In 2024, Yang Xuehong hired an air conditioner technician and advertised their services for free in Zhuhai, a rapidly growing coastal city near Hong Kong.
Armed with a questionnaire on climate risks, she then accompanied them house to house, conducting informal interviews with residents as the technician worked. People kept telling Yang that their arthritis would flare up during stormy weather.
She had encountered in her own community a symptom of climate change showing up all around the world.
“We don’t stick too rigidly to the questionnaire,” explains Yang, founder of the Zhuhai Root, Stem and Leaf Environmental Protection Promotion Centre. “We just go with the flow of the conversation.”
Her small non-profit had initially focussed on promoting low-carbon lifestyle. But in 2024 it started to focus on local adaptation to the changing climate. Arthritis initially struck Yang as a mobility concern. Could residents evacuate if a typhoon made it necessary? But she soon learned it was a broader, quality-of-life issue too.
She requested diagnostic records from the community health station and they revealed a significant upward trend in hospital visits for arthritis since 2020, the year the archive begins. Yang’s team started to classify arthritis as a “climate-sensitive condition”.
Community members, she found, were unlikely to draw the connection between their pain and a global issue like climate change. “They know rain triggers their pain. They know this pain is linked to weather changes.” But, she says, they rarely asked bigger questions like: “Why is the climate changing? How does this relate to me? What changes will it bring to my life? To my body?”
Asking such questions is an important step for communities to understand climate change, Yang believes.
Climate change is amplifying non-infectious diseases
Answering them is not simple. Recent research has revealed profound links between the health of people and our environment under the stress of climate change. Though its role in the spread of infectious diseases is widely recognised, studies are also tying it to non-infectious inflammatory disorders like arthritis.
One found a 14% global increase in arthritis between 1990 and 2020, listing climate change alongside diet and stress as major factors.
A number of meta-analyses and review articles over the past few years have also found climate change involved in the growing prevalence of allergic diseases and immune-mediated diseases such as asthma. The work has been done by multinational teams of health scientists collating research from around the world.
Well aligned on the solutions the research suggests, they consistently call for cutting of fossil fuel emissions and provision of stronger funding for climate adaptation, especially in the Global South.
Arthritis is among a number of chronic inflammatory disorders “increasing in parallel at an epidemic rate”, says Ioana Agache, a professor of allergy and clinical immunology at Transylvania University in Brasov, Romania.
Also on the rise are allergies, asthma, allergic rhinitis, metabolic disorders like diabetes and obesity, chronic inflammatory bowel diseases, neurological diseases such as Alzheimer’s, mental health disorders and cancers, she says.
Agache told Dialogue Earth that these conditions are all associated with a number of common factors: systemic microinflammation; a dysregulated immune-system response and microbiome; and defects in the function of our skin, gut, nose or lungs – which together form the transmissible barrier between our bodies and our environments.
Researchers have identified a second “major wave” of chronic inflammatory disorders, starting in the 2000s, says Agache. This coincides with increased “climate-change-derived aggressors” such as extreme weather events and wildfires. It also correlates with new pathogens and the increasing presence of microplastics and nanoparticles, Agache adds.
The first wave had been identified in the 1970s, says Agache, coinciding with the introduction of certain cleaning agents, outdoor pollution, fast foods and cosmetics with certain additives.
Climate action plans fail to address the latest research
Last November, several civil society health networks attended the COP30 climate conference in Brazil. Representing health organisations from different countries, they called for lower emissions and more funding for climate adaptation, especially in the Global South, where climate impacts are more intense and countries have fewer resources to adapt. But the conference had no dedicated negotiation track for health issues.
The body which runs climate COPs, the UN Framework Convention on Climate Change (UNFCCC), does however require countries to consider health impacts when preparing the national adaptation plans they submit to it.
Meanwhile the UNFCCC and World Health Organization (WHO), with whom the UNFCCC has increasingly partnered over the last several years, both encourage countries to voluntarily develop health national adaptation plans.
By May 2025, only 27 countries had made such plans, according to a WHO analysis. And of the 59 that had submitted national adaptation plans, “noncommunicable diseases” were among the two “least mentioned risks”, demonstrating less focus in adaptation planning. The most frequently mentioned risks were extreme weather events, and vector- and water-borne diseases.
“Prioritising mitigation and adaptation measures for noncommunicable diseases is a huge unmet need,” says Agache.
China as a case study
In China, the 2025 Lancet Countdown Report found that funding gaps significantly impacted local execution of health-adaptation planning: 77% of provinces reported a lack of multisectoral coordination; 67% cited insufficient funding; and 53% faced gaps in surveillance systems and risk-assessment technologies, such as weather monitors or tools to analyse weather data.
Overall, China’s adaptation planning would benefit from “upstream” strategies, said Lu Hui, deputy chief physician of a public hospital in Guangdong province, during a public talk. Such strategies would create preventative, systemic interventions that address the source of health impacts. They could include public health education to reduce vulnerable populations’ exposure to heatwaves, rather than treating their “downstream” consequences.
Lu discussed interventions as simple as communicating with elderly people that they are more likely to get heatstroke if they don’t use air conditioning in summer, even if they haven’t needed it before. A focus on responding to the “downstream” impacts often results in “half the result with twice the effort”, according to Lu.
China’s National Climate Adaptation Strategy 2035 gestures towards the importance of addressing these challenges. It outlines the need to improve analysis and assessment of “the complexity, wide scope, and far-reaching nature of direct and indirect threats of climate change to natural ecosystems and socio-economic systems”, as well as to incorporate climate adaptation at the local level.
The National Climate Health Adaptation Plan (2024-2030) also lists “proactive adaptation” as a priority, which suggests a need for the “upstream” strategies mentioned by Lu.
Around China, local groups like Yang’s are increasingly addressing the impacts of climate change on their communities. Yang says she corresponds regularly with other researchers. And the questionnaire she created was based off an IPCC climate risk framework and community-led response materials. But issues like noncommunicable diseases are rarely included in such materials.
“I don’t really look at research papers,” she said. “My own climate risk assessments, aside from following this framework, are largely based on my lived experience in this community.”
