Integrated indicators for tracking climate mitigation and adaptation: a protocol for a rapid review with a focus on health co-benefits and trade-offs

<ns3:p>Background Climate mitigation and adaptation policies influence a wide range of climate-sensitive health determinants, yet current monitoring systems often treat these domains separately. Integrated indicators capable of capturing co-benefits and trade-offs across climate and health, and the synergies between mitigation and adaptation, could strengthen accountability and support coherent policymaking. This rapid review aims to identify how health-related indicators used in climate adaptation and mitigation intersect, and to assess their potential for integrated monitoring frameworks. Methods This protocol outlines a rapid review conducted in accordance with established rapid-review guidance. The review builds on existing indicator sets from national climate–health assessments and additional evidence from mitigation-focused syntheses. A multi-layered search strategy will be applied in PubMed and targeted grey literature sources, limited to studies published from 2000 onward in high- and upper-middle-income settings relevant to the United Kingdom. Screening will follow an adapted Population–Intervention–Outcome framework, with dual-reviewer piloting and single-reviewer screening thereafter. Data extraction will capture study characteristics; indicator details; health-related exposures and outcomes; evidence of co-benefits or trade-offs; equity considerations; and policy relevance. Quality appraisal will use the STROBE checklist for observational studies and an adapted GHEMMS tool for modelling studies. Findings will be synthesised narratively and summarised in tables, informing a long list of candidate indicators for subsequent assessment by policy partners. Results As this is a protocol, no results are yet available. Planned outputs include coded evidence on cross-domain indicator usage, consistency of health pathways, equity gaps, and the strength and feasibility of candidate indicators. Conclusions This rapid review will provide the first structured synthesis of health-related indicators that bridge climate mitigation and adaptation. The findings will support the development of integrated monitoring approaches that better reflect the interdependencies of climate action and health, with direct relevance for ongoing national and international indicator-setting efforts.</ns3:p>