Counting children out: we are underestimating the health impacts of climate change without birth cohort studies

Abstract The majority of physical and mental health conditions have their origin during childhood. It is also well-established that children face unique vulnerability to environmental stressors. Climate change will make extreme heat, wildfires and flooding more frequent throughout Europe, and worsen biodiversity loss, with implications for children’s health, wellbeing, and education. However, most studies of the health impact of climate change, and associated adaptation and mitigation policies, rely on all-age mortality as an outcome, masking child-specific and life-course impacts of one of the major global public health threats of our time. We argue for a combined-birth cohort approach to climate and child health research: leveraging recruited birth cohorts for mechanistic insights and administrative data-based birth cohorts for national-level analyses, including among smaller, vulnerable groups. Innovative uses of these complementary, longitudinal data resources enable robust, policy-relevant evidence relevant to pregnant women, children and across the life course. This will make climate change’s full impact on pregnant women, children and adolescents visible, simultaneously addressing an urgent scientific need as well as intergenerational equity concerns.