FOREWORD

Climate change poses an existential threat to human health. Air pollution, extreme temperatures, water and food insecurity, and the spread of vector-borne diseases cause millions of deaths annually, with worsening impacts projected. Approximately 3.3 billion people live in areas designated as highly susceptible to climate change, the large majority of which are in low- and middle-income countries, and these communities have experienced mortality rates 15 times higher due to floods, drought, and storms over the past decade (IPCC 2022).

Research on climate and health is urgently needed to shed light on the mechanisms behind health impacts, demonstrate efficacy of adaptation and mitigation strategies, and improve predictive capabilities. To date, research has primarily covered topics of heat impacts and respiratory morbidity and mortality, while gaps persist in topics of mental health, nutrition, migration, maternal and child health, and inequity. A lack of robust evidence related to climate change mitigation and adaptation strategies, as well as on climate projections, hinders effective response, especially in low- and middle-income countries. These challenges are compounded by the scarcity of long-term datasets, fragmentation of climate and health data across stakeholders, and inadequate capacity for data disaggregation. Closing these gaps will be essential to identifying climate impacts on specific populations, predicting the impacts of climate on health, and developing targeted solutions.

Globally, research gaps include uneven international distribution of climate and health studies. Central Asia, North and Central Africa, and South America are particularly underrepresented in current research (Berrang-Ford et al. 2021). Gaps in regionally specific research and data limit governments’ ability to develop evidence-based strategies to address the health impacts of climate change.

The National Academy of Medicine developed this research agenda in partnership with Kaiser Permanente with the aim of advancing scientific understanding and shaping effective interventions and policies related to climate

and health. It was developed through an extensive review of existing literature and frameworks, consultations with experts across diverse fields, and meaningful engagement with community stakeholders. These contributions provided valuable insights into emerging and ongoing issues at the intersection of environmental factors, climate change, and human health.

Our inquiry revealed four significant areas of research need. First, there is a need for more evidence on how climate change poses serious health risks. Second, the publication underscores a need for evidence to support mitigation and adaptation strategies, particularly for vulnerable populations, and build resilience and infrastructure. Third, stronger research, technology, and capacity are needed, including investments in data systems, workforce development, and sustained funding. Finally, there is a need for science to inform policy and governance and need to translate scientific findings into clear and accessible language to engage policymakers and the public.

Effective response to the climate crisis depends on robust scientific evidence. Critical to this is the inclusion of underrepresented stakeholders and a focus on those who are most vulnerable to climate impacts. Interdisciplinary collaboration, community insights, and innovation will drive sustainable solutions that enhance health equity and improve resilience for all. A Research Agenda to Protect Human Health and Build Resilience in the Face of a Changing Climate provides a roadmap for researchers, policymakers, and practitioners to contribute to climate change response while safeguarding human health and well-being for future generations.

Victor J. Dzau, MD

President

National Academy of Medicine