Climate-adaptive health sojourning on the Tibetan Plateau margin: pathways to bridge healthy aging and socio-ecological sustainability

Population aging and intensifying summer heat are increasing interest in seasonal mobility among older adults. The eastern and northeastern margins of the Tibetan Plateau contain low- and moderate-altitude valleys and foothill settlements with cool summer climates, extensive natural environments, Tibetan and Qiang cultural heritage, traditional health resources and improving rail accessibility. This Perspective examines their potential for health sojourning, defined as recurrent temporary relocation to a climatically suitable destination for extended residence to maintain health, functional ability and well-being. Its public health relevance lies in changing the environment where older adults spend part of the year. Residence for several weeks or months in cooler and greener settings may reduce heat exposure and may support physical activity, nature contact, restorative routines, social participation, and continuity of daily life. Moderate altitude is treated as an environmental context rather than a therapeutic exposure because evidence derives mainly from long-term residents and individual responses vary. Cultural participation may enrich destination life through meaningful activity, learning, social contact and place familiarity, while primary care, medication access, and care coordination are important for safe extended residence. Socio-ecological sustainability is treated as a complementary development goal rather than an assumed property of health sojourning. Rail-oriented access, longer stays, adaptive reuse of existing buildings, ecological limits, and community participation may lower environmental costs under appropriate conditions. Recent health sojourning practices across county-level jurisdictions in Sichuan and Gansu provinces illustrate established, emerging, and planned forms of this mobility while identifying evidence gaps for future research.