Child health on a warming planet

Author: Rob Hughes, Geoffrey Mboya and Elizabeth Kimani

We have an understandable tendency to put things, people, and issues into boxes. One example of this has been how we’ve historically talked about environmental health separately from child health. For example, separating environmental health departments from those looking at maternal and child health (including at the World Health Organization, no less). But on a warming planet, as we try to mitigate the severity of climate change while also trying to adapt to the its impacts, it’s about time that we better connected these conversations. In this blog, we illustrate how child health is intimately connected to that of our planetary systems, and what that means to academics, policymakers and broader society – including children and young people.

The air we breathe provides a powerful illustration of these connections. Put simply, there is a common cause of much of the toxic pollution that undermines our health from cradle to grave and in settings as different as Mombasa and Manchester: burning fossil fuels. Whether this is to heat our homes, cook our food or power the ways we move around, “burning stuff” is making both us and our planet sick. The early-life harms of air pollution include increased risk of being born too small or too soon, undermining the growth of our lungs and increasing children’s risk of developing asthma. And this is the same fossil fuel burning that is driving climate change and causing global heating.

The scale of the harms from air pollution is depressing – more than 9 in 10 children around the world breathe air that does not meet the WHO’s air quality standards. But flipping this around, cleaning the air is a compelling strategy to improve (child) health. In effect, we are storing up health problems that will affect our next generation of adults, but many of these can be prevented if we take urgent and impactful actions to mitigate climate change, key being stopping burning fossil fuels. It should be a ‘no brainer’ for policymakers to focus on this.

There is little separation between housing and industry in Mukuru slum in Nairobi © Geoffrey Mboya

Global warming and rising temperatures are also affecting child health. Increasing number of studies show heat stress is becoming more common and dangerous, particularly for children. The risks start before and during pregnancy, but extend well beyond. Share on X Little research has been done to see how heat in classrooms affects our children, but what has been conducted, mostly in high-income countries, shows that excessive heat – in the context of children’s physiological and social vulnerability – puts them at greater risk of dehydration, heat stress, and diarrhoea. It also undermines children’s learning, probably through the effects of sitting in an overly hot school and being taught by an uncomfortably hot teacher, alongside the effects of lack of sleep in hot evenings. For example, in Our Lady Of Nazareth Primary School in Mukuru Kwa Njenga, Nairobi, a typical class houses close to 60 learners in a poorly ventilated space where daytime temperatures can peak to 35°C. Learning in such an environment is a serious health concern in this context.

Scarce and polluted water resources undermine public health © African Population Health Research Center

Unfortunately, this would become a very very long blog if we attempted to unpack all the connections between climate and child health. Thankfully this has been done elsewhere, with a comprehensive attempt to map the links here. But here are just some of these connections:

  1. Food and water insecurity. Disruptions to these will impact young children most, risking undermining progress on reducing malnutrition and preventing child deaths.
  2. (Un)natural disasters. In times of crisis, children and young people are especially vulnerable. They, despite having done the least to cause the increase in risks of extreme weather events, they risk suffering most, especially when displaced from their homes.
  3. Patterns of disease, including vector-borne diseases like malaria. Again, there is a risk that recent progress may be reversed, undermining child health.
  4. Mental health and climate anxiety. Both due to the mental health effects of crises and  the rising tide of climate anxiety as young people worry about facing an uncertain future.

It’s also helpful to think about the underlying factors at play here. Key to this must be a recognition of the physiological vulnerabilities, intergenerational and international injustices, and democratic deficits which underlie the connections between climate change and child health.

Children are especially vulnerable to the impacts of climate change. For example, their body composition means they’re at higher risk from the effects of heat, their developing lungs are especially vulnerable to the effects of pollution, and their smaller stature and higher respiratory rates can place them at higher risk of inhaling dirty air in cities. And all of these vulnerabilities are amplified at times of crisis or unnatural disaster. These factors, and the life-long impacts of these early-life exposures on both individuals and whole societies through the risk of erosion of human capital, illustrate the injustice at play here; children, especially in the global south, have done the least to cause climate change, yet risk suffering from the greatest harms associated with it.

Additionally, there is a democratic deficit on these issues, as children often have few formal ways to influence climate politics and policy. Robust and effective mechanisms are needed to enable young people to have their voices heard and listened to and actively participate in decision-making. This would be an overdue response to their justified demands to be heard through the Fridays for Future movement and similar initiatives. Incorporating young people’s lived experience across different regions, including those residing in urban informal settlements who are often the least represented, is critically important in these conversations. And underlying all of this are deeper, pressing questions about unequal resource distribution around the world.

So, where do we go from here? Firstly, we must think about climate change when talking or writing about maternal and child health. We need to also ensure that children and young people are participating fully in the conversation; we’re trying to do that through the Children, Cities and Climate initiative, but have more work to do. Better understanding and quantifying the connections between climate change and child health should also inform adaptation efforts and help to make a strong case for the loss and damage funds that are owed to low- and middle-income countries to fund these efforts.

These arguments can and should also add wind to the windmills of our efforts to rapidly decarbonise our economies, especially those of us who live in high-income, high-emission countries.

In conclusion, we need to continue breaking down the silos between environmental health and child health. Most of us now recognise that climate change is not (just) about polar bears and melting ice caps; it’s about our children’s futures. But policy action and budget allocations are yet to reflect the importance of these connections. By acting faster and boldly on this we can help ensure our children’s health and well-being now and in the future.


About the Authors

Rob Hughes is a clinical research fellow at the London School of Hygiene and Tropical Medicine, where he’s leading work on child health and development in informal urban settlements and the Children Cities and Climate Initiative on the connections between urban child health and climate change. He’s also advised the Clean Air Fund, and WHO, amongst others.

Elizabeth Kimani is a Senior Research Scientist and Lead, Nutrition and Food Systems Unit at the African Population and Health Research Center (APHRC). Her research focuses on child nutrition, development and health, and food systems transformation to make them more nourishing, inclusive, resilient, human centered and sustainable in terms of human and environmental health.

Geoffrey Mboya is a youth Co-Chair youth of the LSHTM-led Children, Cities and Climate Initiative and Communication Liaison Officer Veterinarians International. He’s a passionate community organiser from Mukuru Kwa Njenga, an urban informal settlement in Nairobi, Kenya.


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