The Impact of Climate Change on Pediatric Health:

A Literature Review on Emerging Riskss

El impacto del cambio climático en la salud pediátrica:

una revisión de la literatura sobre los riesgos emergentes

Revista Ecuatoriana de Pediatría

Editorial: Sociedad Ecuatoriana de Pediatría (Núcleo de Quito, Ecuador)

Tipo de estudio: Artículo Original

Área de estudio: Odontopediatría

Páginas: 24-36

Codígo DOI: https://doi.org/10.52011/RevSepEc/e274

URL: https://rev-sep.ec/index.php/johs/article/view/274

ABSTRACT

Climate change represents one of the most signiﬁcant global health threats of the 21st century, with children

being particularly vulnerable to its eﬀects. This literature review examines the emerging risks posed by climate

change on pediatric health, highlighting the multifaceted impacts on respiratory health, heat-related illnesses,

vector-borne diseases, nutrition, mental health, and exposure to waterborne pathogens. Additionally, the review

explores the disproportionate eﬀects on children from marginalized communities, underscoring the urgent need

for targeted interventions and policies. By synthesizing current research, this article aims to raise awareness

among healthcare professionals and policymakers about the pressing need to protect pediatric populations

from the evolving challenges of climate change.

Keywords: pediatric health, climate change, emerging risks, environmental health, public health interventions.

Kirolos Eskandar1

Revisión Sistemática

1. Diakonie Klinik Mosbach; Germany.

Kirolos Eskandar https://orcid.org/0000-0003-0085-3284

Correspondencia: Diakonie Klinik Mosbach; Germany / kiroloss.eskandar@gmail.com

Recibido: 10/feb/2024 - Aceptado: 12/abril/2024 - Publicado: 30/sep/2024

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RESUMEN

El cambio climático representa una de las amenazas más importantes para la salud mundial en el siglo XXI,

y los niños son particularmente vulnerables a sus efectos. Esta revisión bibliográﬁca examina los riesgos emer-

gentes que plantea el cambio climático para la salud pediátrica, destacando los impactos multifacéticos en

la salud respiratoria, las enfermedades relacionadas con el calor, las enfermedades transmitidas por vectores,

la nutrición, la salud mental y la exposición a patógenos transmitidos por el agua. Además, la revisión explora

los efectos desproporcionados en los niños de las comunidades marginadas, lo que subraya la necesidad

urgente de intervenciones y políticas especíﬁcas. Al sintetizar la investigación actual, este artículo tiene como

objetivo crear conciencia entre los profesionales de la salud y los responsables de las políticas sobre la nece-

sidad apremiante de proteger a las poblaciones pediátricas de los desafíos cambiantes del cambio climático..

Palabras clave: salud pediátrica, cambio climático, riesgos emergentes, salud ambiental, intervenciones de

salud pública.

Revisión Sistemática

Introduction

Climate change, driven largely by human

activities such as fossil fuel combustion and

deforestation, has emerged as a critical

global challenge, with profound impacts on

health and well-being. The earth’s climate is

undergoing rapid changes, including rising

temperatures, shifting precipitation patterns,

and an increase in the frequency and seve-

rity of extreme weather events. These chan-

ges have far-reaching implications, particu-

larly for vulnerable populations, including

children (Romanello et al., 2023).

Children are uniquely susceptible to the

health impacts of climate change due to

their developing physiology, higher exposure

to environmental hazards, and dependence

on caregivers for protection and care. Unli-

ke adults, children breathe more air relative

to their body weight, have a higher meta-

bolic rate, and their bodies are still growing

and developing, making them more sensiti-

ve to pollutants and temperature extremes

(Ahdoot et al., 2024). Additionally, children

are more likely to suﬀer from the secondary

eﬀects of climate-related disruptions, such

as displacement, food insecurity, and the

spread of infectious diseases (IPCC, 2022).

Given these vulnerabilities, the intersection

of climate change and pediatric health de-

mands urgent attention. This literature re-

view seeks to explore the emerging risks

that climate change poses to pediatric po-

pulations, with a focus on understanding

how these risks manifest and what strate-

gies can be employed to mitigate them.

The objectives of this review are to provide

a comprehensive overview of the current

state of knowledge on the subject, identify

gaps in the literature, and suggest directions

for future research. By doing so, this review

aims to contribute to the growing body of

evidence needed to inform public health

interventions and policy decisions that pro-

tect the health and well-being of children in

the face of a changing climate (Corvalan

et al., 2022).

Methodology

This literature review was conducted using

a systematic approach in accordance with

the PRISMA (Preferred Reporting Items for

Systematic Reviews and Meta-Analyses)

guidelines, ensuring a comprehensive and

unbiased selection of relevant studies. The

methodology involved several key steps:

database selection, search strategy develo-

pment, study selection, data extraction, and

quality assessment.

1. Database Selection: The search for re-

levant literature was conducted across mul-

tiple reputable databases, including Pub-

Med, Google Scholar, Scopus, and Web of

Science. These databases were chosen for

their extensive coverage of medical, envi-

ronmental, and public health literature, en-

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Revisión Sistemática

suring that the review captured a broad

range of studies relevant to the impact of

climate change on pediatric health.

2. Search Strategy: A precise and systema-

tic search strategy was developed in con-

sultation with a research librarian to ensure

comprehensive retrieval of relevant studies.

The search terms included a combination

of keywords and MeSH (Medical Subject

Headings) terms related to the topic. The

main keywords used were “Pediatric Heal-

th,” “Climate Change,” “Emerging Risks,” “En-

vironmental Health,” and “Public Health In-

terventions.” Boolean operators (AND, OR)

were employed to combine terms eﬀecti-

vely, and the search was limited to studies

published in English.

The search strategy was iteratively reﬁned

to enhance sensitivity and speciﬁcity. Sear-

ches were performed across all databases,

and reference lists of selected articles were

also hand-searched to identify any additio-

nal studies that might have been missed in

the initial search.

3. Study Selection: The inclusion criteria for

studies were established prior to the search

to ensure consistency and relevance. These

criteria included:

• Language: Only articles published in

English were considered.

• Population: Studies focusing speciﬁcally

on pediatric health (children and ado-

lescents up to 18 years of age).

• Focus: Research reporting on the impact

of climate change on pediatric health,

including emerging risks and associated

public health interventions.

• tudy Type: Both observational and expe-

rimental studies, including case studies,

cohort studies, cross-sectional studies,

and systematic reviews, were included.

An initial search yielded 133 articles. After

the removal of duplicates, 102 articles re-

mained. These articles were then screened

based on their titles and abstracts by two

independent reviewers. Articles that clear-

ly did not meet the inclusion criteria were

excluded. The remaining articles (n=46) un-

derwent full-text review, resulting in a ﬁnal

selection of 34 articles that met all the in-

clusion criteria.

4. Data Extraction: A standardized data

extraction form was developed to syste-

matically gather relevant information from

each included study. The data extraction

process was performed independently by

two reviewers to minimize errors and bias.

Key information extracted included study

design, population characteristics, clima-

te-related exposures, health outcomes, and

key ﬁndings related to pediatric health. Dis-

crepancies between the reviewers were re-

solved through discussion and consensus,

with a third reviewer consulted if necessary.

5. Quality Assessment: To assess the qua-

lity and risk of bias in the included stu-

dies, the Joanna Briggs Institute (JBI) Critical

Appraisal Tools were utilized for diﬀerent

study designs. Each study was assessed

for methodological rigor, clarity of repor-

ting, and relevance to the review question.

Studies were classiﬁed as high, moderate,

or low quality based on these criteria. This

quality assessment was integral in interpre-

ting the results and drawing conclusions

from the literature review.

6. Data Synthesis: The ﬁndings from the

included studies were synthesized qualita-

tively, with a focus on identifying common

themes, emerging risks, and potential inter-

ventions. The synthesis aimed to provide a

comprehensive overview of the current sta-

te of knowledge on the impact of climate

change on pediatric health and to highlight

areas where further research is needed.

To provide a clear overview of the study

selection process, the PRISMA ﬂow diagram

is included below (ﬁg. 1), illustrating the num-

ber of records identiﬁed, screened, and in-

cluded in the review, along with reasons for

exclusion at each stage

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Figure 1. Illustrates the PRIMSA ﬂow diagram

II. Respiratory Health and Air Quality

The respiratory health of children is increa-

singly jeopardized by the escalating levels

of air pollution, a consequence of industria-

lization, urbanization, and climate change.

Air pollution, particularly the rise in ﬁne par-

ticulate matter (PM2.5) and other airborne

pollutants, has become a critical concern

for pediatric health. Children are especially

vulnerable due to their developing respira-

tory systems, higher minute ventilation per

body weight, and the fact that they often

engage in outdoor activities, increasing their

exposure to polluted air (Aithal et al., 2023).

Fine particulate matter (PM2.5) refers to air-

borne particles with a diameter of less than

2.5 micrometers, small enough to bypass

the upper respiratory defenses and pene-

trate deep into the lungs. Once inhaled,

these particles can cause signiﬁcant inﬂam-

mation in the airways, leading to conditions

such as asthma, bronchitis, and other chro-

nic respiratory diseases. Children exposed

to high levels of PM2.5 are at a higher risk

of developing asthma, with studies indica-

ting that early-life exposure can alter lung

development and immune responses, pre-

disposing them to chronic respiratory issues

(Zhang et al., 2023). This is particularly con-

cerning in urban environments where PM2.5

levels are frequently elevated due to traﬃc

emissions, industrial activities, and, increasin-

gly, wildﬁres driven by climate change.

Asthma is now the most prevalent chronic

disease among children, and its incidence

is rising in tandem with worsening air qua-

lity. The Global Initiative for Asthma (GINA)

reports that air pollution is a signiﬁcant tri-

gger for asthma exacerbations, leading

to increased hospital admissions, missed

school days, and a reduced quality of life

for aﬀected children (Zanobetti et al., 2024).

The pathophysiology of asthma exacerba-

ted by air pollution involves a complex in-

terplay between genetic predisposition and

environmental factors. Pollutants such as

ozone, nitrogen dioxide, and PM2.5 contri-

bute to airway inﬂammation, hyperrespon-

siveness, and oxidative stress, which are key

mechanisms in asthma pathogenesis.

Moreover, the impact of air pollution on

pediatric respiratory health is not uniform

but varies with seasonal changes. During

winter, for instance, the combination of in-

creased particulate emissions from heating

sources and meteorological conditions that

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trap pollutants close to the ground leads to

spikes in air pollution levels. These seaso-

nal variations correlate with higher rates of

respiratory infections and asthma exacer-

bations in children (Aithal et al., 2023). Addi-

tionally, climate change-induced phenome-

na such as prolonged pollen seasons and

more frequent wildﬁres further contribute

to deteriorating air quality and respiratory

health in children.

Children from socioeconomically disadvan-

taged backgrounds are disproportionately

aﬀected by poor air quality. These children

often live in areas with higher pollution levels

due to proximity to industrial zones or ma-

jor roadways and may lack access to ade-

quate healthcare. This exacerbates health

disparities, as these children are more likely

to suﬀer from severe asthma and other res-

piratory conditions without timely and eﬀec-

tive treatment (Zanobetti et al., 2024).

III. Heat-Related Illnesses

Children are particularly vulnerable to

heat stress and heat-related illnesses due

to their unique physiological and beha-

vioral characteristics. Their bodies genera-

te more heat during physical activity and

have a lower capacity to sweat compared

to adults, which makes it harder for them

to regulate body temperature eﬀectively.

Additionally, children tend to spend more

time outdoors during peak heat periods,

further increasing their exposure to extreme

temperatures. These factors contribute to a

heightened risk of heat-related illnesses in

pediatric populations (Berger et al., 2023).

The correlation between rising global tem-

peratures and the incidence of heat-rela-

ted illnesses in children is well-documented.

Even small increases in temperature can

lead to a signiﬁcant rise in emergency de-

partment visits for conditions such as heat

exhaustion, dehydration, and heatstroke.

These conditions are particularly dange-

rous for children because their bodies can

become overwhelmed quickly, leading to

potentially life-threatening situations if not

treated promptly. Moreover, heat stress can

exacerbate pre-existing conditions like as-

thma and cardiovascular diseases, leading

to more severe health outcomes in children

(Cichowicz & Bochenek, 2024).

Urban environments, especially those cha-

racterized by “heat islands,” present addi-

tional risks. Urban heat islands are areas

within cities that experience signiﬁcantly hi-

gher temperatures than surrounding rural

areas due to human activities and the con-

centration of heat-absorbing materials such

as asphalt and concrete. The lack of ve-

getation and green spaces in these areas

further intensiﬁes the heat, creating environ-

ments that are particularly hazardous for

children. Increased temperatures in urban

heat islands have been linked to higher inci-

dences of heat-related illnesses, respiratory

problems, and even impacts on cognitive

development and academic performance

in children (Cichowicz & Bochenek, 2024).

The impact of heat on pediatric health also

varies seasonally, with a signiﬁcant increase

in heat-related illnesses observed during the

summer months, especially in regions expe-

riencing heat waves. Children in low-income

communities are particularly vulnerable as

they may lack access to air conditioning

or other cooling mechanisms, making them

more susceptible to the adverse eﬀects of

high temperatures (Berger et al., 2023).

IV. Vector-Borne Diseases

The impact of climate change on vec-

tor-borne diseases is increasingly evident as

rising temperatures and shifting precipita-

tion patterns expand the geographic range

of disease-carrying vectors like mosquitoes

and ticks. This expansion, coupled with the

introduction of new vector species into pre-

viously unaﬀected regions, is resulting in a

growing number of pediatric cases of di-

seases such as malaria, dengue, Zika, and

Lyme disease.

As climate change drives warmer tempe-

ratures, vectors such as Aedes mosquitoes,

which transmit dengue, Zika, and chikun-

gunya, are migrating to higher altitudes and

latitudes. This shift has led to the emergen-

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ce of these diseases in regions where they

were previously rare or non-existent. For

example, the spread of dengue and chi-

kungunya in Europe and the southern Uni-

ted States illustrates the expanding threat

posed by these vectors (Adepoju et al.,

2023). The rise in global temperatures also

facilitates longer seasons of vector activity,

thereby increasing the duration of exposure

to these diseases (Caminade et al., 2014).

Children are particularly vulnerable to vec-

tor-borne diseases due to their developing

immune systems and greater exposure to

outdoor environments where vectors thrive.

In regions like sub-Saharan Africa, where

healthcare infrastructure is already strained,

the rising incidence of these diseases poses

a signiﬁcant public health challenge. This

situation is exacerbated by socioeconomic

factors, such as poverty and lack of ac-

cess to preventive measures, which heigh-

ten the vulnerability of pediatric populations

(Walker et al., 2015).

Moreover, the interplay between climate

change and urbanization creates environ-

ments conducive to the proliferation of vec-

tors. Urban heat islands, characterized by

higher temperatures in cities compared to

surrounding rural areas, further amplify the

risk of vector-borne diseases. These areas

provide ideal breeding grounds for mosqui-

toes, especially in water storage containers

and poorly managed waste sites, which

are common in rapidly growing urban cen-

ters in low- and middle-income countries

(LMICs) (Eder et al., 2018).

V. Nutrition and Food Security

Climate change signiﬁcantly impacts global

agriculture and food security, with serious

implications for pediatric health, particularly

in terms of nutrition and food security. Rising

global temperatures, increased frequency

of extreme weather events, and shifts in

precipitation patterns directly aﬀect agri-

cultural productivity, which in turn inﬂuen-

ces the availability and quality of food. This

environmental instability disrupts food pro-

duction systems, leading to reduced crop

yields, loss of arable land, and diminished

food diversity, all of which are essential for

maintaining adequate nutrition in children

(Tirado et al., 2013; FAO, 2023).

Children are particularly vulnerable to the

adverse eﬀects of food insecurity and mal-

nutrition caused by climate change. In many

regions, the decline in agricultural output

has led to increased food prices, making

nutritious food less accessible, especially for

low-income families. The result is a higher

incidence of nutritional deﬁciencies in chil-

dren, including protein-energy malnutrition

and deﬁciencies in essential vitamins and

minerals such as iron, zinc, and vitamin A.

These deﬁciencies can have long-lasting

eﬀects on a child’s physical and cognitive

development, potentially leading to stunted

growth, weakened immune systems, and

lower academic performance (FAO, 2019;

Myers et al., 2014).

The impact of climate change on food se-

curity is not uniform across the globe. Cer-

tain regions, particularly those in developing

countries, are more severely aﬀected due

to their reliance on rain-fed agriculture and

limited resources to adapt to changing con-

ditions. In these areas, children are more li-

kely to experience the detrimental eﬀects of

food scarcity and malnutrition, exacerba-

ting existing health disparities. Additionally,

climate change is expected to increase the

frequency of extreme weather events, such

as droughts and ﬂoods, which further dis-

rupt food production and exacerbate food

insecurity (Bryan et al., 2023; FAO, 2023).

Moreover, the nutritional quality of food is

also being compromised by climate chan-

ge. Elevated levels of atmospheric carbon

dioxide (CO2) have been shown to reduce

the concentrations of essential nutrients in

staple crops like wheat, rice, and legumes.

This phenomenon, known as the “carbon

nutrient penalty,” decreases the protein

content and vital micronutrients such as iron

and zinc in these foods, further contributing

to the risk of malnutrition in children who

rely heavily on these staples for their daily

nutritional intake (Myers et al., 2014; Tirado

et al., 2013).

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VI. Mental Health Impacts

Climate change poses signiﬁcant threats to

pediatric mental health, particularly throu-

gh its impact on extreme weather events

and environmental stressors. Children are

especially vulnerable to the psychological

eﬀects of climate-related disasters, such as

hurricanes, ﬂoods, wildﬁres, and prolonged

droughts. These events often lead to im-

mediate and long-term mental health cha-

llenges, including anxiety, depression, and

post-traumatic stress disorder (PTSD) (Van

Nieuwenhuizen et al., 2021; Cruz et al., 2020).

Children’s heightened vulnerability can be

attributed to several factors. They are more

likely than adults to experience severe trau-

ma and disruption in their lives following a

disaster. The loss of home, separation from

caregivers, and the destruction of their fa-

miliar environment can be profoundly des-

tabilizing. Furthermore, the ongoing stress

from living in disaster-prone areas or under

the threat of extreme weather events can

lead to chronic anxiety and other stress-re-

lated disorders. These conditions may not

only aﬀect the child’s emotional well-being

but can also impede cognitive develop-

ment and academic performance (Cruz et

al., 2020; Van Nieuwenhuizen et al., 2021).

Additionally, the rise in global temperatures

is linked to an increase in mental health is-

sues among children. Heatwaves and high

ambient temperatures are associated with

a greater incidence of aggressive beha-

vior, substance abuse, and even suicide in

aﬀected populations. Children, who are still

developing coping mechanisms, may stru-

ggle more than adults to manage these

stressors, leading to long-term psychologi-

cal eﬀects (Vergunst & Berry, 2021).

Urban environments, particularly those with

poor infrastructure to manage heat and di-

sasters, exacerbate these issues. The con-

cept of “urban heat islands,” where cities

experience signiﬁcantly higher temperatures

than their rural counterparts, adds another

layer of risk for children. Prolonged exposu-

re to extreme heat without adequate relief

can result in both physical and psychologi-

cal stress, further contributing to the rise in

mental health issues among the pediatric

population (Vergunst & Berry, 2021).

VII. Waterborne Diseases and Access

to Clean Water

The eﬀects of climate change on water-

borne diseases and access to clean water

present signiﬁcant challenges for pediatric

health. Children are particularly vulnerable

to these impacts due to their developing

immune systems and dependency on clean

water for nutrition and hygiene.

Climate change exacerbates the incidence

of waterborne diseases by inﬂuencing fac-

tors such as ﬂooding, droughts, and water

contamination. Flooding, for instance, often

leads to the contamination of water su-

pplies with pathogens like Escherichia coli,

cholera, and giardia, increasing the risk of

diarrheal diseases in children. As climate

change increases the frequency and seve-

rity of such weather events, the exposure

of children to these pathogens is expected

to rise signiﬁcantly. Droughts, on the other

hand, reduce the availability of clean water,

concentrating contaminants in limited wa-

ter sources and forcing communities to use

unsafe water, further heightening the risk of

disease outbreaks among children (Kolstad

and Johansson, 2011).

The correlation between climate change

and the rise in diarrheal diseases among

children is well-documented. Diarrheal di-

seases are already a leading cause of mor-

bidity and mortality in children under ﬁve,

and climate change is expected to worsen

this burden. Warmer temperatures, altered

rainfall patterns, and the increased frequen-

cy of extreme weather events create ideal

conditions for the proliferation of water-

borne pathogens. Studies have shown that

ambient temperature increases can elevate

the incidence of bacterial diarrhea in chil-

dren, with regions like sub-Saharan Africa

and South Asia being particularly vulnera-

ble (Philipsborn et al., 2016).

Moreover, ensuring access to clean water

is becoming increasingly diﬃcult in the con-

text of climate change. In many regions,

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infrastructure is insuﬃcient to cope with

the increasing variability in water availabili-

ty, leading to frequent disruptions in water

supply. This challenge is particularly severe

in urban slums and rural areas where chil-

dren are most at risk. The lack of access to

safe drinking water not only increases the

incidence of waterborne diseases but also

contributes to malnutrition, as contamina-

ted water is often linked to nutrient loss in

children suﬀering from repeated bouts of

diarrhea (Carlton et al., 2016).

VIII. Impact of Extreme Weather Events

Extreme weather events, such as hurrica-

nes, ﬂoods, and wildﬁres, present signiﬁcant

challenges to pediatric health, both physi-

cally and emotionally. These events are be-

coming more frequent and severe due to

climate change, and children are especially

vulnerable due to their developing bodies

and dependence on adult care.

Physically, extreme weather events can lead

to injuries, respiratory problems from smoke

and poor air quality, and exacerbation of

chronic conditions like asthma. The chaos

during these events often disrupts access to

essential healthcare services, further jeopar-

dizing children’s health. For example, wildﬁ-

res not only cause direct harm through bur-

ns and smoke inhalation but also displace

families, leading to loss of access to regu-

lar medical care and medications. Similarly,

ﬂoods can contaminate drinking water su-

pplies, leading to waterborne diseases that

disproportionately aﬀect children (Butsch et

al., 2023).

Emotionally, the trauma associated with the-

se disasters can have profound long-term

eﬀects. Children exposed to extreme wea-

ther events are at an increased risk of de-

veloping anxiety, depression, and post-trau-

matic stress disorder (PTSD). The disruption

of daily life, loss of home, and even the

death of loved ones are traumatic expe-

riences that can impact a child’s mental

health for years. Studies have shown that

children who experience such trauma may

struggle with these issues long after the

event, with some requiring ongoing mental

health support (Sprang et al., 2023).

Displacement caused by these events often

leads to a breakdown in the social and

support networks that are crucial for chil-

dren’s well-being. For instance, after hurri-

canes or ﬂoods, families may be forced to

relocate, disrupting children’s schooling and

social connections, which are vital for their

emotional stability and development. Case

studies from recent hurricanes and wildﬁres

in the United States have highlighted the-

se impacts, showing that children in aﬀec-

ted areas often experience higher rates of

mental health issues and lower overall we-

ll-being in the years following these events

(Blue Shield of California, 2023).

IX. Socioeconomic and Environmental

Justice Issues

The intersection of socioeconomic dispa-

rities and environmental justice is a critical

component in understanding the impact of

climate change on pediatric health. Climate

change exacerbates existing health dispa-

rities among children from diﬀerent socioe-

conomic backgrounds, particularly aﬀecting

those from low-income families and mar-

ginalized communities. These children are

more likely to live in areas with poorer en-

vironmental conditions, such as neighbor-

hoods with higher exposure to air pollution,

limited access to clean water, and inade-

quate housing that cannot eﬀectively pro-

tect against extreme weather events. This

increased vulnerability stems from structural

inequalities that limit access to resources

and services that could mitigate the eﬀects

of climate change.

Children in low-income families are often

more exposed to environmental hazards

like polluted air and contaminated water,

which directly contribute to higher rates

of respiratory illnesses, developmental di-

sorders, and other health issues. For ins-

tance, families living in subsidized housing

are more likely to experience ﬂooding and

inadequate ventilation, which can exacer-

bate conditions like asthma (Walker et al.,

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2024). Additionally, these families may lack

the ﬁnancial resources to recover from cli-

mate-related disasters, such as buying insu-

rance or relocating from hazardous areas,

further entrenching their vulnerability.

Environmental justice plays a pivotal role

in addressing these disparities. Historically,

environmental justice movements have sou-

ght to highlight and address the dispropor-

tionate burden of environmental hazards

on communities of color and low-income

populations. These communities are often

located in areas with higher environmental

risks, such as proximity to industrial sites,

landﬁlls, or highways, which contribute to

poor health outcomes. The Environmental

Protection Agency (EPA) and other organi-

zations have recognized the need to ad-

dress these inequities through targeted po-

licies and interventions (Bolte et al., 2023).

Policies aimed at promoting environmental

justice and reducing health disparities in-

clude the Justice40 Initiative, which seeks to

ensure that 40% of federal climate-related

investments beneﬁt disadvantaged commu-

nities. Additionally, public health frameworks

like the CDC’s BRACE (Building Resilience

Against Climate Eﬀects) emphasize the im-

portance of incorporating justice, equity, di-

versity, and inclusion (JEDI) principles into

climate adaptation planning. These eﬀorts

are crucial in developing strategies that not

only address the immediate health impacts

of climate change on children but also tac-

kle the underlying socioeconomic factors

that contribute to these disparities (Walker

et al., 2024).

X. Adaptation and Mitigation Strate-

gies

Adaptation and mitigation strategies are

critical to addressing the signiﬁcant health

challenges that climate change poses to

children. As climate change continues to in-

tensify, there is a growing need for innovati-

ve public health interventions aimed at miti-

gating its impact on pediatric health. These

strategies encompass a range of approa-

ches, from healthcare delivery to policy in-

novations and community programs, each

designed to protect children’s health in the

face of climate-related risks.

One of the primary strategies involves im-

proving healthcare infrastructure to enhan-

ce resilience against climate-induced shoc-

ks. This includes reinforcing hospitals, clinics,

and supply chains to withstand extreme

weather events and ensuring that heal-

thcare services remain accessible during

and after such occurrences. Strengthening

climate-health surveillance systems is also

essential, enabling early detection of clima-

te-related health risks and facilitating timely

interventions to prevent widespread health

crises (Mosadeghrad et al., 2023).

Healthcare providers play a crucial role

in addressing climate-related health risks,

particularly in pediatrics. Pediatricians and

other healthcare professionals are increasin-

gly advocating for the integration of clima-

te considerations into healthcare practices.

This includes educating families about the

health risks associated with climate change,

such as heat-related illnesses and respira-

tory conditions, and promoting behaviors

that reduce these risks. Moreover, health-

care providers are essential in advocating

for policies that prioritize children’s health in

climate change mitigation and adaptation

eﬀorts. They can inﬂuence policy by par-

ticipating in public discourse, advising on

healthcare policies, and collaborating with

government agencies and NGOs to deve-

lop comprehensive climate-health strategies

(Ahdoot et al., 2015).

Community-level interventions are also pi-

votal. Programs that promote environmen-

tal sustainability and resilience in local com-

munities can signiﬁcantly reduce the health

impacts of climate change on children.

These initiatives often focus on improving

access to clean water, enhancing food se-

curity, and ensuring that vulnerable popula-

tions receive adequate healthcare services

during extreme weather events. Furthermo-

re, public awareness campaigns can help

communities better understand the links

between climate change and health, en-

couraging proactive measures to protect

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Pagína 33 | VOL.25 N°3 (2024) Septiembre - Diciembre

children from climate-related health threats

(Mosadeghrad et al., 2023).

Innovation in policy and healthcare deli-

very are equally important. Governments

at all levels are encouraged to develop

and implement long-term policies that re-

duce greenhouse gas emissions and invest

in public health infrastructure. This inclu-

des funding for research on climate-health

linkages, supporting educational programs

that raise awareness about climate chan-

ge’s health impacts, and enacting legisla-

tion that ensures the protection of children’s

health in climate policies. These eﬀorts are

vital for creating a sustainable future where

children’s health is safeguarded against the

growing threats of climate change (Ahdoot

et al., 2015).

XI. Future Directions and Research

Gaps

The future directions and research gaps in

studying the impacts of climate change on

pediatric health underscore the need for

a more comprehensive and interdisciplinary

approach. While existing research highlights

the immediate risks, such as respiratory di-

seases, heat-related illnesses, and the psy-

chological impacts of extreme weather, the-

re are signiﬁcant gaps in understanding the

long-term and indirect eﬀects. For instance,

the cumulative impact of multiple climate

stressors on children’s development is not

well-studied, nor is the interplay between

socio-economic factors and climate vulne-

rability in pediatric populations (Romanello

et al., 2021).

Current studies often focus on isolated as-

pects of climate change, such as air po-

llution or temperature increases, without

considering the combined eﬀects of these

and other factors like food insecurity, vec-

tor-borne diseases, and mental health. This

narrow focus limits the ability to develop

comprehensive mitigation strategies. Addi-

tionally, there is a lack of longitudinal studies

that track health outcomes over time, which

is crucial for understanding the long-term

consequences of early childhood exposure

to climate-related risks (Swain et al., 2018).

Another signiﬁcant gap is the limited re-

search on vulnerable populations, including

children from low-income families, Indige-

nous communities, and those living in hi-

gh-risk geographic areas. These groups are

often disproportionately aﬀected by climate

change, yet they are underrepresented in

current research. Understanding the unique

vulnerabilities of these populations is essen-

tial for developing targeted interventions

that address both immediate and long-term

health risks (Egorova et al., 2021).

Furthermore, there is a need for more in-

terdisciplinary research that integrates pers-

pectives from public health, environmental

science, social sciences, and policy studies.

This would enable a more holistic unders-

tanding of how climate change impacts pe-

diatric health and what strategies could be

most eﬀective in mitigating these impacts.

For example, combining data from envi-

ronmental monitoring with health outcomes

data could help identify early warning signs

of climate-related health issues in children

(Swain et al., 2018).

In terms of future research, there is a

pressing need for studies that explore the

eﬀectiveness of adaptation and mitigation

strategies speciﬁcally designed for pedia-

tric populations. This includes evaluating

the impact of public health interventions,

such as air quality improvement programs

and heatwave response plans, as well as

broader policy initiatives aimed at reducing

carbon emissions and promoting environ-

mental sustainability (Romanello et al., 2021).

Finally, it is crucial to foster greater colla-

boration between researchers, healthcare

providers, policymakers, and communities

to ensure that research ﬁndings are transla-

ted into eﬀective actions. This collaborative

approach is essential for closing the existing

research gaps and ensuring that future stu-

dies are aligned with the real-world needs

of vulnerable pediatric populations (Egoro-

va et al., 2021).

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Pagína 34 | VOL.25 N°3 (2024) Septiembre - Diciembre

tifying research gaps and proposing inno-

vative mitigation strategies, this review hi-

ghlights the critical steps needed to protect

future generations from the adverse eﬀects

of a changing climate.

1- ETHICS APPROVAL AND CONSENT

TO PARTICIPATE:

“NOT APPLICABLE”

2- CONSENT FOR PUBLICATION:

“NOT APPLICABLE”

Revisión Sistemática

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