Adaptation and mitigation approaches to reduce heat-related health risks: An overview of systematic reviews

Background

Though various reviews proposed to reduce heat-related morbidity and mortality, the evidence remains fragmented and heterogeneous. This synthesis has high-order evidence from published systematic reviews and meta-analyses to assess the health impacts of extreme heat, appraise the quality of evidence, and identify critical research and policy gaps.

Methods

This review was conducted and reported in accordance with the standard checklist. Comprehensive searches of five databases identified systematic reviews, with or without meta-analysis, published from inception to November 2025 that evaluated interventions to prevent heat-related health outcomes. Two reviewers independently screened studies, extracted data, and assessed methodological quality using the AMSTAR-2 checklist. A quantitative synthesis was not conducted because of heterogeneity. A thematic analysis was conducted to summarise the findings.

Results

Of 1299 records identified, 13 systematic reviews met the inclusion criteria. Interventions were categorized as national, community, and individual levels. National level demonstrates the most effective in the reduction of heat-related mortality and morbidity. Community-level approaches further reduce exposure and improve heat preparedness. At the individual level, air-conditioning provides strong protection but limited sustainability. Across all levels, adaptation approaches yielded immediate and measurable reductions in heat-related morbidity and mortality, whereas mitigation approaches are essential for long-term risk reduction but remain under-evaluated in health terms.

Conclusions

A coordinated, multi-level strategy integrating national, community, and individual interventions is most effective for reducing the health impacts of extreme heat. Sustainable and context-specific approaches, particularly those targeting vulnerable populations, are critical for strengthening climate-resilient public health systems.