Bottom up Adaptation Strategies for a Sustainable Europe

Aline Chiabai on the Bottom-Up Approach to Climate and Health


Aline Chiabai – Adaptation Dialogue

Climate change is among the greatest risks to human health. According to the World Health Organisation (WHO), climate change could cause an annual increase of 250,000 additional deaths worldwide in the period 2030-2050.

“The deaths caused by the 2003 European heat wave are a clear example of the consequences that climate change can have on society if we fail to adapt in an appropriate way”, says Aline Chiabai, an environmental economist at the Basque Centre for Climate Change (BC3).

Within the BASE project Chiabai studies the health impacts of climate change and how social systems can plan effective adaptation. Together with her colleagues at BC3 and the Autonomous University of Madrid, Chiabai has analysed which measures and policies are needed to adapt our health systems as well as the associated costs and benefits for society.

“Health can be affected by climate change impacts in different ways. For example, in the case of flooding, there can be direct impacts i.e. injury or loss of life, but also indirect impacts e.g. increased risks of water contamination or deterioration of mental health resulting from material losses and displacement as a cause of flooding.”

“In the case of heat waves, people are directly exposed to higher extreme temperatures which can cause thermal stresses (such as heat exhaustion or heat cramps), or exacerbate pre-existing cardiovascular and respiratory problems. Indirect effects include the aggravation of health problems as a result of the interaction between urban air pollution and heat extremes. Other indirect consequences include increased pressures and costs for public health and health care facilities, impacts on agriculture, increased use of air conditioning and water, and impacts on ecosystems, among others.”

“Though the whole population might be exposed, children, the elderly, urban poor, and people in poor health are usually the most vulnerable groups. These groups are therefore the focus in targeted prevention and emergency response interventions.”

“The highest impacts are expected in cities, especially in neighbourhoods with poorly adapted buildings lacking ventilation or air-cooling systems. In temperate countries, heat-related mortality might be offset by a decrease in mortality due to cold snaps during winter, though these results are still under discussion.“

On adaptation costs and benefits

BASE research has highlighted the importance of economic assessments of adaptation measures, using appropriate tools such as cost-benefit or cost-effectiveness analysis. Economic assessments are an important pre-requisite in planning adaptation, together with the employment of local data on climate, health and population.

The BASE project team has analysed the long-term costs and benefits of heat watch/warning systems in the case study city of Madrid. Madrid is characterised by intense episodes of heat waves and droughts during summer time. Warning systems are generally based on a critical temperature above which an abnormal increase in health impacts is expected.  

“Physical acclimatisation plays a crucial role. People living for example in Oslo are less acclimatised to high temperatures than people living in Cape Town. Equally other local factors such as demographic, behavioural, financial, technological and infrastructural parameters come into play. ‘What is the proportion of elderly people in the city?’, ‘Do buildings have air-conditioning systems? ‘How does urban planning affect the effect of heat islands?’ ´Are citizens and vulnerable groups sufficiently informed?’. All these factors influence acclimatisation processes and people’s preparedness to face the impacts of climate change.” “As a result, each city must identify locally appropriate threshold temperatures for sounding the alarm at different levels of risk, and there might be great geographical differences. Local factors should therefore be considered in the analysis of costs and benefits and updated over time to take into account the evolution of climatic factors as well as all other social and technological components.”

“Measures such as heat warning systems are designed to specifically reduce health risks. However, other measures include comprehensive programmes with a wide range of inter-sectoral benefits. This is the case for example with green infrastructures in cities, such as green roofs or urban parks. Green infrastructure can provide multiple positive outcomes. These include first and foremost, the health benefits associated with better air quality, less noise and heat island effects, improved mental health and reduced obesity due to the promotion of more active lifestyles.

“But green infrastructure also provides a range of other benefits to the environment and society e.g. improved quality of urban ecosystems (biodiversity, carbon sequestration, water purification, etc.), reduced health inequalities, greater community cohesion, aesthetic value and recreational activities.”

“As the WHO noted at the December 2015 COP21 meeting in Paris – “investments in low-carbon development, clean renewable energy and greater climate resilience are also investments in better health”. In this sense the health sector needs to collaborate with other sectors to produce integrated strategies for addressing climate change, thus contributing to mitigation efforts and to the transition to a low-carbon economy.”

“So we need a broader perspective when assessing adaptation and impacts of climate change. Economic indicators are important to help decision-makers set priorities when faced with limited budgets. But other factors such as social inequalities, distributional effects among population groups, ethical issues, as well as synergies and trade-offs among sectors are important to consider. These differing impacts, factors synergies and trade-offs can be taken into account through participatory approaches – as carried out within the BASE project – and help to account for the complexity of modern urban systems.”

“According to the WHO, health adaptation is generally expected to provide benefits that are higher than the implementation costs. Prompt action will promote higher levels of resilience in the face of future climate change impacts on health. For the health sector this includes measures for monitoring of diseases, their development and public exposure, the improvement of preparedness and emergency response plans to extreme events such as heat waves and collaboration between the health sector and other sectors. Efforts towards climate mitigation such as the reduction of air pollution, the promotion of active transport and the reduction of animal consumption can bring important health co-benefits and significant cost savings for the health care system.”

“All in all, the central question is how to plan adaptation in a way that is compatible with the transition to a low carbon economy and the necessary changes in lifestyle. Crucial points seem to include the need for cross-sectoral collaboration with engagement of different social actors with multiple perspectives, integration among adaptation measures in different sectors, coordination among agencies and institutions at local, national and regional scale.”