The Impact of Blue-Green Infrastructure on Morbidity and Mortality during Extreme Heat

Abstract

ABSTRACT

Background

Extreme heat events are one of the deadliest effects of our changing climate. Blue-green infrastructure aids

with ambient temperature regulation and has an overall positive effect on human health. Studies

documenting the impact of blue-green infrastructure on human health during extreme heat are fragmented

across multiple disciplines, with no current synthesis completed.

Objective

To examine the current evidence regarding the impact of blue-green infrastructures on human morbidity and

mortality during extreme heat.

Methodology

A PubMed literature review search was conducted in June 2024 using 13 common terms to describe blue-green

infrastructure, five terms for extreme heat, plus health. Included studies evaluated a blue-green infrastructure

variable and health outcome during measured extreme heat. Non-in situ human research was excluded.

Synthesization was conducted using an ecosystems service theoretical framework.

Results

The PubMed search terms yielded 145 articles, 124 did not meet the necessary criteria, and 21 were synthesized.

Sixty-seven percent showed a statistically significant (p-values 0.001 to 0.05) direct association between blue

green infrastructure presence and health outcomes during extreme heat. Mortality rate and mental health were

studied most frequently. An additional 19% of studies found similar statistically nonsignificant trends. Three

studies found no consistent interaction

Conclusion

Blue-green infrastructure may play a critical protective role for human health during extreme heat.

Public health implications

Blue-green infrastructure is an economically accessible and sustainable method of mitigating many of the effects

of climate change, including water management and lowered surface temperatures. While its impact on health is

likely multifactorial, its protective role on morbidity and other health outcomes during heat waves should be

embraced as a viable part of future public health climate resiliency plans.