Towards a climate-resilient healthy future: the Lancet Countdown in Europe 

Introduction: As one of the major contributors to global greenhouse gas emissions and the world’s third largest economy, Europe is a key stakeholder in the world’s response to climate change and has a global responsibility and opportunity to transition towards a low-carbon economy for healthier, more resilient societies with clean air and liveable cities. The Lancet Countdown in Europe is the first comprehensive assessment that monitors health and climate change over space and time in Europe reporting on 33 indicators focusing on (section 1) impact, exposure, and vulnerability; (section 2) adaption, planning and resilience; (section 3) mitigation actions and health co-benefits; (section 4) economics and finance; and (section 5) politics and governance.

Results: Health risks (section 1) for almost all indicators tracked have been increasing. Illustratively, clinically relevant pollen seasons are starting 10-20 days earlier each year (1981-2020), the climatic suitability for water-borne and vector-borne diseases (e.g., malaria, dengue, Vibrio) have been rapidly increasing (1951-2020), and - assuming no adaptation - heat exposure is estimated to have increased by 57% between the first and second half of the 21^st century. However, some encouraging trends for adaptation (section 2) could be observed - with countries adopting adaptation plans for health (15/22 assessed in 2021), cities recognising the threat of climate change to public health (118/197 assessed in 2021), or countries implementing early warning systems. Despite some progress in the reduction of the carbon intensity of energy systems and phasing out coal for electricity generation, European mitigations efforts remain inadequate to meet 2030 and 2050 reduction targets (section 3); European energy systems should decarbonise five times the current pace to reach net-zero CO₂ emissions by 2050. Likewise, despite improvements in air pollution levels due to stringent air pollution emission controls, 94% of the European population is still estimated to live at PM_2·5 concentrations higher than the WHO guideline (5 μg/m3 annual mean). Indicators in section 4 illustrate several substantial economic losses due to climate-related health impacts, including losses to due extreme events or reduced labour supply. Yet, European countries still provide overall subsidies to fossil fuels (total of €70·7 billion in 2019), providing further financial strains to meeting decarbonisation targets. Lastly, whilst strengthening the response to climate change requires key actors and institutions to engage with the health dimensions of climate change political, corporate, scientific, and individual engagement remains low (section 5) in the past decades.

Conclusion: This data highlights the accelerating trends in health-related hazards, exposures, vulnerabilities and risk from climate change, and the insufficiently ambitious adaptation and mitigation actions in Europe. However, with health, wellbeing, and equity at its core, accelerated action in line with climate targets could support a healthy, climate-resilient future for all.