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Abstract

Anthropogenic climate change will affect the distribution and urgency of health risks around the world. However, the majority of adverse health impacts of climate change can be avoided by implementing suitable adaptation policies. Planned adaptation to the health impacts of climate change comprises a broad range of public health interventions. Most of these measures are not only effective in a changed climate but they also current health risks. Successful planned adaptation depends on an awareness of and information about the problem, on the existence of effective response strategies, and on the availability of the resources, information, and incentives to actually implement them. The main challenges in developing adaptation strategies for human health are to account for the diversity of health impairments, regional conditions and adaptation actors, and for the large uncertainty about future changes in most climate-sensitive health risks. This report reviews a broad range of 'conceptual frameworks of adaptation' as to their relevance for assessments of planned adaptations to the health impacts of climate change. These frameworks originate from the largely distinct communities concerned with climate change, public health, natural hazards, and risk management. The term 'conceptual framework of adaptation' is used here to denote any representation of concepts that can assist the design and assessment of policy strategies aimed at reducing climate-sensitive health effects. In our review, we distinguish the following categories of conceptual frameworks: typologies of climate change assessments; guidelines for climate change risk assessments; conceptual frameworks for vulnerability and adaptation to climate change; typologies of adaptation measures and adaptive systems; and evaluation frameworks for adaptation strategies. We fnd that no single approach to adaptation policy assessment can deal with the diversity of climatesensitive health impairments, regions, and information needs of adaptation actors. Further more, no single conceptual framework addresses all questions that are important in adaptation assessments for human health. However, the review of the diverse set of conceptual frameworks enables us to name the most important guidelines for human health vulnerability and adaptation assessment; to identify those criteria that determine the most suitable approach for assessing adaptation to the health effects of climate change in different decision situations; to evaluate the potential for and urgency of planned adaptation; and to identify key questions for developing and implementing effective adaptation strategies to be addressed in any adaptation assessment for human health.