Source: The Conversation – UK
The health risks men and women are exposed to and the illnesses they develop vary widely across lifetimes and places. Yet climate policy and health services often overlook these differences.
Some of these differences are stark. For example, more women than men die from being exposed to the smoke of cooking fires, but for most of adult life a man is more likely to die from this exposure than a woman of the same age. In Europe, studies of individual heatwaves have found women to be at higher risk of heat-related death.
In Latin America and the Caribbean though, men die from heat-related causes at nearly twice the rate that women do, according to the Global Burden of Disease study. Coordinated by the Institute for Health Metrics and Evaluation, this study is the largest systematic effort ever made to count what kills people and what makes them ill, producing comparable estimates of deaths, disease and disability for every country, by age and sex, every year since 1990.
Despite these inequities, the monitoring systems that track climate change and its effects on health fail to capture the full picture. Much of the data is categorised by gender when collected, but when the data is transferred to the monitoring systems, the experiences of women and men are merged into a single total. As a result, the decision-making that informs climate policy and health systems is underpinned by data that is oversimplified.
We have just audited four of those systems: the Belém Adaptation Indicators agreed at last year’s UN climate summit in Brazil, the World Health Organization’s survey of health ministries, a scorecard that grades countries’ climate plans on health and the Lancet Countdown, an annual scientific stock take. Of the 45 indicators from across these four reports that measure people’s lives (rather than tracking systems or plans), only one reports results separately for women and men.
All four reports draw on surveys and death registers that are often separated by sex, then published as one merged figure. That total is what reaches the people who decide what counts as progress and where the money goes.
That might be a philanthropic funder choosing which programmes to back, a government filling in the UN’s new adaptation scorecard in the only format its definitions allow, or the negotiators who will use those scorecards to judge whether the world is adapting in 2028 at Cop33.
At the UN climate summit Cop31, currently underway in Antalya, Turkey, we have an opportunity to change what gets reported in the future about how climate affects men and women’s health.
Why one number misleads
Sex and gender shape climate risk. Data is often reported by sex but then differences are explained by a combination of sex and gender (social roles, norms, structures). The biological makeup of human bodies affects how they physiologically respond differently to heat and smoke. Pregnancy brings additional risks.
The gendered norms of daily life put women and men in different places and situations: who works on a building site in 40°C heat, who cooks indoors over wood, who can get to a clinic.
It is easy to assume that women bear the greater risk. Often they do, but only accurately categorised data can tell us if that is always the case.
Women are more exposed to smoke from cooking stoves, for example, and it claims a larger share of their overall ill health, yet it kills more men. This is because men often reach midlife with hearts and lungs already damaged by a range of factors such as smoking and by the dust, fumes and diesel exhaust of working in mines, on building sites, farms and near traffic, so a smaller exposure to cooking smoke does greater damage.
The point is not to pit the sexes against each other. Knowing why they differ, whether through exposure, susceptibility or access to cooling, transport or care, tells you where to intervene. A single total hides all of that nuance.
We assessed a total of 211 indicators based on whether they reveal whether women and men are affected differently. Only the Lancet Countdown’s count of outdoor workers does. Of the 166 indicators that measure plans, systems and environments, only five mention sex or gender in some way.
A publishing decision, not a data gap
For much of this gap, the data already exists. The Lancet Countdown’s own methods appendix shows that three of its indicators use data split by sex and then merge it before publication. The Belém indicators that count people will draw on household surveys, death registers and workforce records, which routinely report by sex. These could be published by sex in the next reporting cycle with little or no new data collection.
Where the data is really missing or scattered, filling the gap costs money, and that is where climate and health funders could make the most difference.
The Belém indicators are the UN’s new yardstick for whether countries are adapting to climate change, but the details of each indicator remain to be written.
Decisions still need to be made at the global level on what each indicator measures, which data sources they use, and whether results are broken down by groups such as women and men. These detailed definitions, the output of a technical working group, are due to be agreed in November 2027.
Countries will then build their reporting systems around them. The record so far is not encouraging. Of the 16 expert proposals for health indicators circulated in May 2025, three asked for results by sex. By September 2025 there was one. The eight adopted at Cop30 in November 2025 include none.
The technical group was due to be formed in June 2026, but governments could not agree who should sit on it, so the decision returns to Cop31. If it includes people who know how to produce statistics by sex, and if reporting by sex becomes the default wherever the source data already have it, the next decade of climate adaptation can show who it reached – and who is being left behind.
We will repeat our audit as each framework updates. This means that governments will know whether their adaptation is reaching men and women equitably according to need. Funders will know whether their money is.
Kent Buse is Co-CEO of Global 50/50 whose report is mentioned in this piece. He is also an unpaid board member and trustee of the World Obesity Federation. Global 50/50 is funded by the Gates Foundation.
Sarah Hawkes is Co-CEO of Global 50/50 whose report is mentioned in this piece. Global 50/50 is funded by the Gates Foundation.