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Lessons from the field: Case studies to advance research on climate adaptation strategies and their impact on public health
There is an urgent need to develop scientific evidence on the impact of climate adaptation strategies on public health. The overarching goal of this collection is to identify and understand current or historical adaptation responses—particularly in low- and middle-income countries (LMICs)—that can be better harnessed to address deteriorating health outcomes due to climate-led stressors using relevant and appropriate research approaches and methodologies, thereby contributing to building a solutions-oriented evidence base focused on the threats to health from global climate change.
Goals
Examining Health
Center the importance of examining health as a critical outcome in the larger climate adaptation research and implementation agenda.
Adaptation Research
Encourage scholars and funders to conduct and support more high-quality adaptation research related to climate and health, especially in LMICs that are disproportionately impacted by climate change.
Review Strategies
Review current adaptation strategies to improve our understanding of the adaptive capacity of populations most at risk of climate change health impacts.
Identify Outcomes
Identify how and when the impact of climate-led adaptation responses on public health outcomes has been or can be assessed through research.
Context and Process/Selection
Context
Climate change poses threats to human health across a wide range of illnesses and injuries. Existing evidence confirms an unprecedented rise in the incidence of climate-led stressors, including, but not limited to, increased ambient temperatures, extreme and erratic precipitation, extreme weather events, sea level rise, wildfires, and desertification. These stressors have exacerbated exposure to conditions such as high heat stress, reduced air quality, food and water systems disruption, migration and internal displacements, resource conflicts, disrupted healthcare systems, and changes in infectious agents. This has led to worsening public health outcomes such as premature mortality, heat-related illnesses, exacerbation of non-communicable diseases, increased vector-borne diseases, poor maternal and child health outcomes, malnutrition, and mental health consequences. 1
There exists a broad consensus that adverse consequences of climate change on health are already occurring, with the greatest impacts affecting LMICs and communities that have been historically marginalized in places all around the globe. These climate shifts will continue to worsen in many places for decades to come—further exacerbating health inequities. This calls for urgent attention to identify effective adaptation practices that can mitigate public health risks and consequences due to climate change in LMICs.
Adaptation is broadly defined by the Intergovernmental Panel on Climate Change (IPCC) as the process of adjustment to actual and potential climate-led impacts.2 Examples of adaptation strategies include, but are not limited to, heat-resistant crops, behavior change, effective climate communication and awareness building, green infrastructure, wetland restoration, coastal land preservation, health system resilience (both structural and functional), health workforce capacity-building, and microfinancing. 3 ,4
- Increase our knowledge of evidence-based adaptation strategies that impact health.
- Support the use of innovative research approaches that incorporate quantitative and/or qualitative assessments to better understand the impact of climate adaptation strategies on health outcomes.
- Increase our understanding of the impacts of climate change adaptation on health among populations disproportionately impacted by climate change, including those in LMICs and under-resourced and marginalized populations globally.
- Encourage use of implementation science methodologies to translate adaptation strategies that promote the uptake, scale-up, and spread across different contexts.
- Increase opportunities to strengthen climate and health research capacity and support scholars from LMICs to study climate adaptation and health and publish their results.
1 Hess, J.J., et al., An evidence-based public health approach to climate change adaptation. Environmental Health Perspectives, 2014. 122(11): p. 1177-1186.
2 Sharma, J. and N.H. Ravindranath, Applying IPCC 2014 framework for hazard-specific vulnerability assessment under climate change. Environmental Research Communications, 2019. 1(5): p. 051004.
3 Scheelbeek, P.F., et al., The effects on public health of climate change adaptation responses: a systematic review of evidence from low-and middle-income countries. Environmental Research Letters, 2021. 16(7): p. 073001.
4 Bryan, E., et al., Can agriculture support climate change adaptation, greenhouse gas mitigation and rural livelihoods? insights from Kenya. Climatic Change, 2013. 118(2): p. 151-165.
Process and Selection
Between August and November 2023, researchers, practitioners, and implementers from any country, especially LMICs, were encouraged to submit two-page case study proposals to NIH for review, outlining the adaptation strategies used, health outcomes of interest, data sources, and proposed analysis. All applications were reviewed by a Steering Committee of diverse global experts and scored based on the following selection criteria:
- Scientific and public health relevance of the case study.
- Innovative and scientific approach used to develop the case study.
- Case study location (preference will be given to locations that are underrepresented in the literature, e.g., LMICs).
- Extent to which the proposal discusses specific health impacts associated with the adaptation strategy.
- Focus on underrepresented, under-resourced, marginalized, and at-risk populations.
- Extent to which the case study discusses a specific climate change adaptation measure(s) or strategy addressing a specific climate hazard.
- Relevance of case study to future research and priority areas within the climate change and health landscape.
- Diversity of the submitting authors in terms of geographic locations, interdisciplinarity of teams, areas of expertise (preference will be given to authors under-represented in the field, e.g., authors from LMICs).
A total of 133 applications were received, with case study proposals from more than 40 countries. After the review and scoring process, 15 proposals were selected by the Steering Committee to be developed into full case study articles to be submitted for publication in the supplement with up to $15,000 support for analysis and writing. This selection was made with the goal of creating a diverse collection based on the geographic location of the case study, the geographic locations of authors and their institutions, adaptation strategies described, relevant climate stressors and exposure pathways, and health outcomes assessed.
Guest Editors
Select members of the Steering Committee contributed as Guest Editors for this special issue supplement. Dr. Praveen Kumar, who co-led the larger climate change adaptation initiative, collaborated to conceptualize and oversee the development of this special issue collection and also facilitated administrative activities throughout the editing and publication process.
Funding
This collection was commissioned by the Fogarty International Center at NIH with support from the NIH Climate Change and Health Initiative between August 2023 and November 2024.
