The impacts of climate change and how our societies can cope and better prepare for the threats and risks posed to our health and wellbeing have been key areas of work for the EEA this year. We sat down with three experts, Ine Vandecasteele, Aleksandra Kazmierczak and Eline Vanuytrecht, who have looked specifically at how we can improve our adaptation and build resilience in cities as well as identifying emerging climate health risks posed by floods, droughts and water quality.

What role can cities play to better protect citizens and improve resilience?


Cities have a critical role to play not only in protecting their own citizens, but in ensuring overall, long-term climate resilience and environmental sustainability. The triple crises of climate change, biodiversity loss and pollution are interlinked and reinforcing, and the impacts are even further exacerbated in densely built and densely populated urban areas.

With an increasing number of people living in urban areas, cities have the responsibility and urgency to act, but they also have the potential to be true drivers of change. Cities may be more ambitious than the national level in their climate targets and 51% of Europe’s larger cities now have dedicated local climate action plans also with clear objectives on adaptation.

Ine Vandecasteele
Ine Vandecasteele
Expert on urban adaptation

Cities can tailor adaptation projects to specific local climate impacts and take into account local needs, sensitivity and culture. Community engagement is also recognised as one of the main enablers of successful adaptation, and this is the level of governance at which this is best done. Cities across Europe have highly diverse contexts, capacities and experiences, and are at very different stages of adaptation readiness, but most are already taking some form of action.

Can you mention some good examples of urban adaptation projects?

Adaptation policies and measures aim to increase climate resilience. In urban areas measures may include actions to increase infiltration of excess rainwater, to provide cooling, to avoid construction in high-risk areas, or to inform the population and provide insurance measures and social support networks. Good examples of adaptation projects usually come from cities with sustained political support and funding for adaptation and strong community involvement.

In Poznan, Poland, a natural playground project transforms playgrounds to multi-functional green spaces open to the public and focusing on eco-education and awareness raising on the importance of nature. Similar to the OASIS project in Paris, this allows additional green space to be open to the public to be able to shelter during heatwaves. Another example I can mention is in the city of Gent, in Belgium, which is already limiting new construction of buildings with a ‘net zero’ requirement — so that if a new construction is to be approved, an equal area of the city needs to be unpaved, or converted back to green space.

Will these projects be enough amid growing climate risks to reduce the negative impacts?

Unfortunately no, while they are very important locally, they will only have a limited impact unless massively upscaled and mainstreamed. In the first place, everything possible needs to be done to meet climate mitigation targets, linked with an overhaul of our current unsustainable consumption and production patterns. If this is not done, then climate impacts in the future will far exceed anything manageable with adaptation actions.

For example, 91% of cities include some form of nature-based solutions in their adaptation plans, recognising the many co-benefits of urban green and blue spaces. But, due to the magnitude of current and expected future climate impacts, these actions alone will likely not be enough to significantly reduce negative impacts, even locally. They will still have to be combined with physical infrastructure, as well as efficient early-warning systems and governance and economic measures.

Adaptation can help to reduce local vulnerabilities, but the current rate of uptake of actions will not be enough. While the importance of adaptation is increasingly recognised in Europe, it still needs to be embraced across all sectors and all governance levels to prepare our societies to face current and future climate-related impacts. The involvement of citizen groups and the private sector in enabling more widespread investment in adaptation and maintenance of adaptation projects could prove pivotal. The mainstreaming of adaptation needs, especially across the most affected sectors, such as water and health, would also be a significant step forward.

You can find out more from our recent EEA report ‘Urban adaptation in Europe’ which highlights the urgent need to adapt European cities to climate change and provides an overview of actions they are taking. 

Why should we be concerned about the climate risks posed to our health from floods, droughts and water quality?

Aleksandra Kazmierczak
Aleksandra Kazmierczak
Expert on climate change and human health


Our society is very much exposed to the climate risks such as floods, water scarcity and poor water quality. One in eight Europeans currently live in areas potentially prone to river flooding. While many of those areas have flood defences, the level of security they offer varies. Floods not only result in deaths (nearly 5,600 people lost their lives directly as a result of floods over the last 4 decades) and injuries, and also cause stress, often resulting in post-traumatic stress disorder and longer mental health implications, such as depression, for the people affected.

Floods can also cause pollution: nearly 15% of industrial facilities in Europe are sited in potential riverine flood-prone areas. An estimated 650,000 combined sewer overflows across Europe worsen water quality following heavy rainfall events.

At the same time, permanent water stress already affects 30% of people in southern Europe. Water restrictions and rationing — already in place in some regions — and inevitable price increases as the supplies run dry may affect poorer or larger households’ ability to meet their hygiene needs. In addition, prolonged spells of dry and hot weather facilitate the spread of wildfires; again, mainly in southern Europe, but increasingly in other regions. Wildfires not only pose the direct health risk of flames; being exposed to the harmful chemicals in wildfire smoke has both acute and long-lasting health implications.

The quality of water we drink or swim in, while overall very good, is also at risk. Rising air and water temperatures facilitate pathogen growth, increasing the risk of waterborne diseases. Low flows during dry periods will result in higher concentrations of pollutants and pharmaceuticals, requiring costly wastewater treatment. Further, during dry and hot periods, cyanobacterial blooms in nutrient-rich waters can jeopardise water quality.

Is this a growing problem?

Yes. Climate change is happening here and now. The rainfall patterns are changing and are projected to do so further, with very heavy rainfall events — the main reason for floods — becoming more likely across Europe. Sea levels are rising along most of the European coasts, increasing the magnitudes of coastal floods and increasing the risk of saline intrusions into groundwater aquifers. Droughts and wildfire risk will increase in the future in most of Europe, with southern Europe a particular hotspot.

At the same time, the current patterns of development put more and more people in harm’s way — more than 900,000 people moved into potential flood-prone areas between 2011 and 2021! Droughts are likely to increase competition for scarce water resources among agriculture, industry and public water supply.  

Various risks are emerging in different European regions. Southern and eastern Europe is facing an increasing risk of West Nile virus outbreaks, driven by the changing rainfall patterns improving suitability for the mosquitoes carrying out the virus and making the virus transmission between animals and humans more likely. Rising infectious diseases driven by high water temperatures include vibriosis, contracted through contact with Vibrio bacteria in warm, low-salinity waters, in particular along the Baltic Sea and North Sea coasts.

Other emerging risks to human health include mobilisation of chemicals and potentially pathogens due to permafrost thaw in northern Europe and ciguatera poisoning around Canary Islands, Madeira and in the west Mediterranean.

What are the key actions that could be taken to prevent further health impacts?

Effectively preventing health risks from floods, water scarcity and worsened water quality under the changing climate requires action from multiple actors. To give a couple of examples, the health sector must be better prepared to deal with climate-related problems in the future, through higher resilience of healthcare facilities to extreme weather events; better education and training of healthcare workforce; preparedness to deal with a greater demand for healthcare due to injuries, increased incidence of infectious diseases or mental health problems.

Beyond the health sector, climate-aware spatial planning and resilient built environments are key to reducing people’s exposure to water-related risks under the changing climate. We should avoid new or further development in risk areas and implement nature-based solutions such as constructed wetlands or sustainable drainage systems supporting the natural water cycle. We should also prioritise designing buildings to ensure their resilience to floods, fires and droughts. In the long term, relocation away from floodplains, wildfire-prone areas and water-scarce locations can be considered.

How is the European Climate and Health Observatory working to improve adaptation?


The European Climate and Health Observatory improves our insights into the health threats induced by climate change and potential intervention to respond to those, with the ultimate aim of protecting the health of the European population and making Europe’s health system more resilient. It does that by making knowledge, data and tools on the interplay between climate and health easily accessible.

On the Observatory portal, our stakeholders can find evidence on the health risks imposed by for example heat, droughts and floods, as well as by less evident climate-driven hazards such as landslides or infectious diseases. Data-driven indicators allow us to monitor the evolution of how exposed, vulnerable or impacts our health is by climate change.

Eline Vanuytrecht
Expert — European Climate and Health Observatory

In addition, the portal also provides highly actionable information, for example, forecasts of air pollutants or pollen, map viewers that visualise health risks such as the location of schools or hospitals in flood-risk areas, and case studies of implemented responses to health risks. These resources can inspire climate action and assist in preparing for and responding to health risks. Next to providing access to all these resources on the portal, the Observatory also fosters collaboration and knowledge exchange among relevant actors that have a role in building Europe’s resilience against climate-related health impacts.

How does the Observatory work in practice?

The Observatory is a partnership of several international organisations with expertise and an interest in climate and/or health, which all contribute to developing and making knowledge on climate-health risks and responses accessible. The EEA is managing the Observatory partnership, together with the European Commission. All partners work to realise the objectives included in jointly agreed biannual work plans, which deliver outputs constantly enriching the Observatory portal.

Besides, the EEA regularly publishes reports building on the knowledge in the portal, such as the recent report that brings together insights on how to respond to the risks from floods, droughts and water quality.

How has the Observatory helped to improve adaptation and resilience?

The Observatory resources allow its users to monitor key climate-related health risks and impacts, and inspires their climate action through the examples of effective and inclusive interventions. The Observatory also plays a key role in awareness raising of the climate-health issue and makes the health community and other stakeholders in Europe more climate-literate and better involved in adaptation decision-making.

Based on the Observatory activities, policy makers can integrate adaptation more systematically and consistently in national and sub-national health policies and systems, and public authorities can better anticipate and prevent climate-related threats to health in a timely manner.

What future reports will the EEA produce in this area of work?


One subject that emerges strongly from the adaptation work focused on urban issues and on health, as well as more broadly from European Climate Risk Assessment is the inequality of climate impacts on different parts of our society, and the need for responses that are equitable, taking into account the existing inequalities to ensure the same opportunities and outcomes for all.

In recognition of the importance of ‘just resilience’, EEA will publish a report focused on this subject in 2025. From the health perspective, the EEA, the European Commission and other partners are currently shaping the European Climate and Health Observatory workplan for 2025-26, which will determine the themes to focus on.

We also hear from our stakeholders that the information and knowledge collated in the Observatory portal should be disseminated better to the decision makers at national and sub-national level and health practitioners in the European countries. So, what we are planning to focus on in the immediate future is making sure that the knowledge reaches key actors, contributing to the capacity building on the nexus of climate and health.


We will continue to monitor, assess and highlight important efforts at the subnational level on adaptation, with continuous updates on the EEA’s Climate-ADAPT platform. We will also focus on more regular, short briefings in the future.

A consistent message that emerged from this report was the need to further support small municipalities, which may have fewer financial and technical resources to be able to implement adaptation actions. An upcoming briefing would look at how these municipalities could be better supported, also at EU level.

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