Climate change adaptation responses are being developed and delivered in many parts of the world in the absence of detailed knowledge of their effects on public health. Here we present the results of a systematic review of peer-reviewed literature reporting the effects on health of climate change adaptation responses in low- and middle-income countries (LMICs). The review used the ‘Global Adaptation Mapping Initiative’ database (comprising 1682 publications related to climate change adaptation responses) that was constructed through systematic literature searches in Scopus, Web of Science and Google Scholar (2013–2020). For this study, further screening was performed to identify studies from LMICs reporting the effects on human health of climate change adaptation responses. Studies were categorised by study design and data were extracted on geographic region, population under investigation, type of adaptation response and reported health effects. The review identified 99 studies (1117 reported outcomes), reporting evidence from 66 LMICs. Only two studies were ex ante formal evaluations of climate change adaptation responses. Papers reported adaptation responses related to flooding, rainfall, drought and extreme heat, predominantly through behaviour change, and infrastructural and technological improvements. Reported (direct and intermediate) health outcomes included reduction in infectious disease incidence, improved access to water/sanitation and improved food security. All-cause mortality was rarely reported, and no papers were identified reporting on maternal and child health. Reported maladaptations were predominantly related to widening of inequalities and unforeseen co-harms. Reporting and publication-bias seems likely with only 3.5% of all 1117 health outcomes reported to be negative. Our review identified some evidence that climate change adaptation responses may have benefits for human health but the overall paucity of evidence is concerning and represents a major missed opportunity for learning. There is an urgent need for greater focus on the funding, design, evaluation and standardised reporting of the effects on health of climate change adaptation responses to enable evidence-based policy action.

The scientific literature on climate change adaptation has become too large to assess manually. Beyond standard scientometrics, questions about if and how the field is progressing thus remain largely unanswered. Here we provide a novel, inquisitive, computer-assisted evidence mapping methodology that combines expert interviews (n = 26) and structural topic modelling to evaluate open-ended research questions on progress in the field. We apply this to 62 191 adaptation-relevant scientific publications (1988–2020), selected through supervised machine learning from a comprehensive climate change query. Comparing the literature to key benchmarks of mature adaptation research, our findings align with trends in the adaptation literature observed by most experts: the field is maturing, growing rapidly, and diversifying, with social science and implementation topics arising next to the still-dominant natural sciences and impacts-focused research. Formally assessing the representativeness of IPCC citations, we find evidence of a delay effect for fast-growing areas of research like adaptation strategies and governance. Similarly, we show significant topic biases by geographic location: especially disaster and development-related topics are often studied in Southern countries by authors from the North, while Northern countries dominate governance topics. Moreover, there is a general paucity of research in some highly vulnerable countries. Experts lastly signal a need for meaningful stakeholder involvement. Expanding on the methods presented here would aid the comprehensive and transparent monitoring of adaptation research. For the evidence synthesis community, our methodology provides an example of how to move beyond the descriptive towards the inquisitive and formally evaluating research questions.

Context: Shifting from current dietary patterns to diets rich in plant-based (PB) foods and lower in animal-based foods (ABFs) is generally regarded as a suitable strategy to improve nutritional health and reduce environmental impacts. Despite the recent growth in supply of and demand for novel plant-based foods (NPBFs), a comprehensive overview is lacking. Objectives: This review provides a synthesis of available evidence, highlights challenges, and informs public health and environmental strategies for purposeful political decision-making by systematically searching, analyzing, and summarizing the available literature. Data Sources: Five peer-reviewed databases and grey literature sources were rigorously searched for publications. Data Extraction: Study characteristics meeting the inclusion criteria regarding NPBF nutrient composition and health and environmental outcomes in high-income countries were extracted. Data analysis: Fifty-seven peer-reviewed and 36 grey literature sources were identified; these were published in 2016–2022. NPBFs typically have substantially lower environmental impacts than ABFs, but the nutritional contents are complex and vary considerably across brands, product type, and main primary ingredient. In the limited evidence on the health impacts, shifts from ABFs to PB meats were associated with positive health outcomes. However, results were mixed for PB drinks, with links to micronutrient deficiencies. Conclusion: If carefully selected, certain NPBFs have the potential to be healthier and nutrient-rich alternatives to ABFs and typically have smaller environmental footprints. More disaggregated categorization of various types of NPBFs would be a helpful step in guiding consumers and key stakeholders to make informed decisions. To enable informed policymaking on the inclusion of NPBFs in dietary transitions as part of a wider net-zero and health strategy, future priorities should include nutritional food standards, labelling, and subdivisions or categorizations of NPBFs, as well as short- and long-term health studies evaluating dietary shifts from ABFs to NPBFs and standardized environmental impact assessments, ideally from independent funders.

Self-reporting is an important mechanism of the UNFCCC to collect information about what countries are doing to achieve their climate change mitigation and adaptation targets and how much progress has been made. Here we empirically test four hypotheses about what countries prioritise in their self-reporting through the National Communications. Using quantitative text analysis methods (structural topic modelling and keyness statistics), we analyse over 600 submissions (from 1994 to 2019) and find evidence that vulnerable countries highlight impacts, vulnerability, and adaptation rather than mitigation targets, whereas high-emitting countries tend to focus their messaging more on mitigation. Despite the Paris Agreement being considered a “watershed moment”, we find no statistically significant increase in focus on climate solutions post-Paris, and no significant increase in attention to adaptation. Our global assessment and the methods used offer a novel perspective to understand what gets framed as important by governments. Finally, we provide reflections on how self-reporting mechanisms can be used for global stocktaking of progress on climate action.