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The Lancet Countdown 2019

The 2019 report of The Lancet Countdown offers an up-to-date assessment of climate change impacts on human health, along with what we have done and are doing to address it. The report draws from journal articles, and both government and non-government organizations from all over the world to evaluate our progress in-line with climate goals outlined in the Paris Agreement. This report is divided into five categories: climate change impacts, exposures and vulnerability; adaptation, planning and resilience for health; mitigation and health co-benefits; economics and finance; and public and political engagement.

I. Climate Change Impacts, Exposures and Vulnerabilities

The report identifies several factors of climate change that affect health, including extreme temperature, extreme weather events, wildfires, disease, flooding and droughts, and limited food access. These are occuring on a global scale with more frequent extreme heat events, changes in disease transmission pathways, and decreased food access, in particular, causing worsened health outcomes over the years. This does not mean that every country has seen an increase in these climate-related events. For example, only Africa, Asia and the Americas have seen more frequent flood and storm events. Within countries, certain groups of people will be more susceptible to climate-related impacts depending on various physical and socioeconomic factors. These include elders and children, and it seems that vulnerability, particularly among the elderly, is only increasing.

The authors conclude this section by drawing attention to areas that are less well studied. Specifically, they say health risks faced by migrant populations and mental health impacts of climate change must be better understood.

II. Adaptation, Planning, and Resilience for Health

Adaptation aims to decrease the negative impacts of climate change on health. The report acknowledges that climate change and its effects on health will place a dramatic burden on healthcare and other health-related systems globally. Here, the authors examine how we have been and can make the necessary adaptations to meet the demands of a warming planet.

This section sourced feedback through a voluntary survey sent to low-, medium-, and high-income countries. It found that climate change adaptation planning has received a fair amount of attention on the local and national stages: more than 50% of the countries surveyed for this report had rolled out a national health and climate change plan and the majority of cities had begun or finished an assessment of climate change vulnerability, however they did vary in comprehensiveness. Further, more countries are providing climate services to their health sectors to help prepare for climate-related health risks.

While we have been making progress and are now more aware of the link between climate change and health, the authors acknowledge that adaptation responses have been slow. Therefore, increased efforts to adapt our health systems to a changing climate are necessary.

III. Mitigation Actions and Health Co-Benefits

In contrast to adapting to them, mitigation aims to prevent the impacts of climate change. Efforts such as carbon pricing policy and the development of energy efficient technologies both work to decrease greenhouse gas emissions and, as a result, the negative health impacts of climate change. In this report, the authors examine mitigation efforts and suggest further steps.

Air pollution is given as an example. Particulate matter from vehicle exhaust and greenhouse gas emissions contribute to air pollution. Approximately 83% of cities assessed in this report do not meet the World Health Organization’s recommended air quality levels. In 2016 alone, 2.9 million premature deaths were linked to air pollution. Despite the evident health impacts of pollution, greenhouse gas emissions have increased worldwide, by 2.6% from 2016 to 2018. Agricultural, transportation, and healthcare sectors still rely heavily on fossil fuels, with farming-related emissions increasing by more than 10% since 2000. Renewable energies are highlighted as a mitigation measure for air pollution from fossil fuel use. These have seen an upward trend in use, and are more becoming commonly used for electric vehicles.

These trends are promising - but we still have a ways to go. The authors suggest emission reduction plans will lead to health benefits and decrease burden on the healthcare sector. Lastly, the report highlights the importance of consulting healthcare professionals when developing emissions reduction policy.

IV. Economics and Finance

Climate change inaction has huge economic repercussions which affect factors that influence human health, such as climate change vulnerability and adaptation needs. For example, the additional costs of 3°C of warming in comparison to 2°C is estimated to add up to US$4 trillion by 2100.

Shifts to low-carbon economies have slowed and even reversed in some sectors. In 2018, fossil fuel investments increased while those in low-carbon energy sources have decreased. To combat fossil fuel use, carbon pricing policies have been implemented in some jurisdictions. Currently, about 13% of global greenhouse gases are covered by a carbon pricing program. These programs have substantially increased global government revenues, hitting $43 billion between 2017 and 2018. Money received through carbon pricing programs are primarily used for mitigation efforts.

Overall, this section shows that mitigating climate change is in our financial best interests.

V. Public and Political Engagement

This final section reviews efforts that can help the general public understand links between climate change and health, in order to prioritize adaptation and mitigation efforts. Wide-spread engagement is needed to ensure we can fully address climate change. This section reviews progress seen in and the roles of media, individual engagement, government, and corporations in promoting climate change action.

Firstly, media is a key resource in keeping up with climate change information and government actions. Over the past decade, media outlets have devoted more attention to the health impacts of climate change. However, outlets are more likely to discuss climate change if it can be connected to a current event, otherwise it does not receive sustained attention. Second, internet use was identified as a way to drive individual engagement. As an information-seeking behaviour, internet use can connect people to global knowledge. The Lancet found that an interest in health-related content is a primary driver to learn more about climate change, suggesting that direct links would better-inform those looking for information.

Further, governments should advocate for the reduction of climate change-related health effects on the global stage. Climate change now receives more attention from governments than ever before; but, interestingly, engagement in discussions of climate change and health are led by small, developing countries such as Fiji and Samoa. Lastly, the corporate sector can push for a carbon-free economy by way of leveraging political and public influence. Engagement is still low in these sectors. Very few corporations, including those in the health sector, have made a clear link between climate change and health in their annual progress reports.

This section demonstrates an improvement in our effort to connect climate change and health, particularly in the media and our governments. Despite this, there must be a stronger push to cement a clear relationship between the two in order to provide much-needed, wide-spread, and consistent support for climate action.

Overall, the Lancet Countdown 2019 report shows that the global community have been taking important steps to address climate change, but are not progressing as fast as needed. The findings in this report keep government bodies, organizations, and the global community more broadly, accountable for addressing climate change. Greater efforts from a wide range of sectors can ensure we limit warming well below the 2°C threshold and safeguard our health.

Find the full report here.


1. Watts N, Amann M, Arnell N, Ayeb-Karlsson S, Belesova K, Boykoff M, et al. The 2019 report of The Lancet Countdown on health and climate change: ensuring that the health of a child born today is not defined by a changing climate. The Lancet, 2019. 394(10211):1836-78. Available from:

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