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Sarah E. Scales, Julia Massi, and Jennifer A. Horney

Climate change is affecting every region of the world and is accelerating at an alarming rate. International efforts for mitigating climate change, like the Paris Agreement, through reductions in greenhouse gases are vital for slowing the global increase in temperatures. However, these mitigation measures will not have immediate impact, so urgent action is needed to address negative impacts currently posed by climate change. Adaptation measures are central to this response now, and will continue to be critical for protecting human health as temperatures rise and climate-related disasters increase in both frequency and severity. To maximize the effectiveness of adaptation measures, the health impacts of disasters should be well-characterized at the global, regional, national, and local levels. Surveillance and early warning systems are vital tools for early identification and warning of hazards and their potential impacts. Increasing global capacity to identify causes of morbidity and mortality directly and indirectly attributable to disasters are in line with the objectives of the Sustainable Development Goals and Bangkok Principles of the Sendai Framework for Disaster Risk Reduction. Both improving data collected in disaster settings and more effectively using that information in real time are central to reducing the human-health impacts of disasters. The human-health impacts of climate change and associated disasters are interrelated. Climate change and commensurate changes in environmental suitability, vector viability, and human migration strongly influence the prevalence and seasonality of infectious and communicable diseases. Both drought and flood contribute to food and water insecurity, leading to a higher prevalence of undernourishment and malnourishment, especially in children. Compromised nutritional status, in conjunction with resulting human migration, leave individuals immunocompromised and populations at a high risk for spread of infectious disease. Extreme heat exposure likewise compromises individuals’ ability to regulate their physiological response to external stressors. Disasters of all classifications can result in exposure to environmental hazards, decrease air quality, and negatively affect mental health. Accordingly, health adaptation measures to climate change must be equally interrelated, addressing needs across disciplines, at both individual and community levels, and incorporating the many facets of the health needs of affected populations.


Increasing natural disaster losses in the past decades and expectations that this trend will accelerate under climate change motivated the development of a branch of literature on the economics of natural disaster insurance. A starting point for assessing the implications of climate change for insurance and developing risk management strategies is understanding the factors underlying historical loss trends and the way that future risks will develop. Most studies have pointed toward socioeconomic developments as the main cause of historical trends in natural disaster risks. Moreover, evidence reveals that climate change has been a contributing factor, which is expected to grow in importance in the future. Several supply and demand side obstacles may prevent natural disaster insurance from optimally fulfilling its desirable function of offering financial protection at affordable premiums. Climate change is expected to further hamper the insurability of natural disaster risks, unless insurers and governments proactively respond to climate change, for example by linking insurance coverage with risk reduction activities. A branch of literature has developed about how the functioning of insurance should be improved to cope with climate change. This includes industry-level responses, reforms of insurance market structures, such as public–private natural disaster insurance provision, and recommendations for addressing behavioral biases in insurance demand and for stimulating risk reduction. In view of the rising economic losses of natural disasters, this field of study is likely to remain an active one.