Abstract
Background: Children are more vulnerable than adults to climate-related health threats, but reviews examining how climate change affects human health have been mainly descriptive and lack an assessment of the magnitude of health effects children face. This is the first systematic review and meta-analysis that identifies which climate health relationships pose the greatest threats to children. Objectives: We reviewed epidemiologic studies to analyse various child health outcomes due to climate change and identify the relationships with the largest effect size. We identify population-specific risks and provide recommendations for future research. Methods: We searched four large online databases for observational studies published up to 5 January 2023 following PRISMA (systematic review) guidelines. We evaluated each included study individually and aggregated relevant quantitative data. We used quantitative data in our meta-analysis, where we standardised effect sizes and compared them among different groupings of climate variables and health outcomes.
Abstract from Weeda LJZ, Bradshaw CJA, Judge MA, et al.: How climate change degrades child health: A systematic review and meta-analysis. Sci Total Environ 2024;920:170944. https://doi.org/10.1016/j.scitotenv.2024.170944
Knowledge Transfer of Derya Dikmen (Ankara)
Climate change refers to long-term changes in temperatures and weather patterns caused by human activities [1]. Climate change primarily impacts the entire global system, but its effects are felt at all levels of the ecological system, from macro to micro. Furthermore, climate change has an impact on the social, economic, and environmental factors contributing to illness, pandemics, and deaths especially among vulnerable groups [2]. Children and young people are most exposed to the impact of climate change. According to the World Health Organization, children are vulnerable to environmental risks like air pollution, inadequate access to safe water, hazardous chemical waste, and climate change impacts via skin exposure, inhalation, ingestion, and transplacental exposure [3].
Any person under 18 is considered a child and has the right to the best healthcare, clean drinking water, healthy food, and a clean and safe environment. Unfortunately, climate change has taken away the right of children to a healthy life from the preterm period into adulthood [4].
Children are more vulnerable to pollution and climate change impacts because of their higher metabolic rate, quick growth and development, underdeveloped detoxification systems, immature immune systems, and increased exposure to toxins from the outdoors [5]. UNICEF’s Children’s Climate Risk Index [6] states that nearly half of the world’s child population lives in high-risk countries in terms of climate change. The report also showed that 9 out of 10 children are exposed to air pollution, 1 out of 3 face heatwaves, water scarcity, and lead poisoning, 1 out of 4 are exposed to vector-borne diseases, and 1 out of 6 are affected by extreme weather conditions. Reducing environmental risks could prevent 1 out of 4 child deaths. The risk to the child begins during fetal development; maternal exposure to fine particulate air pollution or high environmental temperatures raises the likelihood of premature birth and low birth weight [7].
Climate change increases the frequency and intensity of natural disasters and makes land and water scarcer. Thus, climate change poses serious and increasing risks to food security, water supply, public health, agriculture, and natural ecosystems [2].
Children are also more vulnerable to the indirect effects of climate change, such as food shortages and food insecurity. Children are disproportionately affected by food insecurity due to their reliance on caregivers for nutrition [8]. Furthermore, the impact of climate change exacerbates food insecurity, leading to malnutrition in children.
Any threat experienced in childhood can lead to health issues in adulthood. Thus, protecting the environment saves not only the planet but also the well-being of children thus ensuring a better future.
Study Highlights
This systematic review aimed to analyze the effects of climate change on child health and identify the specific risks to children’s health. The review covers various aspects of climate change and child health outcomes, recognizing that different populations will face unique challenges. The findings emphasize the importance of context-specific research to address these diverse impacts effectively. Geography also matters in relation to climate change issues, as well as a country’s economic status.
The review identified strong evidence linking various climate change variables to different child health outcomes, particularly perinatal health (e.g., preterm birth), respiratory conditions, and overall mortality/morbidity. Despite variability among studies, temperature changes and air pollution identified as significant factors affecting child health.
The strongest associations were found between temperature extremes and preterm birth, followed by respiratory outcomes and mortality/morbidity. Air pollution also substantially impacted respiratory and perinatal diseases, highlighting the importance of these factors in child health within the context of climate change.
The review pointed out significant inconsistencies among studies, including variations in climate metrics, lack of raw data reporting, and differing methodologies. These inconsistencies complicated direct comparisons and emphasized the need for standardization in future research.
While some studies explored the combined effects of temperature and air pollution on health outcomes, more research is needed to understand the broader interactions between multiple climate variables and their impact on child health.
The review revealed other factors related to reporting such as high risk of attrition and confounding bias. The lack of precise data on study participants and the results also affects the analysis as clearly defined results are missing thus the further studies needed for transparent data reporting in observational studies.
The study suggests that future research should include multiple climate metrics (e.g., temperature percentiles) and provide raw data to improve comparability and strengthen meta-analyses.
Conclusions for Daily Practice for Dietitians
Climate change is one of the biggest threats to the well being of children today and in the future. Dietitians can play a crucial role in protecting children from the adverse health effects of climate change.
This can achieve through enhancing access to and consumption of diverse and sustainable, climate friendly diets that rely on locally sourced, nutrient-dense foods. Dietitians can also develop nutrition programs specifically targeting children, ensuring that they receive adequate nutrition since the children are most vulnerable to the health impacts of climate change, including malnutrition and diet-related diseases. Dietitians should identify and prioritize support for children from low- and middle-income backgrounds, especially those without reliable access to healthcare, safe drinking water, or consistent food supplies.
It is important for dietitians to raise awareness on the relationship between climate change and nutrition to families and communities. Some of the possible health effects include increased risk of respiratory diseases, malnutrition, and food borne diseases. In order to protect the children from these adverse health effects, dietitians can educate families about the health risks and help communities to prepare and adapt. This includes reducing food waste, proper cooking, portion control, food safety, choosing sustainable and nutritious plant-based foods, and supporting local food producers.
Incorporating these practices into their daily work, dietitians can help protect children from the growing health burdens associated with climate change and contribute to global efforts to create a healthier, more sustainable future.
Disclosure statement
I hereby declare that there are no conflicts of interest regarding this commentary.
