Climate adaptation and health: Improving evidence for action in Oslo

Our results offer a knowledge basis on the health effects related to climate change for Oslo. and can be used for integrated adaptative policies to ensure better public health in the city.

Background: Climate change affects the health and wellbeing of every population and place on the planet in profound ways. In this study, we use results from an ongoing EU project EXHAUSTION to review and summarize the evidence on climate change adaptation on health impacts related to cardiopulmonary disease (CPD) in Oslo. We use standard epidemiological methods to understand key factors affecting health and vulnerability in Oslo due to changing temperatures based on historical data. We focus on vulnerable groups and socio-economic differences to understand how changing temperatures have varied health consequences. We examine specific adaptation options including green areas and housing to understand how we can provide integrated solutions for urban health in in Oslo. We also look at the co-benefits of adaptation measures for other indicators like air pollution. We further work with the Oslo municipality to understand adaptation strategies in Oslo and how our research results can inform these plans.

Methods: We obtain data on CPD related deaths and hospital admissions from the Death Registry and the Norwegian Patient Registry. We used temperature data from the Meteorological Institute and air pollution data from the DEHM model. We apply cohort-based methods using the Oslo HUBRO cohort to understand how historically changing temperatures in the 1998-2018 period have affected the health of populations and the implications of specific vulnerability factors. Analyses on the heat effects of temperature on CPD mortality and morbidity were conducted in the cohort using the time-stratified case-crossover design. The cohort-specific heat effect estimates were pooled separately for each category of potential effect modifiers. For effect modifiers, we used green areas measured in NDVI at the address level of the participants and neighbourhood and socio-economic data on cohort participants derived from SSB.

Results: Our results indicate increasing mortality and morbidity levels in Oslo due to higher temperatures in the past. Green areas and socio-economic differences significantly impact the exposure-response functions, and the mortality and morbidity rates. When using lags of 0-3 days, heat effects on natural-cause and respiratory mortality were also stronger among people aged 65 years and above, women, and people having a low or medium level of education. When we extended the lag to up to 21 days, we observed stronger heat effects among women and people with pre-existing CVD.