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The eighth -- a collaboration between scientists and health practitioners from around the world -- paints a dire picture of continued inaction around climate change and its human cost.

"In this year's report, new projections reveal the dangers of further delays in action, with every tracked health dimension worsening as the climate changes," wrote Marina Romanello, PhD, of the Institute for Global Health in London, and colleagues.

However, they noted, the health community's science-driven approach "is uniquely positioned to ensure that decision makers are held accountable," and can "foster [human-centered] climate action that safeguards human health above all else."

The 2023 report highlights health-related consequences such as life-threatening heat, extreme weather events, rising transmission of infectious diseases, air pollution, and burden on existing health systems.

As the overall temperature of the planet rises, so do days of extreme and dangerous heat. Globally, heat-related deaths in people over 65 increased 85% from 1990-2000 (without climate change, they would have been expected to rise 38%). In the U.S., this effect may be even worse, with an estimated 23,200 heat-related deaths of older adults in 2022.

Climate change also means shifting weather patterns, which expose more communities to extreme weather events and disasters. The report calculates that extreme weather events have led to an estimated $41.5 billion increase in losses between 2010-2014 and 2018-2022, and millions more people are experiencing food insecurity due to heatwaves and droughts.

Cases of infectious diseases such as West Nile and dengue are already growing as conditions become more suitable for the viruses, the report found. Transmission of Zika, chikungunya, malaria, and Vibrio are also expected to increase. In U.S. lowland areas, the transmission season for two malaria-causing parasites has grown longer, and areas of U.S. coastline suitable for Vibrio transmission have also grown in recent years.

Fossil fuel combustion and low adoption of clean energy contributes to air pollution, increasing the risk of many diseases and mortality. Countries lower on the Human Development Index (a measurement encompassing life expectancy, education, and per capita income) are more likely to rely on air-polluting fuels, which can lead to further health problems and strains on healthcare systems. One bright spot is that a reduction in coal-derived air pollution has reduced fossil fuel-derived air pollution-related deaths.

The report notes almost 30% of cities surveyed across the globe are indeed concerned about their healthcare systems being overwhelmed by climate change-related hazards, including extreme heat, heavy rain, and flooding. Extreme weather events are also expected to lead to accelerating economic losses.

But instead of rapidly cutting back on investments and consumption of fossil fuels, "data this year show a world that is often moving in the wrong direction," the report stated. "[D]riven partly by record profits, oil and gas companies are further reducing their compliance with the Paris Agreement." Strategies of the 20 largest oil and gas companies put them on track to far surpass emissions goals from the agreement in the coming decades. U.S. banks, in particular, lead the world in lending to the fossil fuel sector, though lending to the "green sector" -- renewables, energy efficiency, carbon sinks -- hit an all-time high in 2021.

In an invited commentary, Sharon Friel, PhD, of the Australian National University in Canberra, Australia, highlighted a common thread running through climate change-driven health effects: "Known as the commercial determinants of health ... understanding and addressing the profiteering practices of commercial actors that drive the consumptogenic system and contribute to a wide array of health, social, and environmental harms is of growing interest across research, advocacy, and policy," she wrote.

Companies use a number of practices, including lobbying, corporate social responsibility campaigns, marketing practices, and influence on scientific research to maximize continued use of fossil fuels, Friel wrote, and must be held accountable.

"Climate change mitigation is arguably the biggest preventive global health action possible -- without effective mitigation, humanity will be unrecognizable by the time a child born today reaches old age," she wrote.

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