premium discounts for buildings that meet certain benchmarks. For example, homes in Alabama built to FORTIFIED Gold standards can get discounts of 45-55% on the wind portion of property owners’ insurance.52 It is important to note, however, that voluntary standards need incentives or mandates to scale effectively. 4 Install or retrofit cooling systems and ventilation Indoor cooling and ventilation are vital for preventing heat stress as temperatures rise. Climate-smart building design and passive cooling strategies like shading, natural ventilation, reflective roofing and insulation lower indoor temperatures without mechanical cooling. Retrofitting buildings for better cooling also offers significant additional benefits. The Empire State Building retrofit, for example, reduced energy use by 38%, saving $4.4 million annually.53 Air conditioning is currently the main approach for mitigating the health effects of high temperatures. This can, however, create a maladaptive feedback loop where higher AC use leads to more emissions, exacerbating global warming. High-efficiency units can help reduce costs and emissions, but scale-up must be conducted carefully to avoid strains on electrical grids. 5 Construct and maintain climate-resilient buildings and infrastructure Climate-adaptive design, such as floodable ground floors, wind-resistant structural reinforcements and fire-resistant construction in wildfire zones, reduces building failure risk, safeguards health and limits business disruption, inventory losses and liability. The US National Institute of Building Sciences reports that every $1 spent on designing above- code buildings saves $4 in future disaster losses.54 The use of climate-resilient materials can also improve overall resilience, as traditional materials degrade faster or fail under new extremes. As clients and investors increasingly prioritize resilience, developers who incorporate these features will gain a competitive edge and the ability to command premium pricing. Moreover, while upfront costs may be higher, they can often be offset by long-term savings in maintenance and insurance. Arup, a global engineering and design firm, supported the Asian Development Bank’s development of digital tools and analytics and the design of heat-resilient urban environments. A prototype Climate and Health Portal – an integrated platform that brings together data, research and insights to support evidence-based urban planning – represents a key output. Arup designed the portal’s digital framework and interface to ensure accessibility and impact, and, in parallel, conducted a detailed urban heat mapping study in a pilot city using advanced modelling tools such as UHeat and Terrain. The resulting heat stress and risk maps enabled targeted impact analysis and the prioritization of mitigation strategies, helping cities better prepare for rising temperatures.BOX 5 Enhancing heat-resilient urban planning Every $1 spent on designing above-code buildings saves $4 in future disaster losses. Building Economic Resilience to the Health Impacts of Climate Change 26

Building Economic Resilience to the Health Impacts of Climate Change 2025