Children's Health in a Changing Climate
November 11, 2022
Sarah Hubbart

In June 2022, the New England Journal of Medicine published a new scientific review of the wide-ranging impacts that air pollution and climate change have on children’s health. The results are stark. While everyone feels the impacts of climate change, children are especially vulnerable. Nearly every child around the world is considered to be at risk from even the mildest of climate hazards. 

Children are more vulnerable to risks associated with weather and a changing climate due to several factors—they generally spend more time outside than adults, they have different physiology and metabolism than adults, and they are dependent upon caregivers. Infants and children also breathe more air relative to their body weight than adults, increasing their exposure to air pollutants. 

The challenge of addressing climate change starts with awareness. You can help protect your family by understanding and preparing for weather and climate-related risks. 

Climate change exposure pathways and the affects on fetuses, infants and children

From The New England Journal of Medicine,  Frederica Perera, Dr.P.H., Ph.D., and Kari Nadeau, M.D., Ph.D., Climate Change, Fossil-Fuel Pollution, and Children’s Health, Copyright © 2022 Massachusetts Medical Society. Reprinted with permission from Massachusetts Medical Society.

Allergies and Asthma

A warming climate has led to earlier springs and longer growing seasons for many plants. These changes have increased the length and intensity of the pollen season in some parts of the United States, which can increase allergy and asthma episodes

Warmer temperatures also promote the production of more ground-level ozone, which is a known trigger for asthma attacks in some children. While asthma may be associated with genetic factors, the changing environment, and increased air pollution are also contributing factors to the development of the disease. The World Health Organization estimates that more than one billion children globally are exposed to “very high levels” of air pollution, defined as exceeding 25µg/m3.

Young child holding a ball and using an inhaler

What you can do: 

  • Know your child’s asthma triggers.
  • Check the air quality forecast. If air quality is poor and your child has been diagnosed with asthma, consider rescheduling sports and other outdoor activities for another day. 
  • If you do go outside, aim for early morning or evening hours, when air pollution levels and pollen levels are likely to be lower.
  • Consider starting your child’s medications a few weeks before allergy season begins to help manage their symptoms.

Extreme Heat

The number of extreme heat events in the United States continues to rise and climate projections indicate that these events will be more frequent and intense in coming decades. Children do not adapt to heat as efficiently as adults, and often rely on adults to help them stay cool and hydrated during hot weather. Studies also suggest that heat associated with climate change has adverse effects on the mental health of children and adolescents and also affects their ability to learn. 

thermometer reading 100 degree F with a blurred photo of person drinking water

What you can do: 

  • Help children stay hydrated, stay cool, and dress for the weather. 
  • Learn more about preventing heat-related illness from the Centers for Disease Control.

Extreme Weather Events

Climate change has intensified certain extreme weather events like floods and hurricanes. In the United States, approximately 1.7 million people—many of them children—were displaced from their homes in 2020 as a result of natural disasters. In addition to the immediate threats of drowning and physical injury, these events can lead to long-term effects such as the disruption of education and post-traumatic stress disorder.

aerial view of flooded areas with homes underwater

What you can do: 

  • Have a safety plan in place for extreme weather where you live.  
  • Put together a safety kit, which might include extra clothing, water, important documents, and a NOAA Weather Radio.
  • Know where your nearest shelter is or if there is an evacuation route nearby.
  • Review NEEF’s Extreme Weather 101 course to learn the basics about extreme weather and climate change. 

Wildfire Smoke

Climate change has fueled a dramatic increase in wildfires in the West. In 2021, more than seven million acres of land were burned in wildland fires, and the smoke from these types of incidents can travel—and bring their negative health impacts—across thousands of miles. Scientists are still learning about the health impacts of prolonged exposure to wildfire smoke. Children can suffer from asthma complications, pneumonia, and bronchitis, and research has shown increased emergency room visits and hospital admissions for children both during and after a wildfire. Exposure to wildfire smoke in utero has also been linked to low birth weight and preterm births.

wildfire smoke over a highway with city skyline in background

What you can do: 

  • Visit for real-time local air quality updates and email alerts for your ZIP code.
  • Reduce your child’s exposure to smoky conditions by avoiding physical activity outside when wildfires are nearby.
  • Consider purchasing a portable air cleaner or high-efficiency HVAC system filter to improve indoor air quality. Choose one that fits your room size and ensure that it does not produce ozone.
  • Keep your child’s inhaler and other quick-relief asthma medicine with you.

Insect-borne Diseases

The most common insect-borne diseases are spread by fleas, ticks, and mosquitoes. These diseases include Lyme disease, Dengue fever, West Nile virus, and Rocky Mountain spotted fever. As the climate becomes warmer, these insects are able to expand their ranges, potentially exposing more people to infection. Children are more susceptible to insect bites because they generally spend more time outdoors than adults and are dependent upon adults to take preventative measures. 

 Mosquito aedes aegypti, transmissor de vírus

What you can do: 

Learn More About Children’s Environmental Health

It is important for all of us to understand how climate change can impact the health of our families. To call greater attention to the issue, the ​​New England Journal of Medicine group of journals plans to publish at least one article per month related to fossil fuel–driven health impacts.

It is also important to understand that people are impacted by climate change in different ways. All children are at risk from air pollution and climate change, but there are disparities. In the US, children in economically disadvantaged and certain racial and ethnic groups, such as Black and Hispanic children, are disproportionately impacted by the effects of climate change. 

Healthcare professionals can help families minimize environmental health hazards. NEEF’s 2021 Children’s Environmental Health Series examined current social justice and environmental health issues and provided best practices for engaging disadvantaged populations who are disproportionately impacted by environmental factors. You can watch the recorded events and access the resources featured in the Children’s Environmental Health Series on our website.

Medical and public health professionals should review NEEF’s Pediatric Asthma Initiative featuring CDC's EXHALE technical strategies for more information about asthma care and management, including a free, accredited eLearning course developed to help pediatric healthcare providers and clinicians manage environmental asthma triggers and intervention strategies.

Using Nature to Improve Mental Health and Well-being

Remember that access to the outdoors remains important for physical and mental health. There are many ways to safely get outside and enjoy the positive effects of spending time in nature. 

In September 2022, NEEF and the US Forest Service hosted a webinar, “Using Nature to Improve Mental Health and Well-Being,” to share strategies for how healthcare professionals, outdoor interpretive and volunteer staff, and community organizations can use nature as a tool for promoting wellness, resilience, and recovery to their patients and community. You can view a recording of the event, as well as access the resources featured in the presentation, on our website.