Climate Change: Who Is Bearing the Burden?—Extreme Weather Risks, Intergenerational Support, and the Health of Middle-Aged and Older Adults

Abstract Actively addressing the risks posed by population aging and climate change is a major national strategic priority; however, the comprehensive impact of extreme weather risks on the health of middle-aged and older adults, as well as the mechanisms through which these impacts occur, still require further investigation. Based on data from the five waves of the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2020, this study matches meteorological data at the prefecture-level city level to construct an unbalanced panel comprising 43,228 observations. It employs a two-way fixed-effects model to examine the impact of extreme weather risks on the health of middle-aged and older adults and utilizes the instrumental variables method to mitigate potential endogeneity issues. The study found the following: First, extreme weather risks significantly reduce the health status of middle-aged and older adults. This conclusion holds even after a series of robustness tests, including changing instrumental variables, propensity score matching, double machine learning, controlling for COVID-19 interference, altering the sample scope, substituting the dependent variable, bilateral truncation, adding control variables, and adjusting fixed effects; Second, a mechanism analysis indicates that extreme climate risks lead to deteriorating health among middle-aged and older adults through intergenerational support channels, such as increasing the burden of care for grandchildren, reducing upward economic support, and weakening intergenerational emotional interactions; Third, heterogeneity analysis reveals that middle-aged and older adults—particularly women, those with higher incomes and educational attainment, and those residing in the central and eastern regions—experience more significant negative impacts from extreme climate risks; Fourth, further analysis shows that extreme heat is a major contributor to health deterioration among middle-aged and older adults. Mitigating patents and adaptive patents play distinct roles in the process by which extreme heat affects their health: mitigating patents can partially offset health losses, whereas the suppression of adaptive patents exacerbates negative effects.