Page - 418 - in Biodiversity and Health in the Face of Climate Change

418 social-ecological-technological systems. Comprehensively acknowledging the value of ecosystem services, incorporating them into urban planning practices for climate change impacts, and institutionalizing this process can help us achieve this end goal. 18.3 Climate Change, Urban Ecosystems and  Health Despite the fact that “…human health is better now than at any time in history…” (Haines 2018), this progress has come at social and environmental costs such as increasing inequality, increasing energy use and related greenhouse gas emissions, soil degradation, biodiversity loss and severe water stress. Together with increasing urban population pressures, this mixture can become a backlash to what we may perceive as progress in human development. In 2012 approximately 7  million peo- ple died prematurely as a result of exposure to air pollution, making air pollution the world’s largest single environmental health risk. Despite improved availability of health systems and other public services, urban health risks remain: exposure to noise, water and air pollution, diseases related to urban lifestyle, contagious dis- eases connected with crowding (e.g. tuberculosis, sexually transmitted diseases, influenza, and certain rodent- and vector-borne diseases such as dengue fever, etc.), and risks associated with homelessness, violence and inequality. Understanding the complex interactions of climate change, urban system functions and health has been identified as a research priority for cities in the future (Bai et  al. 2018). Climate change will have numerous impacts on human health and well-being in urban environments depending on local conditions and vulnerabilities. The risk of deaths, injuries and epidemics (especially water-, food-, rodent- and vector-borne diseases) from storms, coastal storm surges and floods will increase in disaster- prone areas, exacerbated by damages to important infrastructure and societal ser- vices. Cities are particularly vulnerable to heatwaves since temperatures in certain parts of a city can reach several degrees higher than in surrounding peri-urban and rural areas, due to the so-called urban heat island effect (Zhang et  al. 2017). It has been shown that the risk both of death and of acute episodes of chronic diseases, such as acute respiratory illness, heart attacks and stroke, increases markedly in relation to heat wave events (Michelozzi et  al. 2009). The elderly, persons with chronic cardio-vascular and respiratory diseases, and individuals who have difficul- ties implementing heat-reducing actions during a heat wave are particularly vulner- able, and so are outdoor workers in cities where temperatures may soar during working hours (IPCC 2014; Kovats and Hajat 2008). It is well known that air pollu- tion increases the risks associated with heat, and vice versa, which further increases health risks from heat waves in cities. The urban ecosystem service and urban social-ecological-technological approach have recently developed into several programs exploring the scope and potential of T. Elmqvist et al.