and post-traumatic stress disorder. A rise in mental health conditions is a shared outcome of all the climate events studied in the original report. Rising climate risks Floods will pose the highest acute risk of climate- induced mortality, forecast to account for 8.5 million additional deaths by 2050.14 The effect of rising ocean temperatures on the frequency and intensity of storms can already be seen in places such as the southern US, which has been hit by a series of severe hurricanes since 2020. This included a rare category 5 storm15 in October 2024 and substantial loss of life from storm surges and flooding. High- tide flooding is now four to 10 times more frequent than it was 50 years16 ago in coastal areas. The Earth has already experienced a 20-centimetre rise in average sea levels since 188017 and the rate of increase is accelerating. This has huge implications for tens of millions of people, given that eight of the world’s 10 largest cities are near coasts.18 Currently, about 40% of the global population lives within 100 kilometres of the coast,19 increasing their exposure and vulnerability to rising sea levels and other coastal hazards such as severe storms; this puts populations at risk of being displaced. Rising sea levels20 lead to saltwater intrusion, resulting in higher concentrations of calcium, potassium and magnesium in groundwater. This can contribute to an increase in hypertension and related cardiovascular illnesses, among other health and economic impacts.21Droughts, indirectly linked to extreme heat, are forecast to be the second-highest cause of mortality, with an anticipated 3.2 million additional deaths by 2050. Some 40 million people in Africa are already living in severe drought conditions. Even in more temperate climates, drought is on the rise: 40% of the lower 48 states in the US22 have faced drought conditions for the past two years and 17% of the European Union (EU)23 are facing drought conditions at the time of writing. As a result, high temperatures are threatening food and water security, causing a rise in malnutrition and diseases connected to contaminated water and food. Prolonged heatwaves – a period of abnormally high temperatures relative to seasonal averages – have already killed tens of thousands and led to considerable morbidity and productivity losses. In Europe, for instance, more than 62,000 people died in the record heat between late May and early September 2022.24 Heatwaves are predicted to cause the highest global economic toll at an estimated $7.1 trillion by 2050, due to the loss in productivity. A rising number of wildfires worldwide is also connected to record heat which dries out foliage. Besides the destruction of property and loss of life and livestock, wildfires aggravate air pollution, which in turn exacerbates respiratory illness and cardiovascular diseases. Research suggests that air pollution will lead to 6 to 9 million premature deaths per year by 2060.25Floods will pose the highest acute risk of climate-induced mortality, forecast to account for 8.5 million additional deaths by 2050. Heatwaves are predicted to cause the highest global economic toll at an estimated $7.1 trillion by 2050, due to the loss in productivity. Climate change and health inequities People suffering the brunt of climate-related illnesses will be those in less economically developed regions lacking the resources to recover from climate-related disasters. For instance, the projected mortality rate in Africa is more than 20 times greater than in North and Central America and almost 14 times worse than in Europe.26 Asia is also disproportionately affected, with mortality rates more than 13 times worse than North and Central America. While climate-related disasters are detrimental to healthcare resources for all populations, there are additional threats to vulnerable communities, which already face limited access to quality medical care. Economic losses in Africa are forecast to be twice that of North and Central America, although less severe than in Europe. Asia is expected to experience losses three times higher than North and Central America and 34% higher than Europe over the 2023-2050 period. Low-income and hard-to-reach communities tend to live further from health services and facilities and face additional challenges to accessing health services, such as a lack of transport. These populations often must pay out-of-pocket costs for access for medical supplies and treatment. This differential in access to high-quality care perpetuates the disparities in health outcomes, widening the gap between the levels of mortality and morbidity experienced by disadvantaged populations and more privileged groups. Environmental disasters aggravate inequities and ultimately solutions that address economic disparity are vital for building resilience to climate change. 1.2 Implications for population health and well-being, including global economic impact Research suggests that air pollution will lead to 6-9 million premature deaths per year by 2060. Healthcare in a Changing Climate: Investing in Resilient Solutions 7

Healthcare in a Changing Climate 2025