The Impacts of Extreme Weather Events on Health Systems: An Overview of Reviews

Introduction: Extreme weather events (EWEs) have devastating impacts on populations, ecosystems, and critical infrastructure. While their effects on health have been extensively studied, their impacts on the health system are less understood. This study aims to investigate the impacts of heatwaves, cold spells, floods, landslides, and wildfires on the health system, focusing on changes in system performance, alterations in patient flows, and disruptions to infrastructure. Methods: A systematic review of reviews was conducted using PubMed, Scopus, and Web of Science databases. The search string was developed by combining keywords with Boolean operators. Eligible studies include narrative and systematic reviews (with or without meta-analysis) that address the impacts of selected EWEs on the health system. Only studies published in the last 10 years with full texts available online were included. Results: Of 2108 retrieved reviews, 668 duplicates were removed, 1286 were excluded after title and abstract screening, and 40 were excluded after full-text assessment, resulting in 114 included reviews. The impacts were categorized by type of event and by the affected health system component–e.g., pre-hospital, hospital (emergency pathway, medical and surgical pathway, outpatient pathway, and day hospital), primary care and elderly care, pharmacies, and public health. The impacts concern infrastructure and equipment, care accessibility, quality, service utilization, surge capacity, and resource availability. Conclusion: The results of this study provide insights into the expected impacts of EWEs on the health system and suggest actions to enhance preparedness. Full authorship: Valente Martina, Del Prete Clara, Facci Giulia, Cenati Stefano, Musso Francesco, Calligaro Sara, Ragazzoni Luca, Francesco Barone-Adesi This study is conducted within the Horizon Europe project MOUNTADAPT, co-funded by the EU. Views and opinions expressed are, however, those of the author(s) only and do not necessarily reflect those of the EU or CINEA. Neither the EU nor the granting authority can be held responsible for them.