Integrating Shared Socioeconomic Pathway-informed adaptation into temperature-related mortality projections under climate change.

The extent to which populations will successfully adapt to continued warming temperatures will be a crucial factor in determining future health burdens. Previous health impact assessments of future temperature-related mortality burdens mostly disregard adaptation or make simplistic assumptions. We apply a novel evidence-based approach to model adaptation that takes into account the fact that adaptation potential is likely to vary at different temperatures. Temporal changes in age-specific mortality risk associated with low and high temperatures were characterised for Scotland between 1974 and 2018 using temperature-specific RR ratios to reflect past changes in adaptive capacity. Three scenarios of future adaption were constructed consistent with the SSPs. These adaptation projections were combined with climate and population projections to estimate the mortality burdens attributable to high (above the 90th percentile of the historical temperature distribution) and low (below the 10th percentile) temperatures up to 2080 under five RCP-SSP scenarios. A decomposition analysis was conducted to attribute the change in the mortality burden into adaptation, climate and population. In 1980-2000, the heat burden (21 deaths/year) was smaller than the colder burden (312 deaths/year). In the 2060-2080 period, the heat burden was projected to be the highest under RCP8.5-SSP5 (1285 deaths/year), and the cold burden was the highest under RCP4.5-SSP4 (320 deaths/year). The net burden was lowest under RCP2.6-SSP1 and highest under RCP8.5-SSP5. Improvements in adaptation was the largest factor reducing the cold burden under RCP2.6-SSP1 whilst temperature increase was the biggest factor contributing to the high heat burdens under RCP8.5-SSP5. Ambient heat will become a more important health determinant than cold in Scotland under all climate change and socio-economic scenarios. Adaptive capacity will not fully counter projected increases in heat deaths, underscoring the need for more ambitious climate mitigation measures for Scotland and elsewhere.

Wan K ，Hajat S ，Doherty RM ，Feng Z ... -  《-》

Future ozone-related acute excess mortality under climate and population change scenarios in China: A modeling study.

Chen K ，Fiore AM ，Chen R ，Jiang L ，Jones B ，Schneider A ，Peters A ，Bi J ，Kan H ，Kinney PL ... -  《-》

Future temperature-related mortality considering physiological and socioeconomic adaptation: a modelling framework.

As the climate changes, it is crucial to focus not only on mitigation measures but also on building climate change resilience by developing efficient adaptation strategies. Although population adaptation is a major determinant of future climate-related health burden, it is not well accounted for in studies that project the health impact of climate change. We propose a methodological framework for temperature-related mortality that incorporates two simultaneous adaptation-sensitivity pathways: the physiological pathway, considering both heat adaptation and cold sensitivity, and the socioeconomic pathway, which is influenced by changes in future adaptive capacities. To demonstrate its utility we apply the framework to a case study mortality time-series dataset from Bavaria, Germany. In this modelling framework, we used extrapolated location-specific and age-specific baseline exposure-response functions and propose different future scenarios of cold sensitivity and heat adaptation on the basis of varying slopes of these exposure-response functions. We also incorporated future socioeconomic adaptation in the exposure-response functions using projections of gross domestic product under the respective shared socioeconomic pathways. Future adaptable fractions, representing the deaths avoided under each of the future scenarios, are projected under combinations of two climate change scenarios (shared socioeconomic pathway [SSP]1-2.6 and SSP3-7.0) and the respective plausible population projection scenarios (SSP1 and SSP3), also incorporating the future changes in demographic age structure and mortality. The case study for this framework was done for five districts in Bavaria, for both total non-accidental mortality and cardiovascular disease mortality. The baseline data was obtained for the period 1990-2006, and the future period was defined as 2083-99. In our Bavaria case study, average temperature was projected to increase by 2099 by an average of 1·1°C under SSP1-2.6 and by 4·1°C under SSP3-7.0. We observed the adaptable fraction to be largely influenced by socioeconomic adaptation for both total mortality and cardiovascular disease mortality, and for both climate change scenarios. For example, for total mortality, the highest adaptable fraction of 18·56% (95% empirical CI 10·77-23·67) was observed under the SSP1-2.6 future scenario, in the presence of socioeconomic adaptation and under the highest heat adaptation (10%) provided the cold sensitivity remains 0%. The cold adaptable fraction is lower than the heat adaptable fraction under all scenarios. In the absence of socioeconomic adaptation, population ageing will lead to higher temperature-related mortality. Our developed framework helps to systematically understand the effectiveness of adaptation mechanisms. In the future, socioeconomic adaptation is estimated to play a major role in determining temperature-related excess mortality. Furthermore, cold sensitivity might outweigh heat adaptation in the majority of locations worldwide. Similarly, population ageing is projected to continue to determine future temperature-related mortality. EU Horizon 2020 (EXHAUSTION).

Rai M ，Breitner S ，Wolf K ，Peters A ，Schneider A ，Chen K ... -  《The Lancet Planetary Health》

Temperature-related mortality burden and projected change in 1368 European regions: a modelling study.

Excessively high and low temperatures substantially affect human health. Climate change is expected to exacerbate heat-related morbidity and mortality, presenting unprecedented challenges to public health systems. Since localised assessments of temperature-related mortality risk are essential to formulate effective public health responses and adaptation strategies, we aimed to estimate the current and future temperature-related mortality risk under four climate change scenarios across all European regions. We modelled current and future mortality due to non-optimal temperatures across 1368 European regions, considering age-specific characteristics and local socioeconomic vulnerabilities. Overseas territories were excluded from the analysis. We applied a three-stage method to estimate temperature-related risk continuously across age and spatial dimensions. Age and city-specific exposure-response functions were obtained for a comprehensive list of 854 European cities from the Urban Audit dataset of Eurostat. Regional aggregates were calculated using an aggregation and extrapolation method that incorporates the risk incidence in neighbouring cities. Mortality was projected for present conditions observed in 1991-2020 and for four different levels of global warming (1·5°C, 2°C, 3°C, and 4°C increase) by regions, and subregions using an ensemble of 11 climate models produced by the Coordinated Regional Climate Downscaling Experiment-CMIP5 over Europe, and population projection data from EUROPOP2019. Our results highlight regional disparities in temperature-related mortality across Europe. Between 1991 and 2020, the number of cold-related deaths was 2·5 times higher in eastern Europe than western Europe, and heat-related deaths were 6 times higher in southern Europe than in northern Europe. During the same time period, there were a median of 363 809 cold-related deaths (empirical 95% CI 362 493-365 310) and 43 729 heat-related deaths (39 880-45 921), with a cold-to-heat-related death ratio of 8·3:1. Under current climate policies, aligned with 3°C increase in global warming, it is estimated that temperature-related deaths could increase by 54 974 additional deaths (24 112-80 676) by 2100, driven by rising heat-related deaths and an ageing population, resulting in a cold-to-heat-related death ratio of 2·6:1. Climate change is also expected to widen disparities in regional mortality, particularly impacting southern regions of Europe as a result of a marked increase in heat-related deaths. This study shows that regional disparities in temperature-related mortality risk in Europe are substantial and will continue to increase due to the effects of climate change and an ageing population. The data presented can assist policy makers and health authorities in mitigating increasing health inequalities by prioritising the protection of more susceptible areas and older population groups. We identify the projected areas of heightened risk (southern Europe), where policy intervention aimed at building adaptation and enhancing resilience should be prioritised. European Commission.

García-León D ，Masselot P ，Mistry MN ，Gasparrini A ，Motta C ，Feyen L ，Ciscar JC ... -  《The Lancet Regional Health》

Projection of future temperature extremes, related mortality, and adaptation due to climate and population changes in Taiwan.

Extreme temperature events have been observed to appear more frequently and with greater intensity in Taiwan in recent decades due to climate change, following the global trend. Projections of temperature extremes across different climate zones and their impacts on related mortality and adaptation have not been well studied. We projected site-specific future temperature extremes by statistical downscaling of 8 global climate models followed by Bayesian model averaging from 2021 to 2060 across Taiwan under the representative concentration pathway (RCP) scenarios RCP2.6, RCP4.5, and RCP8.5. We then calculated the attributable mortality (AM) in 6 municipalities and in the eastern area by multiplying the city/county- and degree-specific relative risk of mortality according to the future population projections. We estimated the degree of adaptation to heat by slope reduction of the projected AM to be comparable with that in 2018. The annual number of hot days with mean temperatures over 30 °C was predicted to have a substantial 2- to 5-fold increase throughout the residential areas of Taiwan by the end of 2060 under RCP8.5, whereas the decrease in cold days was less substantial. The decrease in cold-related mortality below 15 °C was projected to outweigh heat-related mortality for the next two decades, and then heat-related mortality was predicted to drastically increase and cross over cold-related mortality, surpassing it from 2045 to 2055. Adjusting for future population size, the percentage increase in heat-related deaths per 100,000 people could increase by more than 10-fold under the worst scenario (RCP8.5), especially for those over 65 years old. The heat-related impacts will be most severe in southern Taiwan, which has a tropical climate. There is a very high demand for heat-adaptation prior to 2050 under all RCP scenarios. Spatiotemporal variations in AM in cities in different climate zones are projected in Taiwan and are expected to have a net negative effect in the near future before shifting to a net positive effect from 2045 to 2055. However, there is an overall positive and increasing trend of net effect for elderly individuals under all the emission scenarios. Active adaptation plans need to be well developed to face future challenges due to climate change, especially for the elderly population in central and southern Taiwan.

Chen CC ，Wang YR ，Wang YC ，Lin SL ，Chen CT ，Lu MM ，Guo YL ... -  《-》