Review of national climate change risk assessment methods for impacts on health and health systems in WHO European Region

Abstract Background Climate change poses significant risks to health and health systems. The European Union climate adaptation strategy sets out the pathway to become climate resilient by 2050 and supports the development of adaptation strategies across all levels of governance. Whilst many European countries have published climate change risk assessments (CCRA), it is unclear to what extent health outcomes have been quantified or prioritised. There is a need to improve methods for CCRA methods to support decision making on adaptation and better quantify future impacts on health. The aim of this study is to review the methods used in national CCRAs for impacts on health and health systems in the WHO European region. Methods National and European level CCRAs were identified from national government websites and European document databases e.g. Climate-ADAPT. The most recently published CCRA from each country was included. Data extracted from CCRAs included climate scenarios used, modelling data, outcomes, types of evidence evaluated, stakeholder involvement, health information, methods for prioritization of adaptation options and urgency scoring. Data extracted from each document was grouped by climate risk or outcome. Results Nearly all WHO EURO countries have conducted a formal assessment of climate risks and over half specifically include risks to health. All countries assessed the urgency to adapt to heat and flooding however, less than half consider the health related risks related to disrupted water supply and quality as well as impacts on food supply and security. The key reported health outcomes identified across countries were mortality, infectious disease, chronic diseases and mental health. Conclusions There is varying progress in the quantification and prioritization of health risks from climate change across Europe. To support better public health decision-making, CCRAs should integrate sub-national and local information for targeted adaptation action.