Communicating uncertainty to policy makers in maps: A systematic scoping review of meaningful to misleading current practice

Policymakers frequently use maps as decision-support tools to support the effective allocation of resources and enhance community resilience against climate-related health threats. Yet, the high legibility of maps can be accompanied by the risk of inappropriate or misleading abstraction of uncertainty. This systematic scoping review explored how uncertainty was communicated in geographical visualisations present in peer-reviewed publications on climate-related infectious diseases in the Asia-Pacific region. A PRISMA-compliant systematic scoping review was carried out in PubMed and Web of Science databases in April 2025. Manuscripts describing primary research on climate-sensitive human diseases in the Asia-Pacific region, and with one or more map, were included. The extent to which uncertainty was explicitly represented, visually within figures or textually in figure captions, was qualitatively assessed and narratively synthesized. Sixty-six manuscripts were identified from an original 2,826 search results, most ( n = 52) of which indicated policymakers, public health authorities, or health practitioners were intended target audiences. Eleven studies reported uncertainty in maps textually, and only three studies explicitly integrated explanatory visual representations of uncertainty into maps. Our findings suggest that most of the current policy-facing literature regarding climate-related infectious disease in the Asia-Pacific region does not employ appropriate visual methods to convey uncertainty in maps. There is an urgent need to improve current practice in the visual communication of uncertainty to support informed, considered policy and planning relating to climate-related infectious disease.