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Long-term observational studies, collecting durable, rigorous data under research quality conditions, e.g. using national cohorts, and assessing exposure– response (climate/aeroallergens/air pollutionhealth) functions. Such studies also need to collect disaggregated data to focus on compiling information on vulnerable population groups and vulnerable territories, accompanied by other research to ascertain the basis for vulnerability and for promoting health equity.

Research and modelling to understand the implications of ‘high-end’ climate change scenarios and nonlinearities (dangerous and irreversible tipping points), what might be the warning signals and time frames, and the various limits to adaptation. Even if there is only limited understanding of thresholds currently, the risks of exceeding them is likely to increase with continued emissions.

Improved understanding of attributing extreme weather events and health outcomes to climate change3: European meteorological64 and public health services should consider making an annual, assessment.

Clarifying, improving and validating indicators of vulnerability and exposure to climate-related hazards (EEA 2017a, 2018), of current health impacts and projected risks, and of adaptation processes, outcomes and health system resilience (Ebi et al. 2018b). Assessments need to include socio-economic impact; economic analysis of the costs of climate-sensitive health impacts and the costs of responding to hazards.

Increasing effort to evaluate and attribute mental health impacts and other indirect effects of climate change.

Evaluating the cost-effectiveness of adaptation and mitigation strategies, taking into account multiple benefits and, where relevant, adverse consequences and trade-offs.

Undertaking behaviour change and implementation research to understand better the levers and barriers to change at the level of individuals, communities and governments.

Encouraging the global collective assessment of research priorities, and agreement on internationally coordinated research funding streams, for example

through the work of the Belmont Forum initiative on Environment, Climate Change and Health. 5.3.2  Improving monitoring and integration of data sets There is need to strengthen understanding of the links between hazard, exposure, susceptibility and outcomes. Opportunities are coming within range to link environmental, socio-economic and health data sets to develop new insights into possible associations and understand current and future trends. There is a core need to improve surveillance (partly by sharing good practice, for example in vector surveillance) with systematic monitoring, data integration and updating, assessment of risks, and provision of alerts for policymakers, health services and other stakeholders. The option to set up a European Observatory (for the EU and neighbouring regions), linked with a Planetary Health Watch System (Haines et al. 2018) or other global observatory (Kulmala 2018) initiatives, to perform these functions, and interact with other relevant interests, for example for air quality, One Health, should now be considered65. When integrating data sets (particularly between human data and biophysical, chemical and biological data), it is important to be aware of differing standards for generating data, and that data sets may not be comprehensive. 5.3.3  Health in all policies Adaptation, mitigation and promotion of resilient and innovative systems requires coherent policy framework and leadership to implement within the intergenerational context. There is a current policy disconnect in that there is significant EU collaboration in tackling some aspects of climate change but health policy is mainly prioritised at the national level. There is need for more EU coordination on health, and policymakers need to go beyond their usual short-term timeframe. Among key priorities for the EU are the following. •

Ensuring that health is a major focus in the impending reform of the EU Adaptation Strategy (Appendix 3).

Reinforcing commitment to current health protection objectives, for example consistent implementation of EU air pollution standards, while informing progress on new standard setting (on PM and O3) according to the accumulating research evidence base, which suggests adverse effects well below current air quality standards.


For example, the European Centre for Medium-Range Weather Forecasts, Efforts in linking data sets and EU policies might also take advantage of the new risk data hub constituted by DG Echo (Civil protection and humanitarian aid operations) that will map loss from extreme weather events as part of extended disaster risk reduction actions in Europe. 65 


Climate change and health  |  June 2019  |  47

The imperative of climate action to protect human health in Europe  

Opportunities for adaptation to reduce the impacts and for mitigation to capitalise on the benefits of decarbonisation. The pace and extent...

The imperative of climate action to protect human health in Europe  

Opportunities for adaptation to reduce the impacts and for mitigation to capitalise on the benefits of decarbonisation. The pace and extent...