Executive Summary

Increasing global interconnectivity, population, and economic growth, and the mutual interdependence of economic and ecological systems, can serve both to reduce vulnerability and to amplify disaster risks (high confidence). Global development pathways are becoming a more important factor in the management of vulnerability and disaster risk. [7.2.1]

The international community has accumulated substantial experience in providing help for disasters and risk management in the context of localized and short-term events associated with climate variability and extremes. Experience in disaster risk management includes both bottom-up and top-down approaches, but most often has developed from disasters considered first as local issues, then at the national level, and only at the international level where needs exceed national capacity, especially in terms of humanitarian assistance and capacity building. [7.2.4]

There are two main mechanisms at the international level that are purpose-built and dedicated to disaster risk management and climate change adaptation. These are the United Nations International Strategy for Disaster Reduction (UNISDR) and the United Nations Framework Convention on Climate Change (UNFCCC), in particular in its adaptation components. This chapter focuses on these two bodies while recognizing that there are many others that have an international role to play. Page limitations require a selective approach and a comprehensive assessment of all relevant bodies is impractical. The UNISDR and the UNFCCC are very different institutions with different mandates and scope and objectives, and with varying strengths and capacities (high confidence).

Introduction

Current climate extremes and projections for future changes to climate have resulted in growing attention to the health effects of climate on all human populations, urban and rural (McMichael et al., 2003; Confalonieri et al., 2007; Costello et al., 2009). Indeed, almost all the impacts of climate change have direct or indirect consequences for human health. However, for a number of reasons, city dwellers – especially those in low- and middle-income nations – are especially vulnerable to the health impacts of climate change.

In this chapter we present issues and case studies relevant to human health in cities under climate change conditions. In Section 7.2, we discuss the most relevant conclusions from the health chapter of the IPCC Fourth Assessment Report (Confalonieri et al., 2007), looking at its application to cities. In Section 7.3, we present an overview of urban health outcomes and their climate-related drivers. In Section 7.4 the factors that can modify the impacts of climate change on human health in urban areas are discussed. Section 7.5 presents examples and case studies of adaptations that protect city residents from some of the health impacts and risks posed by climate change. A brief discussion of needed changes in energy, transportation, and other sectors to reduce emissions of harmful pollutants and provide co-benefits for human health is found in Section 7.6. The urgent need for better, more urban focused and targeted research is discussed in Section 7.7. Conclusions are presented in Section 7.8.