The 2021 Report

People in every region of the world are increasingly seeing their health affected by climate change. Key trends seen in previous Lancet Countdown Reports are getting worse and exacerbating already existing health and social inequities–the 2021 report gives a code red for health.

Our 2021 Report tracks the relationship between health and climate change across five key domains and over 40 indicators.

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Key message

Every region of the world is affected by climate change and its health impacts are getting worse. We are seeing more frequent and more intense extremes of heat harming people’s health in rich and poor countries; 72% of countries saw an increase in human exposure to wildfires; the environmental suitability the transmission of diseases like dengue, malaria and cholera is increasing around the world; and in 2020, up to 19% of the global land surface was affected by extreme drought in any given month – putting people in danger of food and water insecurity. Compounded with insufficient adaptation measures, the most vulnerable people are the worst affected, and climate change is already exacerbating inequities.

Key message

With current commitments putting the world on track to 2.4°C of warming, the cost of inaction on climate and health will vastly outweigh the costs of acting now. Rapid decarbonisation could prevent most of the 3.3 million deaths from air pollution that occur each year, the 842,000 deaths associated with excessive red meat consumption, and result in better physical and mental health from higher exposure to nature and more physical activity.

Key message

The COVID-19 pandemic has demonstrated the need for increased international co-operation in the face of global crises. COVID-19 recovery presents an unprecedented opportunity to invest in a future of economic and environmental sustainability, improved health and reduced inequities. However, this will only be possible if the world acts together to ensure that no person is left behind. Decision-makers must act today and show strong leadership. A better future is still possible.

Explore key findings of this year’s report

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Climate Change Impacts, Exposures and Vulnerability

Climate Change Impacts, Exposure and Vulnerability

A changing climate has profound implications for human health, with more frequent heatwaves and extreme weather events, changing patterns of infectious disease, and the exacerbation of existing health challenges around the world. Indicators in this section track how these impact on human health.

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Adaptation, Planning, and Resilience for Health

Adaptation, Planning, and Resilience for Health

Indicators in this section track how communities, health systems, and governments are understanding the health risks of climate change, the strategies and resources they are deploying, and how adaptation and resilience measures are being implemented globally.

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Mitigation Actions and Health Co-Benefits

THE HEALTH BENEFITS OF THE RESPONSE TO CLIMATE CHANGE

Tackling climate change could be the greatest global health opportunity of the 21st century. Many of the interventions required to mitigate and adapt bring enormous benefits for human health and wellbeing in the form of cleaner air, healthier diets, and more liveable cities. Indicators in this section track the world’s efforts to mitigate climate change, and the health benefits of this response.

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Economics and Finance

Economics and Finance

The data here works to track the financial and economic dimensions of the effects of climate change, and of mitigation efforts required to respond to these changes. Indicators here monitor the economic costs of climate change and its drivers, as well as the investments and economic tools being deployed to transition to a low-carbon economy.

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Public and Political Engagement

Public and Political Engagement

Public and political engagement underpins the foundations of the world’s collective response to climate change, with reductions in global emissions at the speed required by the Paris Agreement depending on engagement from all sectors of society. The indicators in this section track the links between health and climate change in the media, national governments, the corporate sector, and the broader public.

  • Icon_1_Green Created with Sketch. Climate Change Impacts, Exposures and Vulnerability
    • 1.1.1 Vulnerability to Extremes of Heat

      Although vulnerability to heat in the low and medium Human Development Index (HDI) country groups is 27–38% lower than in the very high HDI group, it is increasing in all groups and, since 1990, it has increased by 19% in the low HDI group and by 20% in the medium HDI group.

    • 1.1.2 Exposure of Vulnerable Populations to Heatwaves

      Children younger than 1 year were affected by 626 million more person-days of heatwave exposure and adults older than 65 years were affected by 3·1 billion more person-days of heatwave exposure in 2020 than in the 1986–2005 average.

    • 1.1.3 Heat and Physical Activity

      The past four decades saw an increase in the number of hours in which temperatures were too high for safe outdoor exercise, with people in the low Human Development Index country group having an average loss of 3·7 h of safe exercise per day in 2020.

    • 1.1.4 Change in Labour Capacity

      295 billion hours of potential work were lost due to extreme heat exposure in 2020, with 79% of all losses in countries with a low Human Development Index occurring in the agricultural sector.

    • 1.1.5 Heat and Sentiment

      Exposure to heatwave events worsens expressed sentiment, with a 155% increase in negative expressions on Twitter during heatwaves in 2020 from the 2015–19 average.

    • 1.1.6 Heat-Related Mortality

      Heat-related deaths in people older than 65 reached a record high of an estimated 345000 deaths in 2019; between 2018 and 2019, all WHO regions, except for Europe, saw an increase in heat-related deaths in this vulnerable age group.

    • 1.2.1 Wildfires

      Nearly 60% of countries had an increase in the number of days people were exposed to very high or extremely high fire danger in 2017–20 compared with 2001–04, and 72% of countries had increased human exposure to wildfires across the same period.

    • 1.2.2 Drought

      In 2020, up to of 19% of the global land surface was affected by extreme drought in any given month.

    • 1.3.1 Climate Suitability for Infectious Disease Transmission

      The R0 for all arboviral diseases tracked has increased, and, in 2020, was 13% higher for transmission by A. aegypti and 7% higher for transmission by A. albopictus than in baseline years.

    • 1.3.2 Vulnerability to Mosquito-Borne Diseases

      While vulnerabilities to arboviruses transmitted by A. albopictus and A. aegypti have decreased across all countries since the year 2000, countries in the low Human Development Index group remain on average the most vulnerable

    • 1.4.1 Terrestrial Food Security and Undernutrition

      Crop yield potential continues to follow a downward trend, with 6·0% reduction in the crop yield potential of maize, 3·0% for winter wheat, 5·4% for soybean, and 1·8% for rice, relative to the 1981–2010 average crop yield potential.

    • 1.5 Migration, Displacement and Sea-Level Rise

      There are currently 569.6 million people settled below 5 metres above sea level, who could face risks from the direct and indirect hazards posed by the rising sea levels.

  • Icons Final_Green-03 Created with Sketch. Adaptation, Planning, and Resilience for Health
    • 2.1.1 National Adaptation Plans for Health/2.1.2 National Assessments of Climate Change Impacts, Vulnerability and Adaptation for Health

      45 (49%) of 91 countries in 2021 reported having done a climate change and health vulnerability and adaptation assessment. Additionally, 45 (49%) of 91 countries in 2021 reported having done a climate change and health vulnerability and adaptation assessment.

    • 2.1.3 City-Level Climate Change Risk Assessments

      In 2020, 546 (81%) of 670 cities reported having completed or being in the process of doing climate change risk assessments; heat-related illness was the most common climate-related health concern, identified by 169 (55%) of 308 cities.

    • 2.3.3 Urban Green Space

      Globally in 2020, 27% of urban centres were classified as being moderately green or above, an increase from 14% in 2010; the percentage of cities under this classification varied from 17% of urban centres in the low HDI country groups to 39% of urban centres in the very high HDI country group.

    • 2.4 Spending on Adaptation for Health and Health-Related Activities

      Globally, adaptation funding that is directed at health systems represents a small proportion of total climate change adaptation funding (0.3%), and only 5.6% of all transactions with adaptation potential were relevant to health in 2019–20.

  • Icons Final_Green_v2-03 Created with Sketch. Mitigation Actions and Health Co-Benefits
    • 3.1.2 Coal Phase-Out

      In 2019, global coal use for all activities fell 1.2%. Global coal demand is expected to rise by 4.5% in 2021.

    • 3.2 Clean Household Energy

      While progress has been made in the use of clean fuels in the home, in 2019, only 12% of households in the low Human Devleopment Index (HDI) group primarily relied on clean fuels and technologies for cooking. In medium and high HDI group countries, the share of solid biofuel has fallen more rapidly and clean cooking fuel technology use has risen substantially.

    • 3.5.2 Diet and Health Co-Benefits

      Between 2017 and 2018 the estimated deaths due to excess red meat consumption rose by 1.8% to 842,000 deaths.

    • 3.6 Mitigation in the Healthcare Sector

      The healthcare sector was responsible for 4.9% of global greenhouse gas emissions in 2018. Healthcare emissions are positively associated with Human Development Index levels, largely through health spending, but minimal association is seen after emissions of 400 kg CO2eq per capita.

  • Icons Final_Green_v2-05 Created with Sketch. Economics and Finance
    • 4.1.2 Costs of Heat-Related Mortality

      The monetised value of global heat-related mortality increased by 6.7%, from 0.27% of gross world product in 2018 to 0.28% in 2019; Europe continued to be the worst affected region, facing costs equivalent to the average income of 6.1 million of its citizens.

    • 4.1.3 Loss of Earnings from Heat-Related Labour Capacity Reduction

      Working in conditions of extreme heat is a health risk; such conditions could reduce the capacity for paid labour, with an impact on workers’ earnings equivalent to 4–8% of GDP in the low HDI country group in 2020.

    • 4.1.4 Costs of the Health Impacts of Air Pollution

      Equivalent to the annual income of 78.1 million and 99.1 million people, the greatest economic costs of mortality due to air pollution fall on countries in the medium and high HDI country groups; costs relative to GDP decreased between 2015 and 2019 globally, with the exception of costs in southeast Asia.

    • 4.2.5 Production- and Consumption-Based Attribution of CO2 and PM2.5 Emissions

      In 2019, 18% of CO2 and 17% of PM2.5 global emissions were embodied in trade between countries of different Human Development Index levels.

  • Icons Final_Green_v2-06 Created with Sketch. Public and Political Engagement
    • 5.1 Media Coverage of Health and Climate Change

      In 2020, the upward trend in coverage of health and climate change continued but did not match the increase seen in 2019; in 2020, most of the coverage of health and climate change referred to COVID-19.

    • 5.3 Coverage of Health and Climate Change in Scientific Journals

      Original research on health and climate change increased 11-fold between 2007 and 2020, driven primarily by scientists in countries in the very high HDI group; the number of articles on health and climate change that addressed gender remained low; and in 2020, 7% of health and climate change articles referred to COVID-19.

    • 5.4 Government Engagement in Health and Climate Change

      In 2020, 47% of government leaders engaged with the health dimensions of climate change in their statements at the UN General Debate, which is more than double the proportion in 2019; this increase was linked to engagement with the COVID-19 pandemic.

    • 5.5 Corporate Sector Engagement in Health and Climate Change

      In 2020, engagement in health and climate change increased to its highest level among companies in the UN Global Compact. Over a third (38%) of companies referred to the health dimensions of climate change in their 2020 progress reports.

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