Rapid urban growth and accelerating climate change are reshaping the environmental, social, and health conditions of cities worldwide. While contemporary research identifies the environmental impacts of urbanization and the public health risks of climate change, few studies holistically explore the systemic, reinforcing feedbacks that bind the two together. This review presents a systems-based analysis of the “urban climate stress nexus,” emphasizing how land conversion, energy-intensive development, ecosystem degradation, social inequity, and policy cycles interact to drive both environmental instability and declining urban health. Drawing on conceptual system-dynamics frameworks and global empirical evidence, the review demonstrates how urban design, transport infrastructures, governance structures, and community behavior form self-reinforcing loops that amplify climate risks such as urban heat islands, air pollution, water stress, and extreme weather vulnerability. In turn, these environmental pressures disproportionately intensify disease burdens, mental stress, mortality, and social inequality, particularly among marginalized populations. The review also highlights how strategic leverage points, including information flow, adaptive governance, urban green infrastructure, and socio-technological reorganization, can interrupt harmful feedback loops and promote climate-resilient, health-enhancing cities. By integrating complex-systems thinking with global observations, this article provides a comprehensive framework for understanding the dual evolution of urbanization and climate risk, offering future policy, research, and planning directions for building sustainable, equitable, and adaptable urban environments.
Ambreen Ilyas (Fri,) studied this question.