OBJECTIVES: To present the available evidence on the impacts of climate change on health, to analyze the situation in Spain in relation to the European context, to discuss barriers to and catalysts for climate change, and to recommend policy options to reduce the effects of climate change on health. METHODS: We reviewed the literature on the impact of climate change on health. The proposals for adaptation to climate change identified in the framework of the European project coordinated by the WHO/Europe on "Climate, Environment and Health action plans and information systems" were analyzed. RESULTS: The effects of climate change on health include: 1) an increase in the impacts of extreme weather events; 2) an increase of the frequency of respiratory diseases due to changes in air quality and pollen distribution; 3) an increase in the incidence of food-borne, zoonotic and waterborne diseases; and 4) a change in the distribution of infectious diseases and/or their vectors. In Spain, the morbidity and mortality due to heat waves are expected to increase. The main impact related to atmospheric contamination is a predicted increase in fine particles and ozone. There is also a risk of an increase in the geographical distribution of vector borne diseases that are already established in Spain or the establishment of new subtropical vectors. Spain is one of the first European countries to have developed a climate change adaptation plan. This plan provides a framework for coordination among public institutions on activities to evaluate the impacts of climate change, as well as vulnerability and adaptation to this phenomenon, and makes reference to the health sector. CONCLUSIONS: Policy options to reduce the impacts of climate change on health include: 1) integrating health in all policies, strategies and interventions to mitigate and adapt to climate change; 2) strengthening health systems and public health systems to improve their ability to prevent, prepare and respond to the impacts of climate change; 3) raising awareness among all sectors to promote the co-benefits to health of adaptation and mitigation strategies; and 4) promoting research, technological development, data sharing and information exchange across sectors.
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