructing and analyzing a dataset featuring extreme weather events and military conflicts involving a set of stable political entities that existed side by side over several centuries, namely, the three ancient kingdoms of the Korean Peninsula between 18 Before the Common Era and 660 Common Era. Conflicts are classified as desperate if a state experiencing the shock invades a neighbor and opportunistic if a state experiencing the shock is invaded by a neighbor. We find that weather-induced conflict was significant, but largely opportunistic rather than desperate. That is, states experiencing an adverse shock were more likely to be invaded, but not more likely to initiate attack. We also provide evidence that the channel through which weather shocks gave rise to opportunistic invasions was food insecurity, which weakened the power of states to repel attack. Since climate change is projected to give rise to an increased frequency of extreme weather events, these historical findings have contemporary relevance.

Good weather for a ride (or not?): how weather conditions impact road accidents - a case study from Wielkopolska (Poland).

This study offers a likely assessment of extreme meteorological events' impact on human perceptivity, frame of mind or even health during driving which might have had a consequence as a car accident. Research covered an analysis of car accidents during period 2010-2019 in the Wielkopolska (Poland) and four indices like maximum daily temperature, maximum value of humidex, difference between maximum temperatures observed from day to day and also difference between mean atmospheric pressure at the sea level observed from day to day. A distributed lag nonlinear model (DLNM) approach was used to obtain the relationship between these indices and car accidents. Our finding evidence that the "good weather for a ride" conditions are actually generating an increased risk of accidents. For indices related to high temperature, i.e., maximum temperature and humidex, it was possible to identify the critical values by which the risks of car accidents were the highest.

A Multi-Level Operation Method for Improving the Resilience of Power Systems under Extreme Weather through Preventive Control and a Virtual Oscillator.

This paper proposes a multi-level operation method designed to enhance the resilience of power systems under extreme weather conditions by utilizing preventive control and virtual oscillator (VO) technology. Firstly, a novel model for predicting time intervals between successive failures of the power system during extreme weather is introduced. Based on this, this paper proposes a preventive control method considering the system ramping and transmission constraints prior to failures so as to ensure the normal electricity demand within the system. Further, a VO-based adaptive frequency control strategy is designed to accelerate the regulation speed and eliminate the frequency deviation. Finally, the control performance is comprehensively compared under different experimental conditions. The results verify that the method accurately predicted the time of the line fault occurrence, with a maximum error not exceeding 3 min compared to the actual occurrence; also, the virtual oscillator control (VOC) strategy outperformed traditional droop control in frequency stabilization, achieving stability within 2 s compared to the droop control's continued fluctuations beyond 20 s. These results highlight VOC's superior effectiveness in frequency stability and control in power systems.

Climate change is a health crisis with opportunities for health care action: A focus on health care providers, patients with asthma and allergic immune diseases, and their families and neighbors.

Climate change has increased the frequency of extreme weather events and compounded natural disasters. Heat, wildfires, flooding, and pollen are already threatening public health and disproportionately affecting individuals in susceptible situations and vulnerable locations. In this theme issue of the Journal of Allergy and Clinical Immunology, we address what is known and not known about the biologic as well as clinical upstream and downstream effects of climate change on asthma and allergy development and exacerbation. We present potential actions that individuals can take at the family, neighborhood, community, health care system, and national and international levels to build climate resilience and protect their own health and the health and welfare of others. We emphasize the importance of actions and policies that are context specific and just. We emphasize the need for the health care system, which contributes between 3% and 5% of global greenhouse gas emissions, to reduce its carbon footprint and build resiliency. Health care providers play a pivotal role in helping policymakers understand the effects of climate on the health of our patients. There is still a window to avoid the most serious effects of climate change on human health and our planet.