Chapter 14: North America
Executive Summary
Since AR5, climate-change impacts have become more frequent, intense and have affected many millions of people from every region and sector across North America (Canada, USA and Mexico). Accelerating climate-change hazards pose significant risks to the well-being of North American populations and the natural, managed and human systems on which they depend (high confidence1 ). Addressing these risks has been made more urgent by delays due to misinformation about climate science that has sowed uncertainty and impeded recognition of risk (high confidence). {14.2, 14.3}
Without limiting warming to 1.5°C, key risks to North America are expected to intensify rapidly by mid-century (high confidence). These risks will result in irreversible changes to ecosystems, mounting damages to infrastructure and housing, stress on economic sectors, disruption of livelihoods, and issues with mental and physical health, leisure and safety. Immediate, widespread and coordinated implementation of adaptation measures aimed at reducing risks and focused on equity have the greatest potential to maintain and improve the quality of life for North Americans, ensure sustainable livelihoods and protect the long-term biodiversity, and ecological and economic productivity, in North America (high confidence). Enhanced sharing of resources and tools for adaptation across economic, social, cultural and national entities enables more effective short- and long-term responses to climate change. {14.2, 14.4, 14.5, 14.6, 14.7}
Past and Current Impacts and Adaptation
Climate change has negatively impacted human health and wellbeing in North America (very high confidence). High temperatures have increased mortality and morbidity (very high confidence), with impacts that vary by age, gender, location and socioeconomic conditions (very high confidence). Changes in temperature and precipitation have increased risk of vector-borne (very high confidence), water-borne (high confidence) and food-borne diseases (very high confidence). Changes in climate and extreme events have been linked to wideranging negative mental health outcomes (high confidence). The loss of access to marine and terrestrial sources of protein has impacted the nutrition of subsistence-dependent communities across North America (high confidence). Climate change has increased the extent of warmer and drier conditions favourable for wildfires (medium confidence) that increase respiratory distress from smoke (very high confidence). {14.5.2, 14.5.6, Box 14.2}
14.5 Observed Impacts, Projected Risks and Adaptation by Sector
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14.5.6 Health and Well-being
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14.5.6.1 Heat-Related Mortality and Morbidity
High temperatures currently increase mortality and morbidity in North America (very high confidence), with impacts that vary by age, gender, location and socioeconomic factors (very high confidence). Observed increases in heat-related mortality have been attributed to climate change in North America (Vicedo-Cabrera et al., 2021). Temperature effects on health vary based on how unusual the temperature is for that time and location (medium evidence, high agreement), highlighting the important role that temperature extremes and variability play in mortality and morbidity (Li et al., 2013; Lee et al., 2014; Barreca et al., 2016; Allen and Sheridan, 2018). Adaptation has played an important role in reducing observed heat-related deaths (Vicedo-Cabrera et al., 2018b).
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14.5.6.3 Wildfire-Related Morbidity
Smoke from intensified wildfire activity in North America is associated with respiratory distress (very high confidence), and persists long distances from the wildfire and beyond the initial high-exposure time (see Box 14.2; Hutchinson et al., 2018). Exposure to wildfire smoke increases hospital admissions (McLean et al., 2015; Alman et al., 2016; Reid et al., 2016; Yao et al., 2016; Rojas-Downing et al., 2017). Increased wildfire smoke from climate change is projected to result in more respiratory hospital admissions in the western USA by 2046– 2051 (A1B) (Liu et al., 2016; Rojas-Downing et al., 2017).
The magnitude of health risks varies by age (Le et al., 2014; Reid et al., 2016; Liu et al., 2017a; Liu et al., 2017b), gender (Delfino et al., 2009; Rojas-Downing et al., 2017), socioeconomic conditions (Henderson et al., 2011; Rappold et al., 2012; Reid et al., 2016) and underlying medical conditions (Liu et al., 2015). The intersectionality of these subgroups plays an important role in health-related vulnerability to wildfire smoke. Among the elderly in the western USA, risks of respiratory admissions from wildfire smoke was significantly higher for African American women in lower-education counties (Liu et al., 2017b). For Indigenous Peoples, medical visits for respiratory distress, heart disease and headaches increased during a wildfire in California (Lee et al., 2009). In northern Canada, Indigenous livelihoods were disrupted during a wildfire, which negatively impacted mental, emotional and physical health (Dodd et al., 2018a; Howard et al., 2021).
Figure 14.8 | Pathways through which climate change impacts mental health risk in North America
Please refer to page 1984 to see Figure 14.8, which mentions gender.
14.5.9 Livelihoods
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14.5.9.1 Observed Impacts
Climate impacts have damaged livelihoods across North America, especially those of marginalised people (high confidence) and deepened inequalities for these groups (medium confidence). Across North America, climate change has affected livelihoods with larger effects on individuals, households and communities that are already more vulnerable due to a range of pre-existing social and environmental stressors (Olsson et al., 2014; Hickel, 2017; Koch et al., 2019) such as Indigenous Peoples, urban ethnic minorities and immigrants (Guyot et al., 2006; Gronlund, 2014; Klinenberg, 2015). These impacts have also contributed to a deepening of inequalities for marginalised groups (medium evidence, high agreement) (Audefroy and Cabrera Sánchez, 2017; García et al., 2018). As climate hazards further degrade their livelihoods, these groups have faced additional challenges to avoiding or escaping poverty (Ruiz Meza, 2014). Furthermore, these groups have needed to use their more limited resources to manage present challenges, restricting their future capacities to adapt (TolentinoArévalo et al., 2019). Climate impacts have also affected the livelihoods of the middle classes (Domínguez et al., 2020) who have become more vulnerable due to changes in their social and economic security (GarzaLopez et al., 2018). Gender has also been recognised as a determinant of differential vulnerability with implications for women’s livelihoods (Cross-Chapter Box GENDER in Chapter 18).
14.7 Adaptation in North America
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14.7.2 The Solution Space
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14.7.2.3 Transformational Adaptation and Climate Resilience
Equity and justice in climate adaptation have been identified as providing a foundation for resilience in natural, social and built systems (Cochran et al., 2013; Reckien et al., 2017; Schell et al., 2020). This approach recognises that social vulnerability undermines efforts to increase adaptive capacity and that adaptation may also entrench existing social inequities, such as marginalisation of communities of colour, gender discrimination, legacy effects of colonisation and gentrification of coastal communities (Schell et al., 2020; Thomas, 2020). Thus, identifying systemic racism and the effects of colonialism within and across institutions has also been identified as part of achieving more just and equitable adaptation (Shi and Moser 2021). Acknowledgement and incorporation of IK in adaptation planning and implementation also recognises Indigenous sovereignty issues and the importance of the equitable role of Indigenous selfdetermination in governance and planning (see Box 14.1; Section 14.4; Raymond-Yakoubian and Daniel, 2018).
