Assessing adaptation to the health risks of climate change: what guidance can existing frameworks provide?

Climate change adaptation assessments aim at assisting policy-makers in reducing the health risks associated with climate change and variability. This paper identifies key characteristics of the climate-health relationship and of the adaptation decision problem that require consideration in climate change adaptation assessments. It then analyzes whether these characteristics are appropriately considered in existing guidelines for climate impact and adaptation assessment and in pertinent conceptual models from environmental epidemiology. The review finds three assessment guidelines based on a generalized risk management framework to be most useful for guiding adaptation assessments of human health. Since none of them adequately addresses all key challenges of the adaptation decision problem, actual adaptation assessments need to combine elements from different guidelines. Established conceptual models from environmental epidemiology are found to be of limited relevance for assessing and planning adaptation to climate change since the prevailing toxicological model of environmental health is not applicable to many climate-sensitive health risks.