世界银行：2026年气候与健康风险指数报告（英文版）

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THECLIMATEAND

HEALTHRISKINDEX

TrackingClimateChangeRisktoHealthacrossNationalandSubnationalLevelstoPrioritizeAdaptationInvestment

WORLDBANKGROUP

ii

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Pleasecitetheworkasfollows:WorldBank.2025.TheClimateandHealthRiskIndex:TrackingClimateChangeRisktoHealthacrossNationalandSubnationalLevelstoPrioritizeAdaptationInvestment.Washington,DC:WorldBank.

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Contentsiii

Acknowledgementsv

Summaryvii

Globalviii

RegionalHighlights:Africaix

FocusonDistrictsofUttarPradeshstate,Indiaix

FurtherDevelopmentx

1.Introduction1

1.1.OtherIndicesofClimateChangeandHealth2

1.2.KeyGapsAddressedbyaNewIndex3

5

2.Methods

2.1.ARisk-BasedFrameworkforClimateChangeandHealth6

2.2.EstimatingClimateChangeExposure8

2.3.EstimatingSensitivitytoClimateChangeEffectsonHealth10

2.4.EstimatingAdaptiveCapacity11

12

2.5.PrincipalComponentsAnalysisandIndexConstruction

2.6.UncertaintyImpactAnalysis13

14

2.7.DataLimitations

3.Results

15

3.1.ClimateandHealthRiskIndexattheNationalLevel17

3.2.ClimateandHealthRiskIndexattheSubnationalLevel21

3.3.ClimateandHealthRiskIndexDeepDive–IndiaDistricts22

3.4.LinkagesofCHRIResultswithKeyTrends24

4.Discussion

26

4.1.SummaryofKeyImplications27

Annexes30

Annex1.VariablesusedintheClimateandHealthRiskIndex30

Annex2.MethodsforEstimatingExposureatSubnationalLevel37

Annex3.AdditionalDetailsonSensitivityAnalysis40

Annex4.AdditionalDetailsonPrincipalComponentsAnalysis41

iv

Contents

Annex5.AdditionalDetailsonUncertaintyImpactAnalysis49

Annex6.ClimateandHealthRiskIndexatNationalLevel–Tables51

Annex7.ClimateandHealthRiskIndexatSubnationalLevel–Maps65

References68

Acknowledgementsv

ThisreportwasproducedbytheGlobalClimateandHealthProgramintheHealth,Nutrition,andPopulationGlobalPracticeoftheWorldBank.

TheoverallworkwasledbyMikhaelGabrielIglesiasLuzardo(HealthSpecialist)andZaraShubber(Senior

HealthSpecialist,WorldBank)undertheoverallguidanceofTamerSamahRabie(GlobalProgramLead,ClimateandHealth,WorldBank).TheClimateandHealthRiskIndexwasconceptualizedbyZaraShubberandArin

Dutta(formerlyWorldBank)andtheanalyseswereconductedbyArinDuttaandMingyue(Cynthia)Ma(WorldBank).

ThereportgreatlybenefitedfromcomprehensivesupportfromtheClimateChangeKnowledgePortal(CCKPteamintheStrategy,KnowledgeandOutreachunit(SCCSKoftheWorldBank’sClimateChangeGroup,acrossdataprovision,analyticalinputs,andoveralladviceonclimatechangedata.FromtheCCKPteam,theauthorsthankCasparAmman;AnnaCabreAlbos;BalsherSinghSidhu;andPascalSaura.TheauthorsarealsoverygratefultoBenJamesBrunckhorst,ResearchAnalyst,intheWorldBank’sProsperity,PovertyandEquityGlobalPractice,forprovidingadditionaldataandresponsiveadvicethroughoutthestudyprocess.

Theauthorswouldalsoliketothankthereport’speerreviewersfortheirinsightfulcomments:IanForde,LeadEconomist;MersedehTariverdi,SeniorDataScientist;andMacKenzieDove,ClimateChangeSpecialist.

TheauthorssincerelyappreciatethevaluablecontributionsofMattiaAmadio,LanderBosch,andCharlesMinicucci(WorldBank)onissuesrelatedtodataanaly-sisandgeographicinformationsystem(GIS)softwareuse.TheauthorsthankProfessorMoritzKraemeroftheDepartmentofBiology,UniversityofOxford,forprovidingaccesstodataonmosquitopopulations.TheauthorsalsoacknowledgeRonitGuptaandRamonBrown(formerlyWorldBank)forearlyresearchassistance.

TheauthorswouldliketoexpresstheirgratitudetoMoniqueVledder(Director,Health,WorldBankGroup)forherleadershipandsupport.

TheauthorsarealsogratefultothefinancialsupportprovidedbytheJapanPolicyandHumanResources

DevelopmentFund(PHRD)TrustFundandtheHealthSystemTransformationandResilienceMulti-DonorTrustFund,whichiscofinancedbytheMinistryofFinanceofJapan;theForeign,CommonwealthandDevelopment

OfficeoftheUnitedKingdom;TheLeonaM.andHarryB.HelmsleyCharitableTrust;theSwissAgencyforDevelopmentandCooperation;Canada'sDepartmentofForeignAffairs,TradeandDevelopment;andtheSusanT.BuffettFoundation.

vi

IPCC

IntergovernmentalPanelonClimateChange

IPUMS

IntegratedPublicUseMicrodataSeries

KMO

Kaiser

MICS

MultipleIndicatorClusterSurveys

NAP

NationalAdaptationPlan

NASA

NationalAeronauticsandSpaceAdministration

ND

NotreDame

PCA

PrincipalComponentsAnalysis

PM2

ParticulateMatter≤2.5Microns

QGIS

QuantumGeographiclnformationSystem

SDG

SustainableDevelopmentGoals

SEDAC

SocioeconomicDataandApplicationsCenter

SPEI

StandardizedPrecipitationEvapotranspirationIndex

SSP

SharedSocioeconomicPathways

STORM

SyntheticTropicalcyclOnegeneRationModel

UHC

UniversalHealthCoverage

UNEP

UnitedNationsEnvironmentProgramme

UNFCCC

UnitedNationsFrameworkConventiononClimateChange

UNICEF

UnitedNationsInternationalChildren’sEmergencyFund

UPSDMA

UttarPradeshStateDisasterManagementAuthority

WHO

WorldHealthOrganization

ABBREVIATIONS

AC

AdaptiveCapacity

ACAG

AtmosphericCompositionAnalysisGroup

AR

AssessmentReport

AR4

AssessmentReport4

AR5

AssessmentReport5

AR6

AssessmentReport6

CCKP

ClimateChangeKnowledgePortal

CCRI

Children’sClimateRiskIndex

CHRI

ClimateandHealthRiskIndex

CHVA

ClimateandHealthVulnerabilityAssessment

CIESIN

CenterforInternationalEarthSciencelnformationNetwork

CMIP6

CoupledModelIntercomparisonProjectPhase6

CO2

CarbonDioxide

COP28

28thConferenceoftheParties

COVID

CoronavirusDisease

DHS

DemographicandHealthSurveys

DUC

DegreeofUrbanizationClassification

FAO

FoodandAgricultureOrganization

FMOHSW

FederalMinistryofHealthandSocialWelfare

GADM

GlobalAdministrativeAreas

GAIN

GlobalAdaptationlnitiative

GBD

GlobalBurdenofDisease

GHO

GlobalHealthObservatory

GHS

GlobalHealthSecurity

GHSL

GlobalHumanSettlementLayer

GIS

GeographicInformationSystem

GPW

GriddedPopulationoftheWorld

HEFPI

HealthEquityandFinancialProtectionlndicators

HI35

HeatIndex35°C

ILO

InternationalLabourOrganization

IMF

InternationalMonetaryFund

INFORM

IndexforRiskManagement

vii

Summary

Inthecurrentpolycrisis,protectinghumanhealthfromongoingandprojectedclimatechangewillcompetewithotherurgentneeds.Arisk-basedapproachtoclimatechangewillhelpsethigh-levelprioritiesforallocatingresourcesbyidentifyinggeographicareasandpopulationsfacingthegrea-testthreats.SincetheIPCC’sFifthAssessmentReport,riskanalysisistheestablishedwaytoframeimpactsonhumanhealth,buildingonthevariabilityinclimatechangetrends,sensitivityofpopu-lationstoadverseeffects,andthedifferingcapacityofindividualsandsystemstoreducerisks.

TheClimateandHealthRiskIndex(CHRI)isputforwardasarepeatable,rigorousassessmenttoinformnationalandmultilateralactorsonthelocationofthegreatestrelativeriskstohumanheal-thandhealthsystems.

TheCHRIusesdatafrommostlypubliclyavailablesourcesonclimatehazardsandpopulationex-posure,sensitivity,andadaptivecapacitytoproduceaunit-lessmeasureofriskfor185economies,covering99%oftheworld’spopulation,and3,008firstsubnationaladministrativeareas.TheCHRIhasseveralmethodologicalinnovationsandusesinformationatagranularlevel.Todemonstratethisgranularity,analysiswasalsoconductedfor731secondsubnationaladministrativeareasofIndia(districts).

ThepurposeoftheCHRIistoimprovehowclimatechangeandhealthresourcesareinvested:

•Overrepeatedmeasurement,identifyhowriskisshiftingacrossgeographiesandtime,keepingupwithsteadilydeepeningdataonhazardsrelevanttoclimate-sensitivehealthissuesandim-provingadaptivecapacityduetopublicandprivateinvestment.

•Priortoin-depthassessments,determinethespatialdistributionofrisk,screenforareastofocusdiagnosticresources,andassistinadvocacyforadaptationandresiliencespendinginthehealthsector.

•Presentacomprehensiveviewonrisktohumanhealthacrossclimatechangestressorsandextremeevents(shocks)complementingindicesfocusingonchildhealth,disasterandhumani-tariancrisis,andothersub-domains.

TheCHRIevaluatesriskasacompositeofthreecoreelementsmeasuredwith69indicatorscove-ringnationalandsubnationalareas:

•Exposure:theintersectionofhazardwithpopulation.Anexposureindicatormeasurestheshareofpeoplelivinginanareawhereaspecificclimatehazardsatisfyingathresholdis

Summaryviii

present.Exposureisrelevanttohumanhealthriskasitvalueswherepeopleare.Intotal,29hazard-thresholdvariantswereincludedintheanalysis.

•Sensitivity:social,economic,andenvironmentalcharacteristicsofpopulationsthatmakethemsusceptibletotheworseningeffectsofclimatechangeonhumanhealth.Sensitivityindi-catorsinCHRIidentifyfactorsthatareslowordifficulttochangebasedonpolicy.

•AdaptiveCapacity:theabilitytoabsorb,deflect,orreducetheimpactofclimatechangeonhealthandhealthsystems.CHRIincludesmeasuresofadaptivecapacityamenabletopolicyactionathealthsystem(nationalonly)andathousehold(nationalandsubnationalcalculations)levels.

TheCHRIusesadatareductionapproachusingprincipalcomponentsanalysisclusteringinforma-tionaroundkeyfactorsexplainingsignificantvariation.CHRIisalinearcombinationofthenorma-lizedsub-indicesofexposure(E),sensitivity(S)andadaptivecapacity(AC).TheCHRIvalue(E+S-AC)isanormalizedvalue0-100,withhighvaluesindicatinghigherrisks.TheCHRIwasgeneratedsepa-ratelyfornationalandsub-national(i.e.,secondtieradministrativeboundary)levels.

ThekeytakeawaysfromthefirstroundofCHRIimplementationareasfollows.

Global

Globally,almosta10thoftheworld’spopulation,about718millionpeoplein2025,isalreadyathighriskforadverseeffectsonhealthduetoclimatechange.ThiscorrespondstoaCHRIvalueofatleast75.Theburdenofclimateandhealthrisksfallsunevenlyacrossdifferentpopulationgroups.Sub-SaharanAfricaandSouthAsiaaccountfor99%ofthepopulationlivinginhighriskeconomies(CHRI≥75).Inatleast13economies,80%ormoreofthepopulationwasexposedtomoderatelyhighclimateandhealthrisk(CHRI≥60),whilein20economies,atleasthalfthepopulationfacedsimilarlevelsofrisk.

CHRIvalues

werestronglyandnegatively

correlated

with

theWorld

Health

Organization’s

HealthCoverage(UHC)index,

Universal

indicatingthateconomiesfacingthehighestclimateandhealthrisksoftenalsohavethelowestlevelsofessentialhealthservicecoverage,resultingina

compounding

"doublevulnerability".

718millionpeople(almostatenthoftheworld’s

population)areathigh

riskofadverseeffectsofclimatechangeonhealth.

Summaryix

Implication:Thereisaneedtoraiseeffortstoexpandaffordable,high-qualityessentialhealthservicesasaprimarylineofdefenseagainsttheacceleratingimpactofclimatechange.

RegionalHighlights:Africa

Focusingonsub-SaharanAfricaasoneoftheseveralWorldBankregionsmodeled,thesubnationalCHRIhasvaluesfor50economies.AreasofWestern,Central,andEasternAfricawithhotsemi-aridortropicalsavannahclimatezonesfacethehighestrisks.Whilehighexposuretoclimatehazards,suchasheatwavesanddroughts,contributestothepattern;elevatedrisksintheseareasarealsodrivenbypopulations’sensitivity,stemmingfromthelackofaccesstoinfrastructure,suchasimprovedwaterandelectrification,andlimitedhouseholdadaptivecapacity.

Climaterisksarehigh

whereessentialhealthservicecoverageislow–a“double-vulnerability”effect

ConsideringCHRIvaluesalongsideclimatefinan-cingdata,AfricaneconomieswithhigherCHRIvaluesareassociatedwithlowerlevelsofclimatefunding.Insteadofastrong,positivecorrelation,wefindaweak,negativecorrelation.Alargeshareofclimatefinancingisdirectedtowardsmitigation,withlaggingadaptationandresilience-enhancinginvestments.

Implication:TheCHRI,whentrackedalongsideclimatefinancinglevelindicators,willhelpunders-tandwhetherriskandresourceflowsarewellalig-nedinthefuture.

FocusonDistrictsofUttarPradeshstate,India

Asproofofconcept,CHRIvaluesweredevelopedfordistrictsofIndia’smostpopulousstate,UttarPradesh.UttarPradesh,aprimarilyagrarianstateinthenorth,hasfacedincreasinglyintense,frequent,andprolongedheatwavesandassociatedriseinheat-relatedmortality.Thestatealsofacesbothdroughtsandfloods.North-centraldistrictsdemonstratehighestrisks.Mostdistrictshaverelativelyhighhouseholdadaptivecapacity,reflectingsuccessinexpandingthecoverageofsocialprotectionschemesandessentialinfrastructure.Variationsinclimateandhealthrisksweredrivenbydifferencesinsensitivity,highlightingtheneedfortargetedprogramsthataddressthevulnerabilitiesofpopulationsinhigherriskregions.

Summaryx

Implication:CHRIanalysisatthethirdadministrativeleveloffersvaluableinsightsfordecision-ma-kingindecentralizedhealthsystems,suchasthoseinIndonesiandistrictsorKenyancounties.Theseanalysescanempowerlocalgovernmentstoadvocateforresourcestoaddresstheirvul-nerabilitiesandallowprovince-levelorcentralgovernmentstobetterallocatedeeperdiagnosticsandpotentialfinancing.

FurtherDevelopment

TheCHRIisanovelandrobustframeworkforunderstandingandaddressingtheimpactsofclima-techangeonhumanhealthandhealthsystemsglobally,atmultiplelevels.

TheCHRIcanbecomeanormativescreeningtooltoguidedecisionsonallocationofanalyticalandadvocacyeffortsandthusinformfinancingforadaptationandresilience.Withrepeateduse,theCHRIcancreateatimeseriesofriskvalues,unearthingshiftsinresponsetoreductionsinun-derlyingsensitivityandenhancementofadaptivecapacity.Thiscanempowerlocal,nationalandmultilateralpolicymakersandorganizationstoplacehealthatthecenterofclimatechangebasedonthebestpossibleevidence.

ForfurtherdataexplorationoftheCHRI,pleasevisit:

/global/chri

1.Introduction

1

RecentmonthlyorannualbreachesoftheParisAgreement’s1.5°Climitmaysignalmountingchallengestokeepinglong-termglobalwarmingincheck.Countries,theprivatesector,multilateralinstitutions,andindividualsaremakingsignificanteffortstoreducetheirgreenhousegasemissionstomitigatethepossibilityoffurtherclimatechange.EvenaseffortstomeetmitigationgoalssetunderNationallyDeterminedContributionspickuppace,itisclearthatsocietiesmustadapttotheeffectsofacceleratingclimatechange,manyofwhicharealreadymanifest.AccordingtoWorldBankestimates,by2050,theeconomiccostsarisingfromthehealthimpactsofclimatechangeinlow-andmiddle-incomecountries(LMICs)couldreachUS$21trillionfromfivehealthrisksalone—equivalenttoroughly1.3%oftheirprojectedgrossdomesticproduct(WorldBank2024a).

TheeffectsofclimatechangeonhumanhealthandwellbeinghavebeenlongrecognizedandwerereiteratedintheIntergovernmentalPanelonClimateChange(IPCC)SixthAssessmentReportorAR6(IPCC2023).Countriesandmultilateralactorsneedtoaccelerateadaptationandresilience-enhancinginvestments.Inthiscontext,nationalandmultilateralinstitutionspledgedtotakeactiontoincreasetheresilienceofhealthsystemsandputhealthatthecenteroftheclimateagendaatthe2023ConferenceoftheParties(COP28).

However,giventhecurrentpolycrisis,investmentsintoprotectinghumanhealthfromongoingandprojectedclimatechangewillcompetewithotherurgentneeds.Arisk-basedapproachtoclimatechangecanhelptosethigh-levelprioritiesforresourceallocationbyidentifyinggeographicareasorpopulationgroupswhichfacethegreatestthreatinatime-framerelevantforpolicyaction.SincetheIPCC’sFifthAssessmentReport(2014),risk-basedanalysishasbeenrecognizedasasuitableapproachforassessinghealthimpacts,asitaccountsfordifferencesinclimatehazards,populationvulnerability,andcapacitytoreduceharmacrosscountries.

TheGlobalClimateandHealthProgramwithintheWorldBank’sHealth,NutritionandPopulationGlobalPracticehasdevelopedtheClimateandHealthRiskIndex(CHRI),incorporatingdataonclimatehazardsandpopulationexposures,sensitivity,andadaptivecapacity.TheCHRIisameasureofriskforadverseimpactonhumanhealthandhealthsystemscurrentlycovering185economies,aswellas3,008second-levelsubnationaladministrativeareas.Itisintendedtobearepeatable,rigorousassessmentdesignedtoinformnationalandmultilateralactorsonwherethegreatestrelativeriskstohumanhealthandhealthsystemslie.Basedonitsrepeatedfuturemeasurement,theCHRIwillidentifyhowriskisshiftingacrossgeographiesandtime,keepingupwithsteadilydeepeningdataonhazardscriticaltoclimate-sensitivehealthdomainsandimprovingadaptivecapacityasaresultofpublicandprivateinvestment.

2

1.Introduction

Asaprecursortoin-depthclimateandhealthassessments,theCHRIcanassistindeterminingthespatialdistributionofrisk,screenforareastofocusdiagnosticandprescriptiveanalyticalresour-ces,andassistinadvocacyforinvestmentinclimateadaptationandresilienceinthehealthsector.

1.1.OtherIndicesofClimateChangeandHealth

Presentingacomprehensiveviewonhumanhealthacrossclimatestressorsandextremeevents(shocks),theCHRIcomplementsmorespecificriskindices,focusingonchildhealth(UNICEF2024a),disasterandhumanitariancrises(Thowetal.2022),andothersub-domainsofhealth.Byadoptingrisk-basedframing,theCHRIdiffersfromclimateandhealthvulnerabilityindices,whichfollowthevulnerability-basedframingfromIPCC’sFourthAssessmentReport(IPCC2007).Inusingriskasthemethodologicalunderpinning,theCHRIiscloselyalignedtothemethodsbehindtheWorldBank’snewglobalscorecardindicatorof“percentageofpeopleathighriskfromclimate-relatedhazards”(WorldBank2024b).Table1summarizescharacteristicsofsomeprominentindicesup-datedrecentlyinthespaceofclimatechangeandhumanwell-being,wherewell-beingincludeshealth.ItshouldbenotedthatonlytheCHRIconsidersprojectedhazardsalongsiderecent/currenthazarddata,asdiscussedinSection1.2.TheCCRIbuildscloselyonthedatasetusedinINFORMRISK,andconsidersonlycurrenthazarddata.

Table1.VariousGlobalIndicesLinkingClimateChangeandHumanWell-being

NameRiskor

vulnerability

Health-specifi

Exposure

Sensitivity

AdaptiveCapacity

Reference

ND–GAIN1

Vulnerability

No

-(2)

✔(2)

✔(2)

UND2024

Children’sClimateRiskIndex(CCRI)

Risk

Yes

✔(10)

✔(14)

✔(6)

UNICEF2024

INFORMRISK2

Risk

No

✔(30)

✔(20)3

✔(16)

Thowetal.2022

ClimateandHealthRiskIndex(CHRI)

Risk

Yes

✔(29)

✔(13)

✔(27)

WorldBank2025

Figuresinbracketsinthetableshowthenumberofindicatorswithoutcountinganysub-indices.

1ND–GAINhealth-relatedindicatorsonly.ND-GAINexposureindicatorsarenotbaseddirectlyonclimatehazards.

2Focusesonriskoffuturehumanitariancrisesanddisaster,includingduetoclimatechange.

3Termed“vulnerability”indicatorsinthedataset.

3

1.2.KeyGapsAddressedbyaNewIndex

TheanalysisofexposuretoclimatechangehazardsatasubnationallevelforCHRIbuildsonrecentworkfromtheWorldBankonclimateriskanalysisatahighlydetailedgeospatialresolutionlevel(Hilletal.2024),whichunderpinsthedevelopmentoftheglobalscorecardindicatormentionedpreviously.FortheCHRI,thispriorWorldBankworkinformedtheselectionofhazardsappropriatetohumanhealthandhealthsystemsandtheprocessofcalculatingexposurewithahighlevelofgranularity.Intermsofselectionofappropriateindicatorsfortheanalysisofsensitivityandadapti-vecapacity,andtheprocessofcombiningindicatorsappropriatelytogeneratetheindexvalue,theCHRIbuildsonaliteraturecomprisingcountry-andarea-specificclimateandhealthvulnerabilityindices.Studiesformulatingsuchindiceshaveincreasinglycoveredlowandlower-m