Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review Article
  • Published:

A framework for ageing and health vulnerabilities in a changing climate

Nature Climate Change volume 14, pages 1125–1135 (2024)Cite this article

Subjects

Abstract

The twenty-first century will witness historically unprecedented shares of older adult populations with an unfolding set of health-related challenges associated with climate change. Building on existing evidence that focuses on climate–ageing, ageing–health and health–climate connections, this Review summarizes ageing trends and the biophysical, socio-demographic, cultural and contextual pathways that shape the disproportionate impacts of climate-related environmental stress on older adults’ health. We propose a framework to conceptualize how these many factors intersect with climate stressors to impact the health of older adults. We also discuss knowledge gaps and suggest ways to improve social and health science research and data infrastructure.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Thematic foci and study types within pairwise evidence bases in climate–health–ageing research.
Fig. 2: Framework for studying ageing, climate and health.
Fig. 3: Principles to guide socio-demographic data collection to facilitate future research.

Similar content being viewed by others

References

  1. Fact Sheet: Ageing and Health (World Health Organization, 2022); https://www.who.int/news-room/fact-sheets/detail/ageing-and-health

  2. World Population Prospects 2022: Summary of Results (Population Division, UN Department of Economic and Social Affairs, 2022); https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/wpp2022_summary_of_results.pdf

  3. State of World Population Report 2023: The Problem with ‘Too Few’ (United Nations Population Fund, 2023); https://www.unfpa.org/swp2023/too-few

  4. Caplan, Z. U.S. older population grew from 2010 to 2020 at fastest rate since 1880 to 1890. America Counts https://www.census.gov/library/stories/2023/05/2020-census-united-states-older-population-grew.html (2023).

  5. Jang, I. Y., Lee, H. Y., Lee, E. & The 50th Anniversary Committee of Korean Geriatrics Society. Geriatrics fact sheet in Korea 2018 from national statistics. Ann. Geriatr. Med. Res. 23, 50–53 (2019).

  6. Global Issues: Ageing (United Nations, accessed 11 February 2024); https://www.un.org/en/global-issues/ageing

  7. Alburez-Gutierrez, D., Williams, I. & Caswell, H. Projections of human kinship for all countries. Proc. Natl Acad. Sci. USA 120, e2315722120 (2023).

    Article  CAS  Google Scholar 

  8. IPCC Climate Change 2022: Impacts, Adaptation and Vulnerability (eds Pörtner, H. O. et al.) (Cambridge Univ. Press, 2022); https://doi.org/10.1017/9781009325844

  9. Balbus, J. M. & Malina, C. Identifying vulnerable subpopulations for climate change health effects in the United States. J. Occup. Environ. Med. 51, 33–37 (2009).

    Article  Google Scholar 

  10. Ebi, K. L., Ogden, N. H., Semenza, J. C. & Woodward, A. Detecting and attributing health burdens to climate change. Environ. Health Perspect. 125, 085004 (2017).

    Article  Google Scholar 

  11. Helldén, D. et al. Climate change and child health: a scoping review and an expanded conceptual framework. Lancet Planet. Health 5, e164–e175 (2021).

    Article  Google Scholar 

  12. Patz, J. A. & Olson, S. H. Climate change and health: global to local influences on disease risk. Ann. Trop. Med. Parasitol. 100, 535–549 (2006).

    Article  CAS  Google Scholar 

  13. Stanke, C., Kerac, M., Prudhomme, C., Medlock, J. & Murray, V. Health effects of drought: a systematic review of the evidence. PMC 23787891 (2013).

  14. Zaitchik, B. F. in Oxford Research Encyclopedia of Climate Science (Oxford Univ. Press, 2017); https://doi.org/10.1093/acrefore/9780190228620.013.555

  15. Gamble, J. L. et al. Climate change and older americans: state of the science. Environ. Health Perspect. 121, 15–22 (2013).

    Article  Google Scholar 

  16. Hauer, M. & Rose, K. A Systematic Review of Aging and Climate Change (NLCHDD, 2024).

  17. Romanello, M. et al. The 2023 report of the Lancet Countdown on health and climate change: the imperative for a health-centred response in a world facing irreversible harms. Lancet https://doi.org/10.1016/S0140-6736(23)01859-7 (2023).

  18. Berman, J. D., Ebisu, K., Peng, R. D., Dominici, F. & Bell, M. L. Drought and the risk of hospital admissions and mortality in older adults in western USA from 2000 to 2013: a retrospective study. Lancet Planet. Health 1, e17–e25 (2017).

    Article  Google Scholar 

  19. Paavola, J. Health impacts of climate change and health and social inequalities in the UK. Environ. Health 16, 113 (2017).

    Article  Google Scholar 

  20. McDermott, R., Kolanowski, A. M., Fick, D. M. & Mann, M. E. Addressing the health risks of climate change in older adults. J. Gerontol. Nurs. 45, 21–29 (2019).

    Article  Google Scholar 

  21. Cissé, G. et al. in Climate Change 2022: Impacts, Adaptation and Vulnerability (eds Pörtner, H. O. et al.) Ch. 7 (IPCC, Cambridge Univ. Press, 2022).

  22. Geller, A. M. & Zenick, H. Aging and the environment: a research framework. Environ. Health Perspect. 113, 1257–1262 (2005).

    Article  Google Scholar 

  23. Climate Change and Health Initiative Strategic Framework (National Institutes of Health, 2022); https://www.nih.gov/sites/default/files/research-training/initiatives/climate-change/nih-climate-change-framework.pdf

  24. Bunker, A. et al. Effects of air temperature on climate-sensitive mortality and morbidity outcomes in the elderly; a systematic review and meta-analysis of epidemiological evidence. eBioMedicine 6, 258–268 (2016).

    Article  Google Scholar 

  25. About Chronic Diseases (CDC, accessed 8 October 2024); https://www.cdc.gov/chronic-disease/about/index.html

  26. Chowdhury, S. R., Das, D. C., Sunna, T. C., Beyene, J. & Hossain, A. Global and regional prevalence of multimorbidity in the adult population in community settings: a systematic review and meta-analysis. eClinicalMedicine 57, 101860 (2023).

    Article  Google Scholar 

  27. Kriebel-Gasparro, A. Climate change: effects on the older adult. J. Nurse Pract. 18, 372–376 (2022).

    Article  Google Scholar 

  28. Gropper, S. S. The role of nutrition in chronic disease. Nutrients 15, 664 (2023).

    Article  Google Scholar 

  29. Glynn, J. R. & Moss, P. A. H. Systematic analysis of infectious disease outcomes by age shows lowest severity in school-age children. Sci. Data 7, 329 (2020).

    Article  CAS  Google Scholar 

  30. Alzheimer's Dsease and Other Dementias—Level 3 Cause (IHME, accessed 8 October 2024); https://www.healthdata.org/research-analysis/diseases-injuries-risks/factsheets/2021-alzheimers-disease-and-other-dementias

  31. Zuelsdorff, M. & Limaye, V. S. A framework for assessing the effects of climate change on dementia risk and burden. Gerontologist https://doi.org/10.1093/geront/gnad082 (2023).

  32. Bongioanni, P. et al. Climate change and neurodegenerative diseases. Environ. Res. 201, 111511 (2021).

    Article  CAS  Google Scholar 

  33. Wei, Y. et al. Associations between seasonal temperature and dementia-associated hospitalizations in New England. Environ. Int. 126, 228–233 (2019).

    Article  Google Scholar 

  34. Cornali, C. et al. Effect of high climate temperature on the behavioral and psychological symptoms of dementia. J. Am. Med. Dir. Assoc. 5, 161–166 (2004).

    Article  Google Scholar 

  35. Nagae, M. et al. Chronic dehydration in nursing home residents. Nutrients 12, 3562 (2020).

    Article  Google Scholar 

  36. Chevance, G. et al. A systematic review of ambient heat and sleep in a warming climate. Sleep. Med. Rev. 75, 101915 (2024).

    Article  Google Scholar 

  37. Wilson-Genderson, M., Heid, A. R. & Pruchno, R. Long-term effects of disaster on depressive symptoms: type of exposure matters. Soc. Sci. Med. 217, 84–91 (2018).

    Article  Google Scholar 

  38. Gaskin, C. J. et al. Factors associated with the climate change vulnerability and the adaptive capacity of people with disability: a systematic review. Weather Clim. Soc. 9, 801–814 (2017).

    Article  Google Scholar 

  39. Hoogendijk, E. O. et al. Frailty: implications for clinical practice and public health. Lancet 394, 1365–1375 (2019).

    Article  Google Scholar 

  40. Chauhan, S., Kumar, S., Bharti, R. & Patel, R. Prevalence and determinants of activity of daily living and instrumental activity of daily living among elderly in India. BMC Geriatr. 22, 64 (2022).

    Article  Google Scholar 

  41. National Health Interview Survey: Percentage of Any Difficulty with Self Care for Adults Aged 18 and Over, United States, 2019—2023 (CDC NCHS, accessed 8 October 2024); https://wwwn.cdc.gov/NHISDataQueryTool/SHS_adult/index.html

  42. Boonyaratkalin, P., Partiprajak, S. & Piaseu, N. Flood preparedness literacy and behaviors in community dwelling older adults. Disast. Med. Public Health Prep. 15, 452–457 (2021).

    Article  Google Scholar 

  43. Al-rousan, T. M., Rubenstein, L. M. & Wallace, R. B. Preparedness for natural disasters among older US adults: a nationwide survey. Am. J. Public Health 104, 506–511 (2014).

    Article  Google Scholar 

  44. Vos, T. et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 396, 1204–1222 (2020).

    Article  Google Scholar 

  45. Tomic, D., Shaw, J. E. & Magliano, D. J. The burden and risks of emerging complications of diabetes mellitus. Nat. Rev. Endocrinol. 18, 525–539 (2022).

    Article  Google Scholar 

  46. Westphal, S. A. et al. Managing diabetes in the heat: potential issues and concerns. Endocr. Pract. 16, 506–511 (2010).

    Article  Google Scholar 

  47. Lane, K. et al. Burden and risk factors for cold-related illness and death in New York City. Int. J. Environ. Res. Public Health 15, 632 (2018).

    Article  Google Scholar 

  48. Read, D. J., Holian, A., Moller, C. C. & Poutawera, V. Surgical workload of a foreign medical team after Typhoon Haiyan. ANZ J. Surg. 86, 361–365 (2016).

    Article  Google Scholar 

  49. Travia, K. R. et al. Impact of Hurricane Matthew on diabetes self-management and outcomes. N. C. Med. J. 82, 100–107 (2021).

    Google Scholar 

  50. Ochi, S., Hodgson, S., Landeg, O., Mayner, L. & Murray, V. Disaster-driven evacuation and medication loss: a systematic literature review. PMC 25642363 (2014).

  51. Johnson, R. J. et al. Climate change and the kidney. Ann. Nutr. Metab. 74, 38–44 (2019).

    Article  CAS  Google Scholar 

  52. Huang, Y. et al. Heatwave and urinary hospital admissions in China: disease burden and associated economic loss, 2014 to 2019. Sci. Total Environ. 857, 159565 (2023).

    Article  CAS  Google Scholar 

  53. Elser, H. et al. Ambient temperature and risk of urinary tract infection in California: a time-stratified case-crossover study using electronic health records. Environ. Int. 165, 107303 (2022).

    Article  Google Scholar 

  54. Lai, H. et al. Population incidence and associated mortality of urinary tract infection in people living with dementia. J. Infect. https://doi.org/10.1016/j.jinf.2024.106167 (2024).

  55. Chapman, C. L. et al. Kidney physiology and pathophysiology during heat stress and the modification by exercise, dehydration, heat acclimation and aging. Temp. Multidiscip. Biomed. J. 8, 108–159 (2020).

    Google Scholar 

  56. Hooper, L., Bunn, D., Jimoh, F. O. & Fairweather-Tait, S. J. Water-loss dehydration and aging. Mech. Ageing Dev. 136–137, 50–58 (2014).

    Article  Google Scholar 

  57. Kelman, J. et al. Dialysis care and death following hurricane sandy. Am. J. Kidney Dis. 65, 109–115 (2015).

    Article  Google Scholar 

  58. GBD 2019 Hearing Loss Collaborators Hearing loss prevalence and years lived with disability, 1990–2019: findings from the Global Burden of Disease Study 2019. Lancet 397, 996–1009 (2021).

    Article  Google Scholar 

  59. Engelman, A. et al. Responding to the deaf in disasters: establishing the need for systematic training for state-level emergency management agencies and community organizations. BMC Health Serv. Res. 13, 84 (2013).

    Article  Google Scholar 

  60. Shukla, A. et al. Hearing loss, loneliness, and social isolation: a systematic review. Otolaryngol. Neck Surg. 162, 622–633 (2020).

    Article  Google Scholar 

  61. Global Health Estimates 2020: Deaths by Cause, Age, Sex, by Country and by Region, 2000–2019 (World Health Organization, 2020); https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates/ghe-leading-causes-of-death

  62. Chaseling, G. K. et al. Extreme heat and cardiovascular health: what a cardiovascular health professional should know. Can. J. Cardiol. 37, 1828–1836 (2021).

    Article  Google Scholar 

  63. Cheng, J. et al. Cardiorespiratory effects of heatwaves: a systematic review and meta-analysis of global epidemiological evidence. Environ. Res. 177, 108610 (2019).

    Article  CAS  Google Scholar 

  64. Ebi, K. L. & Mills, D. Winter mortality in a warming climate: a reassessment. WIREs Clim. Change 4, 203–212 (2013).

    Article  Google Scholar 

  65. Weilnhammer, V. et al. Extreme weather events in europe and their health consequences – a systematic review. Int. J. Hyg. Environ. Health 233, 113688 (2021).

    Article  Google Scholar 

  66. Meade, R. D. et al. Physiological factors characterizing heat-vulnerable older adults: a narrative review. Environ. Int. 144, 105909 (2020).

    Article  Google Scholar 

  67. Vaidyanathan, A., Malilay, J., Schramm, P. & Saha, S. Heat-related deaths — United States, 2004–2018. Morb. Mortal. Wkly Rep. 69, 729–734 (2020).

    Article  Google Scholar 

  68. Malmquist, A., Hjerpe, M., Glaas, E., Karlsson, H. & Lassi, T. Elderly people’s perceptions of heat stress and adaptation to heat: an interview study. Int. J. Environ. Res. Public Health 19, 3775 (2022).

    Article  Google Scholar 

  69. Arlappa, N. et al. Prevalence of chronic energy deficiency in rural-dwelling older indian adults during a period of severe drought. J. Nutr. Elder. 28, 301–312 (2009).

    Article  CAS  Google Scholar 

  70. Molinsky, J. & Forsyth, A. Climate change, aging, and well-being: how residential setting matters. Hous. Policy Debate 33, 1029–1054 (2022).

    Article  Google Scholar 

  71. McMaughan, D. J., Oloruntoba, O. & Smith, M. L. Socioeconomic status and access to healthcare: interrelated drivers for healthy aging. Front. Public Health 8, 231 (2020).

    Article  Google Scholar 

  72. Bell, S. A., Krienke, L. K., Dickey, S. & De Vries, R. G. ‘Helping fill that gap:’ a qualitative study of aging in place after disaster through the lens of home-based care providers. BMC Geriatr. 21, 235 (2021).

    Article  Google Scholar 

  73. Carr, D., Falchetta, G. & Wing, I. S. Population aging and heat exposure in the 21st century: which U.S. regions are at greatest risk and why? Gerontologist 64, gnad050 (2023).

  74. Jones, B., Dunn, G. & Balk, D. Extreme heat related mortality: spatial patterns and determinants in the United States, 1979–2011. Spat. Demogr. 9, 107–129 (2021).

    Article  Google Scholar 

  75. Hayden, M. H. et al. Adaptive capacity to extreme heat: results from a household survey in Houston, Texas. Weather Clim. Soc. 9, 787–799 (2017).

    Article  Google Scholar 

  76. Bartelmeß, T., Jasiok, S., Kühnel, E. & Yildiz, J. A scoping review of the social dimensions in food insecurity and poverty assessments. Front. Public Health 10, 994368 (2022).

    Article  Google Scholar 

  77. Bednar, D. J. & Reames, T. G. Recognition of and response to energy poverty in the United States. Nat. Energy 5, 432–439 (2020).

    Article  Google Scholar 

  78. Hernández, D. Understanding ‘energy insecurity’ and why it matters to health. Soc. Sci. Med. 167, 1–10 (2016).

    Article  Google Scholar 

  79. Pooler, J. A., Hartline-Grafton, H., DeBor, M., Sudore, R. L. & Seligman, H. K. Food insecurity: a key social determinant of health for older adults. J. Am. Geriatr. Soc. 67, 421–424 (2019).

    Article  Google Scholar 

  80. Belaïd, F. Implications of poorly designed climate policy on energy poverty: global reflections on the current surge in energy prices. Energy Res. Soc. Sci. 92, 102790 (2022).

    Article  Google Scholar 

  81. Lake, I. R. et al. Climate change and food security: health impacts in developed countries. Environ. Health Perspect. 120, 1520–1526 (2012).

    Article  Google Scholar 

  82. Selvarajah, S. et al. Racism, xenophobia, and discrimination: mapping pathways to health outcomes. Lancet 400, 2109–2124 (2022).

    Article  Google Scholar 

  83. Boersma, P., Black, L. I. & Ward, B. W. Prevalence of multiple chronic conditions among US adults, 2018. Prev. Chronic Dis. https://doi.org/10.5888/pcd17.200130 (2020).

  84. Centers for Disease Control and Prevention Chronic Kidney Disease in the United States, 2023 (US Department of Health and Human Services, 2023); https://www.cdc.gov/kidneydisease/publications-resources/ckd-national-facts.html

  85. Younan, D. et al. Racial/ethnic disparities in Alzheimer’s disease risk: role of exposure to ambient fine particles. J. Gerontol. A 77, 977–985 (2022).

    Article  Google Scholar 

  86. Adams, R. M., Evans, C. M., Mathews, M. C., Wolkin, A. & Peek, L. Mortality from forces of nature among older adults by race/ethnicity and gender. J. Appl. Gerontol. 40, 1517–1526 (2021).

    Article  Google Scholar 

  87. Berberian, A. G., Gonzalez, D. J. X. & Cushing, L. J. Racial disparities in climate change-related health effects in the United States. Curr. Environ. Health Rep. 9, 451–464 (2022).

    Article  Google Scholar 

  88. Ronco, M. et al. Exploring interactions between socioeconomic context and natural hazards on human population displacement. Nat. Commun. 14, 8004 (2023).

    Article  CAS  Google Scholar 

  89. Markides, K. S. & Rote, S. The healthy immigrant effect and aging in the United States and other western countries. Gerontologist 59, 205–214 (2019).

    Article  Google Scholar 

  90. Kendall, J. & Anglewicz, P. Migration and health at older age in rural Malawi. Glob. Public Health 13, 1520–1532 (2018).

    Article  Google Scholar 

  91. Mandal, B., Pradhan, K. C., Mohanty, P. & Muhammad, T. Migration status, physical limitations and associated self-rated health: a study of older Indian adults. BMC Geriatr. 23, 316 (2023).

    Article  Google Scholar 

  92. Nabong, E. C., Hocking, L., Opdyke, A. & Walters, J. P. Decision‐making factor interactions influencing climate migration: a systems‐based systematic review. WIREs Clim. Change 14, e828 (2023).

    Article  Google Scholar 

  93. Tsai, P. L. & Ghahari, S. Immigrants’ experience of health care access in Canada: a recent scoping review. J. Immigr. Minor. Health 25, 712–727 (2023).

    Article  Google Scholar 

  94. Evangelidou, S. et al. Screening and routine diagnosis of mental disorders among migrants in primary care: a cross-sectional study. J. Migr. Health 8, 100205 (2023).

    Article  Google Scholar 

  95. Jang, Y. et al. Health risks posed by social and linguistic isolation in older Korean Americans. J. Am. Geriatr. Soc. 69, 3258–3266 (2021).

    Article  Google Scholar 

  96. Zemba, S. & Wilmoth, J. Older Immigrants Are More Likely Than Older Nonimmigrants to Experience Loneliness. (Lerner Center for Public Health Promotion and Population Health, Syracus Univ., 2022); https://www.maxwell.syr.edu/research/lerner-center/population-health-research-brief-series/article/older-immigrants-are-more-likely-than-older-nonimmigrants-to-experience-loneliness

  97. World Bank Open Data—DataBank: World Development Indicators (World Bank, 2024); https://data.worldbank.org/

  98. Neumayer, E. & Plümper, T. The gendered nature of natural disasters: the impact of catastrophic events on the gender gap in life expectancy, 1981–2002. Ann. Assoc. Am. Geogr. 97, 551–566 (2007).

    Article  Google Scholar 

  99. Hunter, L. M., Castro, J., Kleiber, D. & Hutchens, K. Swimming and gendered vulnerabilities: evidence from the northern and central Philippines. Soc. Nat. Resour. 29, 380–385 (2016).

    Article  Google Scholar 

  100. Ashraf, M. A. & Azad, M. A. K. Gender issues in disaster: understanding the relationships of vulnerability, preparedness and capacity. Environ. Ecol. Res. 3, 136–142 (2015).

    Article  Google Scholar 

  101. Oktari, R. S., Kamaruzzaman, S., Fatimahsyam, F., Sofia, S. & Sari, D. K. Gender mainstreaming in a disaster-resilient village programme in Aceh Province, Indonesia: towards disaster preparedness enhancement via an equal opportunity policy. Int. J. Disast. Risk Reduct. 52, 101974 (2021).

    Article  Google Scholar 

  102. Rao, S. A natural disaster and intimate partner violence: evidence over time. Soc. Sci. Med. 247, 112804 (2020).

    Article  Google Scholar 

  103. Holt-Lunstad, J., Smith, T. B., Baker, M., Harris, T. & Stephenson, D. Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspect. Psychol. Sci. 10, 227–237 (2015).

    Article  Google Scholar 

  104. Relationship by Household Type (Including Living Alone) for the Population 65 Years and Over (US Census Bureau, 2022); https://data.census.gov/table/ACSDT1Y2022.B09020?q=B09020

  105. Piette, J. et al. Loneliness Among Older Adults Before and During the COVID-19 Pandemic (Institute for Healthcare Policy & Innovation, Univ. Michigan, 2020); http://hdl.handle.net/2027.42/162549

  106. Keller, R. C. Fatal Isolation: The Devastating Paris Heat Wave of 2003 (Univ. Chicago Press, 2015).

  107. Klinenberg, E. Heat Wave: A Social Autopsy of Disaster in Chicago 2nd edn (Univ. Chicago Press, 2015).

  108. Garner, J. M. et al. A multihazard assessment of age-related weather vulnerabilities. Weather Clim. Soc. 12, 367–386 (2020).

    Article  Google Scholar 

  109. Benmarhnia, T. et al. A difference-in-differences approach to assess the effect of a heat action plan on heat-related mortality, and differences in effectiveness according to sex, age, and socioeconomic status (Montreal, Quebec). Environ. Health Perspect. 124, 1694–1699 (2016).

    Article  Google Scholar 

  110. He, B. J. et al. A framework for addressing urban heat challenges and associated adaptive behavior by the public and the issue of willingness to pay for heat resilient infrastructure in Chongqing, China. Sustain. Cities Soc. 75, 103361 (2021).

    Article  Google Scholar 

  111. Sheridan, S. C. A survey of public perception and response to heat warnings across four North American cities: an evaluation of municipal effectiveness. Int. J. Biometeorol. 52, 3–15 (2007).

    Article  Google Scholar 

  112. Kosatsky, T. et al. Heat awareness and response among Montreal residents with chronic cardiac and pulmonary disease. Can. J. Public Health 100, 237–240 (2009).

    Article  Google Scholar 

  113. Abbinett, J. et al. Heat Response Plans: Summary of Evidence and Strategies for Collaboration and Implementation (CDC, 2020); https://stacks.cdc.gov/view/cdc/93705

  114. Lane, K. et al. Extreme heat awareness and protective behaviors in New York City. J. Urban Health 91, 403–414 (2014).

    Article  Google Scholar 

  115. Richard, L., Kosatsky, T. & Renouf, A. Correlates of hot day air-conditioning use among middle-aged and older adults with chronic heart and lung diseases: the role of health beliefs and cues to action. Health Educ. Res. 26, 77–88 (2011).

    Article  Google Scholar 

  116. 68% of the World Population Projected to Live in Urban Areas by 2050, Says UN (UN DESA, accessed 8 October 2024); https://www.un.org/sw/desa/68-world-population-projected-live-urban-areas-2050-says-un

  117. Older Adult Snapshot (NYC Department for the Aging, 2023); https://www.nyc.gov/assets/dfta/downloads/pdf/reports/Older-Adult-Snapshot%20Vertical-3-pager.pdf

  118. Bukvic, A., Gohlke, J., Borate, A. & Suggs, J. Aging in flood-prone coastal areas: discerning the health and well-being risk for older residents. Int. J. Environ. Res. Public Health 15, 2900 (2018).

    Article  Google Scholar 

  119. Tagtachian, D. & Balk, D. Uneven vulnerability: characterizing population composition and change in the low elevation coastal zone in the United States with a climate justice lens, 1990–2020. Front. Environ. Sci. 11, 1111856 (2023).

    Article  Google Scholar 

  120. Dundon, L. A. & Camp, J. S. Climate justice and home-buyout programs: renters as a forgotten population in managed retreat actions. J. Environ. Stud. Sci. 11, 420–433 (2021).

    Article  Google Scholar 

  121. Elliott, J. R., Brown, P. L. & Loughran, K. Racial inequities in the federal buyout of flood-prone homes: a nationwide assessment of environmental adaptation. Socius 6, 237802312090543 (2020).

    Article  Google Scholar 

  122. Rao, S., Doherty, F. C., Teixeira, S., Takeuchi, D. T. & Pandey, S. Social and structural vulnerabilities: associations with disaster readiness. Glob. Environ. Change 78, 102638 (2023).

    Article  Google Scholar 

  123. MacManus, K., Balk, D., Engin, H., McGranahan, G. & Inman, R. Estimating population and urban areas at risk of coastal hazards, 1990–2015: how data choices matter. Earth Syst. Sci. Data 13, 5747–5801 (2021).

    Article  Google Scholar 

  124. Hauer, M. E., Saunders, R. K. & Shtob, D. Research note: demographic change on the United States coast, 2020–2100. Demography 59, 1221–1232 (2022).

    Article  Google Scholar 

  125. Bolin, R. & Klenow, D. J. Older people in disaster: a comparison of black and white victims. Int. J. Aging Hum. Dev. 26, 29–43 (1988).

    Article  CAS  Google Scholar 

  126. Buffum, M. D., Hutt, E., Chang, V. T., Craine, M. H. & Snow, A. L. Cognitive impairment and pain management: review of issues and challenges. J. Rehabil. Res. Dev. 44, 315–330 (2007).

    Article  Google Scholar 

  127. Rural America at a Glance: 2018 Edition (United States Department of Agriculture, 2018); https://www.ers.usda.gov/webdocs/publications/90556/eib-200.pdf?v=4027.2

  128. Heide-Ottosen, S. The Ageing of Rural Populations: Evidence on Older Farmers in Low and Middle-Income Countries (HelpAge International, 2014); https://doi.org/10.1163/2210-7975_HRD-9997-2014020

  129. Miller, K. E. M., James, H. J., Holmes, G. M. & Van Houtven, C. H. The effect of rural hospital closures on emergency medical service response and transport times. Health Serv. Res. 55, 288–300 (2020).

    Article  Google Scholar 

  130. Cohen, R. A. et al. Geographic Variation in Health Insurance Coverage: United States, 2019 (National Center for Health Statistics, 2021); https://doi.org/10.15620/cdc:107558

  131. Thiede, B. C., Lichter, D. T. & Slack, T. Working, but poor: the good life in rural America? J. Rural Stud. 59, 183–193 (2018).

    Article  Google Scholar 

  132. Kaufman, B. G. et al. The rising rate of rural hospital closures. J. Rural Health 32, 35–43 (2016).

    Article  Google Scholar 

  133. Rural Hospital Closures: Affected Residents Had Reduced Access to Health Care Services (US Government Accountability Office, 2021); https://www.gao.gov/products/gao-21-93

  134. Weiss, D. J. et al. Global maps of travel time to healthcare facilities. Nat. Med. 26, 1835–1838 (2020).

    Article  CAS  Google Scholar 

  135. Jensen, L., Monnat, S. M., Green, J. J., Hunter, L. M. & Sliwinski, M. J. Rural population health and aging: toward a multilevel and multidimensional research agenda for the 2020s. Am. J. Public Health 110, 1328–1331 (2020).

    Article  Google Scholar 

  136. Fejfar, D. et al. Healthcare provider satisfaction with environmental conditions in rural healthcare facilities of 14 low- and middle-income countries. Int. J. Hyg. Environ. Health 236, 113802 (2021).

    Article  Google Scholar 

  137. Hirner, S. et al. Defining measures of emergency care access in low-income and middle-income countries: a scoping review. BMJ Open 13, e067884 (2023).

    Article  Google Scholar 

  138. Rhoades, J. L., Gruber, J. S. & Horton, B. Developing an In-depth understanding of elderly adult’s vulnerability to climate change. Gerontologist 58, 567–577 (2018).

    Article  Google Scholar 

  139. Issa, A. et al. Deaths related to Hurricane Irma — Florida, Georgia, and North Carolina, September 4–October 10, 2017. Morb. Mortal. Wkly Rep. 67, 829–832 (2018).

    Article  Google Scholar 

  140. Theron, E., Bills, C. B., Calvello Hynes, E. J., Stassen, W. & Rublee, C. Climate change and emergency care in Africa: a scoping review. Afr. J. Emerg. Med. 12, 121–128 (2022).

    Article  Google Scholar 

  141. Kien, N. D. et al. Reducing consequences of extreme heat: the role of weather information access. Dialog. Health 4, 100177 (2024).

    Article  Google Scholar 

  142. Guardaro, M., Hondula, D. M., Ortiz, J. & Redman, C. L. Adaptive capacity to extreme urban heat: the dynamics of differing narratives. Clim. Risk Manage. 35, 100415 (2022).

    Article  Google Scholar 

  143. Burkart, K. et al. An analysis of heat effects in different subpopulations of Bangladesh. Int. J. Biometeorol. 58, 227–237 (2014).

    Article  Google Scholar 

  144. Owusu, M., Nursey-Bray, M. & Rudd, D. Gendered perception and vulnerability to climate change in urban slum communities in Accra, Ghana. Reg. Environ. Change 19, 13–25 (2019).

    Article  Google Scholar 

  145. Fernandez, J., García-Pérez, M. & Orozco-Aleman, S. Unraveling the hispanic health paradox. J. Econ. Perspect. 37, 145–168 (2023).

    Article  Google Scholar 

  146. Connor, D. S., Berg, A. K., Kemeny, T. & Kedron, P. J. Who gets left behind by left behind places? Cambr. J. Reg. Econ. Soc. 17, 37–58 (2024).

    Article  Google Scholar 

  147. Curtis, K. J., Fussell, E. & DeWaard, J. Recovery migration after hurricanes Katrina and Rita: spatial concentration and intensification in the migration system. Demography 52, 1269–1293 (2015).

    Article  Google Scholar 

  148. Frumkin, H., Fried, L. & Moody, R. Aging, climate change, and legacy thinking. Am. J. Public Health 102, 1434–1438 (2012).

    Article  Google Scholar 

  149. National Health and Nutrition Examination Survey Biospecimen Program (CDC NCHS, accessed 8 October 2024); https://www.cdc.gov/nchs/nhanes/biospecimens/biospecimens.htm

  150. Guide to DHS Statistics: DHS-8 (ICF, USAID, accessed 8 October 2024); http://www.dhsprogram.com

  151. Health and Retirement Study: Sensitive Health Data (Univ. Michigan, accessed 8 October 2024); https://hrsdata.isr.umich.edu/data-products/sensitive-health

  152. Institute of Medicine Clinical Data as the Basic Staple of Health Learning: Creating and Protecting a Public Good: Workshop Summary (National Academies, 2010); https://doi.org/10.17226/12212

  153. Expanding Climate Change and Health Data Infrastructure to Advance Health Interventions: Linking Health and Environmental Data to Improve Patient and Community Health (ASPE, US Department of Health and Human Services, 2023); https://aspe.hhs.gov/expanding-climate-change-health-data-infrastructure

  154. Li, B. & Kroese, B. Bridging data gaps can help tackle the climate crisis. IMFBlog https://www.imf.org/en/Blogs/Articles/2022/11/28/bridging-data-gaps-can-help-tackle-the-climate-crisis (2022).

  155. Rosenfeld, R. A. & Curtis, K. J. in International Handbook of Population and Environment Vol. 10 (eds Hunter, L. M. et al.) 111–137 (Springer, 2022).

  156. Bloom, D. E. & Zucker, L. M. Aging Is the Real Population Bomb (IMF, 2024); https://www.imf.org/en/Publications/fandd/issues/Series/Analytical-Series/aging-is-the-real-population-bomb-bloom-zucker

  157. Dalton, D. in Gender, Sexuality and the UN’s SDGs: A Multidisciplinary Approach (eds Dalton, D. & Smith, A.) 17–40 (Springer, 2023).

  158. Yon, Y., Mikton, C. R., Gassoumis, Z. D. & Wilber, K. H. Elder abuse prevalence in community settings: a systematic review and meta-analysis. Lancet Glob. Health 5, e147–e156 (2017).

    Article  Google Scholar 

Download references

Acknowledgements

Initial ideas for this work were developed by D.B. and L.H. for the Center on Aging, Climate, and Health (CACHE) (1R61AG086854-01). D.B. and J.F.T. thank the New York City Panel on Climate Change (NPCC) Fourth Assessment Health Working Group, in which many of the ideas were further developed. L.H. also acknowledges that their research was supported in part by an NICHD grant to the CU Population Center (P2CHD066613). We had the good fortune to present early versions of this work in early 2024 at The Baruch Conference on Climate Research, Teaching, and Collaboration (February), the National Institute on Aging Workshop on Impacts of Extreme Weather Conditions and Disasters on Older Adult Health (March), the Columbia Population Research Center/CUNY Institute for Demographic Research Joint Seminar (April) and the Population Association of America Annual Meeting, Columbus, OH (April). We are grateful to seminar participants for their comments and feedback.

Author information

Authors and Affiliations

  1. Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, NY, USA

    Jenna F. Tipaldo

  2. CUNY Institute for Demographic Research, New York, NY, USA

    Jenna F. Tipaldo & Deborah Balk

  3. Marxe School of Public & International Affairs, Baruch College, CUNY, New York, NY, USA

    Deborah Balk

  4. CU Population Center (CUPC), Institute of Behavioral Science, University of Colorado Boulder, Boulder, CO, USA

    Lori M. Hunter

Authors
  1. Jenna F. Tipaldo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Deborah Balk
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lori M. Hunter
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed equally to this work and edited the manuscript at all stages. J.F.T., D.B. and L.H. jointly conceptualized and synthesized inputs into this research, and drafted and revised the manuscript.

Corresponding author

Correspondence to Jenna F. Tipaldo.

Ethics declarations

Competing interests

The authors declare no competing interests.

Peer review

Peer review information

Nature Climate Change thanks Ilona Otto, Jouni Paavola and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Supplementary Information

Appendices 1 and 2.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tipaldo, J.F., Balk, D. & Hunter, L.M. A framework for ageing and health vulnerabilities in a changing climate. Nat. Clim. Chang. 14, 1125–1135 (2024). https://doi.org/10.1038/s41558-024-02156-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41558-024-02156-2

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing