Measuring and monitoring child health and well-being—an integral part of the climate change agenda

Climate change has far-reaching consequences for all aspects of human society (Romanello et al. 2023). Children are uniquely vulnerable to climate change for a multitude of physiological and developmental reasons as well as because of distinctive behaviors such as outdoor play that increase their exposure to climate-related stressors (EPA 2023). Several reviews have summarized the multiple direct and indirect pathways through which climate change negatively affects child health and well-being (Arpin et al. 2021, Helldén et al. 2021, United Nations International Children's Emergency Fund 2021, Orun 2022, Perera and Nadeau 2022, Ahdoot et al. 2024, Etzel et al. 2024, Paz 2024, Proulx et al. 2024, United Nation's International Children's Emergency Fund 2024, Weeda et al. 2024) (Table 1; Supplementary Table S2, Supplementary Figure S1). The evidence suggests that climate change impacts on children accumulate over their life course with both short- and long-term detrimental effects, including those that occur in utero that are linked with women's exposures to excessive heat and experiences of stress due to climate change events during pregnancy (Yarlagadda 2023, Etzel et al. 2024, Proulx et al. 2024). The risks of climate change are not evenly distributed, as countries that emit the lowest greenhouse gas emissions are often the most affected, thereby increasing inequities (Intergovernmental Panel on Climate Change 2024). Climate change also exacerbates child health inequities within countries, increasing the likelihood that children in the most disadvantaged conditions will be left further behind and perpetuating intergenerational cycles of poverty (Arpin et al. 2021, Ahdoot et al. 2024). Children in low-income communities, e.g., are more likely to be homeless or live in houses that are poorly constructed, leaving them exposed to extreme heat, vector-borne diseases, flooding, and air pollution (Williams et al. 2021)