Climate Change–Related extreme events and inequities in health outcomes: An umbrella review

This umbrella review synthesises evidence on the unequal health impacts of climate change–related extreme events using an explicit equity-oriented framework. Following PRISMA guidelines, 28 systematic reviews were identified that assessed the health effects of high temperatures, wildfires, floods, droughts, and mixed extreme weather events. Eligibility required reviews to report effect estimates stratified by at least one PROGRESS-Plus dimension, including place of residence, race/ethnicity, occupation, gender, age, religion, education, socio-economic position, social capital, or pre-existing health conditions. Across climate hazards and health outcomes, consistent evidence of differential impacts across PROGRESS-Plus factors was observed. Age and gender were the most frequently examined modifiers, while socio-economic disadvantage, ethnicity, rural residence, and chronic conditions further intensified vulnerability. PROGRESS-Plus not only highlighted vulnerable groups but also provides a framework for guiding policy and intervention design, ensuring that climate-health strategies are equity-sensitive, context-specific, and aimed at addressing structural drivers of disparities rather than only stratifying outcomes.