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Most cities in low- and middle-income countries have substantial proportions of their population living in informal settlements—sometimes up to 60% or more. These also house much of the city’s low-income workforce; many informal settlements also concentrate informal economic activities. These settlements usually lack good provision for water, sanitation, and other essential services. The conventional government responses were to bulldoze them or ignore them. But from the 1960s, another approach became common—upgrading settlements to provide missing infrastructure (e.g., water pipes, sewers, drains). In the last 20 years, community-driven upgrading has become increasingly common. Upgrading initiatives are very diverse. At their best, they produce high-quality and healthy living conditions and services that would be expected to greatly reduce illness, injury or disablement, and premature death. But at their worst, upgrading schemes provide a limited range of improvements do nothing to reduce the inhabitants’ exclusion from public services. There is surprisingly little research on upgrading’s impact on health. One reason is the very large number of health determinants at play. Another is the lack of data on informal settlement populations. Much of the innovation in upgrading is in partnerships between local governments and organizations formed by informal settlement residents, including slum/shack dweller federations that are active in over 30 nations. Community-driven processes can deal with issues that are more difficult for professionals to resolve—including mapping and enumerations. Meanwhile, local government can provide the connections to all-weather roads, water mains, sewers, and storm drains into which communities can connect.

The Alpine region in Central Europe and its populations in principle face the same types of threats to their health due to climate change as those in other parts of the world. But special geographical and climatic aspects of that region warrant closer and special examination of the connections between health and climate change in the Alps. These include small-scale variation, in some instances steep mountain slopes, and, above all, a larger-than-average increase in near-surface temperatures. To that end, there are main pathways between climate change and health: “Direct effects” describe rather short-term health effects of extreme weather events. Such events have occurred in the past, and therefore ample epidemiological evidence is available for the assessment of their impact. With climate change, such extreme events are predicted to change in frequency and intensity. “Indirect effects” refer to a more complex pathway where long-term changes of various natural and anthropogenic systems in reaction or adaptation to climate change exert adverse or sometimes also beneficial impacts on health. Such systems include ecosystems in which, for example, the prevalence of disease vectors or the allergenicity of pollen will change. But agriculture and forestry or the built environment are also affected by climate change and in turn affect the health of people. “Distant effects” are also rather indirect in nature. But in this pathway, changes due to climate change in other parts of the world affect the health in the Alpine region. Increasing migration into the Alpine region and changing migration patterns are important examples of this pathway. In some instances, most importantly regarding mental health, there is still a need for more studies focusing on the Alpine environments. But apart from these especially understudied topics, as the climate crisis evolves, there is generally a need for continuous research on the health effects of climate change and the potential of health promotion to create co-benefits.