Heat Indicators for Global Health Monitoring, Early Warning Systems and health facility interventions for pregnant and postpartum women, infants and young children and health workers

The HIGH Horizons project centres on pregnant and postpartum women, infants, and health workers, groups heavily affected by climate change.

We quantify and monitor direct and indirect health impacts of extreme heat; test a personalised Early Warning System (EWS); and implement integrated adaptation-mitigation actions in health facilities. Analyses of heat impacts and data science predictive modelling using data from Sweden; Lazio Italy, and health facilities in Kenya, Zimbabwe and South Africa underpin all activities. These analyses and systematic reviews inform testing and selection of global, EU and national indicators.

Background
The 2021 Assessment Report of the UN Intergovernmental Panel on Climate Change noted that global surface temperatures have already risen by 1.1°C compared to the pre-industrial period, and the it gave an ominous warning that the world may reach 1.5° to 2°C of warming earlier than previously anticipated. Record-breaking temperatures are more frequent, intensive, and last longer. Heat-related mortality and morbidity will continue to rise dramatically unless major emission reductions and adaptations are implemented. There are already more than 350,000 deaths annually from extreme heat. Extreme heat is associated with at least 17 causes of death – largely cardiorespiratory or metabolic disease, but also suicide and several types of injury. Severe morbidities linked to extreme heat, however, especially in maternal and child health, occupational settings and through indirect impacts outweigh the numbers of deaths several fold. Most importantly, heat exposure and vulnerability to impacts vary widely across geographical areas, population groups, and by socio-economic status. Designing effective climate policies depends on rigorous quantification and monitoring of heat-related impacts, assessing the costs of inaction, and systematically weighing the costs and benefits of alternative actions among the most vulnerable, highest-risk groups.

Specific objectives
1. Identify and select suitable indicators for quantifying and monitoring the global, EU and national-level health impacts of extreme heat among pregnant and postpartum women, newborns and infants in Europe and sub-Saharan Africa.
2. Develop and test an Early Warning System using a smartphone app to provide individualized heat stress warnings, and locally-adapted messaging for protecting pregnant and postpartum women, infants and health workers.
3. Identify cost-effective, integrated adaptation-mitigation interventions to alleviate heat impacts on health workers, and to reduce carbon emissions associated with health care.
4. Support global and EU climate policies and activities on the monitoring of direct and indirect impacts of climate change on health, and the strengthening of Early Warning Systems through guidance documents, and risk assessment and cost-benefit analysis tools.