Adaptation to heat and concomitant environmental risks in Europe: a GAP Analysis

BACKGROUND: Climate change is increasing the frequency and intensity of extreme events like heatwaves, wildfires and droughts. Within the ENBEL project, a GAP analysis was carried out to provide evidence on vulnerability factors of concomitant environmental risks during heat waves and promote the implementation of public health response. AIM: To assess the level of implementation of heat wave and co-exposures (air pollution, wildfires and drought) response actions and to identify gaps and needs for public health adaptation in Europe. METHODS: A scoping review was performed to identify clinical and social vulnerabilities to heatwaves and concomitant exposures and prevention measures in place. Interviews with key stakeholders will provide additional information on response measures addressed to vulnerable groups as well as identifying needs and gaps for adaptation. Furthermore, an assessment of how Covid-19 recovery plans and funding in Europe are supporting climate adaptation and health care resilience was carried out. RESULTS: From the literature review interventions mainly focused on outdoor workers and athletes, include guidance, plans and actions on hydration, rest in the shade, cooling clothes and food, as well as acclimatization procedures. The elderly are among those consistently targeted in heat prevention plans, with health and social care surveillance, tele-medicine and awareness campaigns carried out during summer in several high-income countries. Regarding multiple environmental exposures, studies on preventive measures are scarce, and stakeholders reported the need for further research, sharing of knowledge and evaluation of measures to enhance action. CONCLUSIONS: Although Covid-19 recovery funding is providing marginal benefits for health systems resilience, key barriers to climate adaptation still remain in terms of limited resources, personnel capacity; governance constraints and unclear policy remit.