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Title: Extreme climatic events and human biology and health: A primer and opportunities 
for future research 
 
Authors: 
Asher Y. Rosinger1,2,* 
 
Affiliations: 
1Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, USA 
2Department of Anthropology, Pennsylvania State University, University Park, PA, USA 
 
Corresponding Author: 
*Asher Y. Rosinger 
The Pennsylvania State University 
219 Biobehavioral Health Building 
University Park, PA 16802 
814-865-5220 
Email: arosinger@psu.edu 
 
 
Acknowledgment 
I would like to thank William R. Leonard for his helpful feedback on this article. AYR is 
supported by Penn State’s Population Research Institute (NICHD P2CHD041025), National 
Science Foundation award #1852406 and NSF award #1924322. 
 
Conflicts of Interest 
The authors report no conflicts of interest. 
 
Data Availability Statement 
Not applicable. 
 
 
 
This is the author manuscript accepted for publication and has undergone full peer review but has
not been through the copyediting, typesetting, pagination and proofreading process, which may
lead to differences between this version and the Version of Record. Please cite this article as doi:
10.1002/ajhb.23843
This article is protected by copyright. All rights reserved.
http://dx.doi.org/10.1002/ajhb.23843
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Abstract 
 
Extreme climatic events are increasing in frequency, leading to hotter temperatures, flooding, 
droughts, severe storms, and rising oceans. This special issue brings together a collection of 
seven articles that describe the impacts of extreme climatic events on a diverse set of human 
biology and health outcomes. The first two articles cover extreme temperatures extending from 
extreme heat to cold and changes in winter weather and the respective implications for adverse 
health events, human environmental limits, well-being, and human adaptability. Next, two 
articles cover the effects of exposures to extreme storms through an examination of hurricanes 
and cyclones on stress and birth outcomes. The following two articles describe the effects of 
extreme flooding events on livelihoods, nutrition, water and food insecurity, diarrheal and 
respiratory health, and stress. The last article examines the effects of drought on diet and food 
insecurity. Following a brief review of each extreme climatic event and articles covered in this 
special issue, I discuss future research opportunities–highlighting domains of climate change and 
specific research questions that are ripe for biological anthropologists to investigate. I close with 
a description of interdisciplinary methods to assess climate exposures and human biology 
outcomes to aid the investigation of the defining question of our time – how will climate change 
affect human biology and health. Climate change is a water, food, and health problem. Human 
biologists offer a unique perspective for a combination of theoretical, methodological, and 
applied reasons and thus are in prime position to contribute to this critical research agenda. 
 
Keywords: Climate change; human biology; stress; food insecurity; water insecurity 
 
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1. Introduction 
The picture painted by climate change is reminiscent of an apocalyptic science fiction movie. 
Hotter days and heatwaves, more frequent extreme weather and rainfall, drought, rising oceans, 
salinization of soil and drinking water, and less food and freshwater (Pörtner et al., 2022). Each 
aspect of climate change carries with it distinct, yet interconnected implications for multiple 
aspects of human biology, health, and disease risk (Ebi et al., 2021; Jay et al., 2021; Joshua et al., 
2021; Metts, 2008; Rakib et al., 2019; Raymond et al., 2020; Romanello et al., 2022; Rosinger, 
2018; Rosinger & Young, 2020). For an exhaustive overview, see the 2022 Intergovernmental 
Panel on Climate Change (IPCC) 6th Assessment Report (Pörtner et al., 2022). 
 
One need only look at the cascade of historic climatic examples during the summer and fall of 
2022 to witness such extreme climatic events. Multiple locations in different continents 
experienced the hottest temperatures ever recorded, including in Pakistan where the daytime 
temperature eclipsed 50° Celsius. The Western United States (U.S.) suffered extreme heat, 
including an infamous “heat dome” coupled with the worst drought in 1200 years (Williams et 
al., 2022). This drought has resulted in the Colorado River, underground aquifers, and lakes 
dipping to dangerously low levels, including Lake Mead which provides drinking water to 25 
million people (Hannoun et al., 2022). The implications of drought reduce both water availability 
and remaining water quality – severely stressing socio-ecological systems and jeopardizing 
human health. Across the Greater Horn of Africa, in Somalia, Ethiopia, and Northern Kenya, 
four consecutive below average rainy seasons have brought the worst drought in 40 years 
resulting in the deaths of hundreds of thousands of livestock and severe famine and food 
insecurity and water insecurity for tens of millions (WHO, 2022). In Western Europe, a trend of 
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extreme heat and prolonged drought (van der Wiel et al., 2022) re-emerged in August 2022, 
resulting in a severe heat wave and wildfires in Portugal. 
 
Moving into late summer, several sites suffered 1000-year rainfall events. Most notably, the 
country of Pakistan suffered such an intense monsoon rainfall that more than two-thirds of their 
districts were affected. One-third of their country was flooded, which resulted in the deaths of 
>1500 individuals, the destruction of >1,000,000 homes, and displacement of fifty million 
people (Sarkar, 2022). In the US, severe flooding hit Eastern Kentucky and St. Louis, leading to 
death and havoc on their infrastructure, and brought national emergencies. In Jackson, 
Mississippi, a city that was already dealing with severe water infrastructural problems and had a 
boil water advisory for the prior month, flooding yielded their water systems unusable as either 
raw water was pushed through the pipes or no water flowed at all. A national emergency was 
declared due to lack of access to drinking water – including bottled water. Additionally, residents 
were unable to shower or flush toilets, further affecting sanitation and risk of disease. The 
situation in Jackson is particularly important to highlight as it was the product of a climatic and 
social disaster – the syndemic (or synergistic epidemic) of what happens when flooding hits a 
town that is 80% black dealing with structural racism and lack of investment in the water supply 
for a town (Nwanaji-Enwerem & Casey, 2022). 
 
In the fall of 2022, two category 4 Hurricanes, Fiona and Ian, created catastrophic damage, 
hitting Puerto Rico, islands in the Caribbean, and the Southeastern United States, and in the case 
of Fiona reaching as far north as Canada. These severe storms served as a reminder that 
populations living in coastal environments suffer disproportionately to severe storms and 
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flooding and the stress associated with the fragility of energy, water, and food services. 
Hurricane Fiona brought damage to places in Puerto Rico that were still recovering from a major 
2017 Hurricane, Maria, that devastated power and water systems on the island (McSorley, 2022; 
Roque et al., 2021). Further, Hurricane Ian was the deadliest in Florida since 1935. 
 
There is not enough space to discuss all of the extreme weather disasters that occurred in 2022. 
Yet all of these extreme climatic events occurred over the span of only a few months, which 
illustrates that the future painted by climate change is already a reality and impossible to deny. 
The fact that so many 1 in 1000 year events are occurring with respect to rainfall, drought, 
floods, and storms, tells us that perhaps we need to a recalibrate those models and projections to 
better match our new reality (Kent et al., 2022). 
 
For readers interested in a deep dive on adaptation and behavioral strategies to cope with climate 
change, please see the 2021 special issue of American Journal of Human Biology. In that issue, 
evolutionary and biological anthropologists as well as archeologists discuss how biological 
adaptation varies from large scale adaptation measures to mitigate climate change (Anne C. Pisor 
& James H. Jones, 2021). 
 
The current special issue, in contrast, aims to examine the toll that extreme climatic events have 
on human biology. This explicit focus on extreme climatic events can provide an understanding 
of what is to come under varying climate futures with respect to the impacts on health and 
human biology. It also broadens our understanding of the limits of human adaptability to 
mitigate these intense physiological and psychosocial stressors imposed by climate change. 
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Human biologists are primed to contribute to this field owing to the breadth of theoretical 
insights of human adaptability, developmental origins of health and disease (DOHaD) and 
plasticity, biocultural analyses, and intergenerational transmission of health. 
 
The current special issue features seven exciting papers that address five of the most important 
extreme climatic events posed by climate change: 1) Extreme Heat, 2) extreme cold and icing in 
the arctic, 3) hurricanes and cyclones, 4) historic flooding, and 5) severe drought. These articles 
delve into how these different extreme weather events affect dimensions of human biology, 
including risk of disease, food insecurity, water insecurity, stress, birth outcomes, well-being, 
nutrition, growth, and chronic disease. They do so by employing a variety of methods, including 
literature reviews, retrospective analyses with biomarkers, and longitudinal and time-series 
analyses. They also examine the aftereffects of these severe climatic events to provide insight 
into the recovery process from these events. 
 
2. Extreme climatic events covered in this special issue 
2.1 Extreme heat 
Most synonymous with climate change is global warming. Earth is currently on pace to surpass 
the 1.5° C rise from pre-industrial levels which scientists, the United Nations (Programme, 
2022), and the Intergovernmental Panel on Climate Change (IPCC) project will to lead to 
catastrophic changes in climate (Pörtner et al., 2022). A shifting of the global temperature to 
hotter temperatures not only leads to changes in vector range and impacts on infectious diseases, 
but it leads to greater risk of heatwaves, which are deadly, particularly to the elderly, children, 
and those pregnant (Jay et al., 2021). Extreme heat is dangerous to health through reduced ability 
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to thermoregulate, increased cardiovascular load, and dehydration (Ebi et al., 2021). Extreme 
heat is dangerous to both humans as well as many land animals, which die during heat waves. 
For example, in Australia during heat waves, koalas, ring-tail possums, and birds all died due to 
loss of body water from active cooling and the inability to replenish that water (Turner, 2020). 
Ringtail possums, similar to other terrestrial animals, in Australia rely on adaptations to deal with 
heat like facultative hyperthermia – i.e., increasing their body temperature to maintain an 
elevated body temperature relative to ambient temperature. In this way, they are able to improve 
the efficiency of their water economy to conserve body water (Turner, 2020), similar to birds 
(Gerson et al., 2019). Prior work by human biologists has demonstrated the connection between 
ambient heat, thermoregulation, and human water needs, by examining how lifestyle and 
environmental changes may modify water needs, thirst perception, risk of dehydration 
(Bethancourt et al., 2021; Rosinger, 2015; Rosinger et al., 2022), as well as other 
cardiometabolic health risks like obesity (Gildner & Levy, 2021; Pontzer, 2021). 
 
In this issue, Wolf, Vecillio, and Kenney (2023) provide an updated review of the literature to 
examine how extreme heat affects adverse-health events and human environmental age 
thresholds to extreme heat. They highlight the relations between extreme heat on morbidity and 
mortality, including kidney failure, heart attacks, stroke, hospital admissions, circulatory and 
respiratory mortality, and all-cause mortality. They demonstrate that the human limits to heat 
stress are lower (i.e., ~32° C) than the previously believed threshold of 35° C for wet bulb 
temperature. This finding has large-scale implications for human adaptability in hotter and more 
humid settings. They highlight the experimental procedures, including heat chambers and 
psychometric charts to better understand these limits (Wolf et al., 2023). Further, they discuss 
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how global demographic patterns of an aging population will play into this dilemma, as those 
aged 65 and over are at greatest risk of mortality from heat stress. These findings are critical and 
help us understand at what ambient conditions risk from hotter temperatures and heatwaves is 
greatest. 
 
2.2 Changes in extreme cold and icing 
While extreme cold does not get the same attention as extreme heat in climate change research, it 
is important to understand how changes in historically cold regions with high snow and ice affect 
health and well-being of populations (Steegmann Jr., 2007). When regions that were previously 
frozen and hard-to-reach become warmer, an influx of people and economic exploration – often 
from the fossil fuel industry – can lead to ecosystem and diseaserisk changes (Snodgrass, 2013). 
Look no further than the permafrost thawing in the arctic and its potential implications for 
anthrax transmission and exposure to other viruses and microbes (Stella et al., 2020; Wu et al., 
2022). It is the well-being and health of indigenous populations living in these regions who will 
be most affected. Anthropologists have previously shed light on how changes in cold weather 
and climate change are interlinked with changing food systems, technology, and physical activity 
levels, which have implications for food insecurity, metabolic health, chronic health, and birth 
outcomes (Egeland et al., 2011; Leonard et al., 2002; Ocobock & Niclou, 2022; Snodgrass, 2013; 
Snodgrass et al., 2005; Sorensen et al., 2009; Young & Mäkinen, 2010). 
 
In this issue, Ocobock and colleagues provide a review of the impact of cold and changes in 
winter weather events on health and wellbeing among reindeer herders focusing on Finland as a 
case study for understanding changes in a rapidly changing Arctic (Ocobock et al., 2023). They 
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focus specifically on what happens when snowfall patterns deviate from historic norms. When 
snowfall and ice-cover arrive later, this has implications for herders’ livelihood and behavioral 
strategies, which can put them at risk. In these types of ecosystems, especially where livelihood 
is intimately connected to the environment, it is critical to examine how changes in cold, snow, 
and ice affect the weight and health of reindeer themselves because this creates feedback loops to 
human food security and well-being. Further, changes in technology, like use of snowmobiles or 
all-terrain vehicles, affect exposure to wind and can increase frostbite. Ultimately, climate 
change will have a cascade of effects on the ecosystems and health of individuals living in these 
arctic environments. Clearly, more work is needed for a deeper understanding of changes in 
exposures and human biology outcomes in these environments. 
 
2.3 Extreme storms: Hurricanes and Cyclones and stress 
Hotter global and water temperatures lead to more frequent and more intense storm events, like 
hurricanes and cyclones (Pörtner et al., 2022). These severe storms are not only detrimental to 
immediate health through the risk of injury, death, property loss, and heightened distress (Pomer 
et al., 2019), but they can also have long-term negative health implications. Stress is a key 
mechanism for investigating the often-invisible effects of these events. Recent work by 
biological anthropologists have shed a light on the damaging impacts of severe storm events on 
body systems in model organisms. An elegant example is a recent study of Cayo Santiago 
monkeys in Puerto Rico who experienced Hurricane Maria in 2017. They found that the rhesus 
macaques who were exposed to the hurricane compared to those who were not experienced a 4% 
change in gene expression tied to aging-related genes and cellular aging of nearly two additional 
years, the equivalent of 7-8 additional human years (Watowich et al., 2022). Understanding the 
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mechanisms linking the impact of hurricanes and cyclones in terms of stress, as well as the 
modifying social factors are critical to understand. This is particularly true for vulnerable groups, 
like pregnant women and their fetuses who are most susceptible to these stress events (Horan et 
al., 2022). 
 
In the special issue, we have two papers that tackle the role of stress among pregnant women 
who experienced hurricanes/cyclones. The first article, by Howells and colleagues (2023) 
examines chronic stress during and after Hurricane Florence in Wilmington, North Carolina in 
2018. They use a retrospective biomarker of chronic stress, hair cortisol concentration, to 
investigate stress both during and 3-4 months after the hurricane in concert with other life risk 
factors. They find that social support, through marriage status, is protective of heightened 
chronic stress both during and after the hurricane. Unmarried women may face additional 
compounding stressors, like lower resource support, that place them at greater risk to navigate 
extreme climatic events and during the aftereffects. These findings are important because they 
shed light on how pregnant people may experience stress and how that affects the fetus – with 
implications for birth outcomes 
 
Second, Parayiwa and colleagues (2023) tackle the question of how severe storms affect birth 
outcomes of pregnant women who experience these shocks. They test this question using two 
category 5 cyclones – one in 2011 and one in 2015 – using robust quantitative methodology of 
interrupted time series analysis. This paper provides a nice model of how climatic data, extreme 
events, and hospital record data can be merged to examine the effects of severe storms. In 
contrast with their hypotheses, they find that early pregnancy exposure to the cyclones were 
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associated with greater proportion of male births, potentially due to spontaneous abortion of 
female fetuses. The fact that they are able to examine two events provides additional strength to 
their findings. More work is needed to understand the impacts of hurricanes and cyclones, 
especially when the actual stress response of the pregnant women is measured – as the prior 
paper by Howells et al (2023) shows that there may be other protective factors that buffer the 
vulnerability to these events. 
 
2.4 Extreme flooding 
Flooding is the most common extreme-weather disaster in recent history and causes the third 
highest death toll after droughts and storms (World Meteorological Organization, 2021). 
Flooding can result from a range of other climatic events, including El Niño/la Niña oscillations, 
severe storms, be spurred by drought, urbanization, and anthropogenic modification of 
environments. All of these factors have the potential to disrupt multiple aspects of health and 
human biology, including water and food insecurity, risk of diarrheal and respiratory diseases, 
psychosocial stress, and nutrition and growth (Ahern et al., 2005; Akukwe et al., 2020; Alderman 
et al., 2012; Rosinger, 2018). Similar to other extreme climatic events, it is marginalized groups 
who disproportionately suffer the health, death, and economic effects from flooding (Alderman 
et al., 2012). 
 
In the special issue, two articles discuss the effects of historic flooding events on human biology. 
First, Rosinger and colleagues (Rosinger et al., 2023) examine changes in measures of well-
being, health, and nutrition from the end of and two months following a historic 2014 flood in 
the Beni, Bolivia among Tsimane’ forager horticulturalists to see how their health recovers. They 
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find that water insecurity and food insecurity were high at the end of the flood, but that only 
water insecurity improved two months later. In contrast, food insecurity persisted as the flooding 
killed crops and resulted in loss of property and livestock. Interestingly, the loss of crops not 
only negatively affected dietary diversity and food availability, but it also changed hydration 
strategies – showing the connection between food and water insecurity. They found that blood 
pressure improved two months following the flood, indicating that the acute stress response to 
the flood dissipated as the water retreated. Nutritionally, adults and children showed divergent 
patterns as adults lost adiposity and children gained weight. Finally, this article demonstrates 
how different illnesses pose challenges at different stages of the recovery from flooding, 
whereby diarrheal prevalence owing to contaminated water decreased, but respiratory illnesses 
increased two months later. 
 
Second, Starkweather (Starkweather et al., 2023) and colleagues examine the economic and 
nutritional effects of flooding using longitudinal data among a Shodagor fishing community in 
relation to an extreme 2017 flooding event in Bangladesh. They demonstrate that rice 
expenditures and fishing productivity were affected by the flood and index this to anthropometric 
data. They ultimately find that the flood, particularly among children and adults from households 
that spent more on rice – potentially as a way to mitigate against decreases in fishing income – 
lost more body mass, which did not recover by 2019. This finding indicates a persistent 
nutritional effect of flooding and provides a longer-term picture of the nutritional effects of 
flooding. Whereas Rosinger and colleagues (2022) found that adults lost measures of nutritional 
status, children at least in the market integrated community were buffered and gained measures 
of adiposity in the short term. What the Starkweather piece tells us is that extreme flooding 
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events may affect nutritional status and energy reserves for multiple years – especially for 
populations already facing nutritional stress. Overall, these two articles indicate the multiple 
facets of well-being, health, and nutrition that flooding touches and how populations that are 
most vulnerable in the global South often bear the consequences for a prolonged period of time. 
 
2.5 Drought and Food systems 
Droughts are the final extreme weather event covered in the special issue and the most lethal as 
they lead to the highest death toll due to their impact on food availability. The lack of water has 
dangerous implications for nutrition, growth, and food security. Global climate change affects 
precipitation patterns, but increasing temperatures increase evapotranspiration leading to greater 
loss of surface freshwaters and groundwater (Pörtner et al., 2022). Human biologists have a long 
history of examining how populations deal with water scarcity and drought, particularly among 
pastoralists and how drought affects birth outcomes, nutrition, dietary strategies, and stress 
(Bauer & Mburu, 2017; Galvin, 1992; Leslie & Fry, 1989; Leslie & Little, 1999; Pike & 
Williams, 2006). Further, droughts are an interesting avenue of research in relation to gestational 
programming, stunting, and long-term outcomes, precisely because it is possible to tie long-term 
drought events to birth records (M. W. Cooper et al., 2019; Epstein et al., 2019; Hyland & Russ, 
2019; Salvador et al., 2020). A DOHaD framework provides a theoretical understanding of the 
mechanisms driving these patterns (Gluckman & Hanson, 2004; Ross & Desai, 2005). In the 
short-run, however, an examination of experiences surrounding food insecurity, stress, and well-
being is critical to understanding how populations navigate these challenging situations. 
 
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It is from this vantage point, that Prall and Scelza (Prall & Scelza, 2023) launch their article in 
this special issue. They examine how recent drought in Namibia affected diet among Himba 
Pastoralists, where two national emergencies were declared during the study period (2016-2019) 
with annual rainfall dropping by half from annual averages. They use serial cross-sectional 
surveys of food insecurity and dietary recall along with stressors over a four-year period. They 
demonstrate that the increasing drought and aridity in concert with market integration led to 
increases in food insecurity, especially with more frequent reports of hunger at night and not 
having food in the house. They further find declines in diet breadth while also seeing a shift in 
dietary strategies. For example, a traditional means of calories among pastoralists is milk, and 
they found that sour milk consumption declined – potentially due to drought impacts on 
livestock. While pastoralists have a long-term adaptation strategy to dealing with arid 
environments, they are not immune to the food and water impacts of climate change 
(Bethancourt et al., 2022). This article casts important light on the ramifications that prior 
colonial policies have on pastoralist populations in regards to access to different resources to 
navigate shocks, like severe drought. 
 
3. Future research directions and methods 
The topics covered in this special issue are only the tip of a fast-melting ice-berg. They provide 
answers but also open up new questions for study. Moving forward, there are many research 
opportunities available for human biologists interested in examining extreme climatic events. In 
the table below, I have outlined a non-exhaustive set of climate change and health questions that 
are well-suited to the theoretical and methodological skillsets of human biologists – some that 
extend from those topics covered in the articles in this special issue as well as other key topics 
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not covered (Table 1). Also, please note that many climate domains are inextricably 
interconnected, whereby extreme storms lead to flooding or extreme heat leads to wildfires and 
drought, and thus studying one domain may necessarily extend to other domains. 
 
For example, while this issue covers extreme heat and cold, hurricanes/cyclones, flooding, and 
drought, other issues of climate change are important domains to investigate, including the 
impacts of wildfires and the synergistic effects of extreme heat and wildfires on air quality, water 
quality, respiratory health, cardiovascular health, and food and water insecurity. Globally, the 
number of extremelyhot days has led to greater risk of wildfires (Romanello et al., 2022). 
Further, examining increasing salinization of water sources will be critical to studies of climate 
change (Kaushal et al., 2021) as they can have implications on the availability of drinking water 
sources and the consumption of high saline water can affect cardiovascular and kidney health 
(Naser et al., 2019; Rosinger, Bethancourt, Swanson, et al., 2021; Scheelbeek Pauline et al., 
2017). Additionally, many human biologists work with island populations. It will be important to 
study how rising sea-levels are affecting their access to clean water and food and all aspects of 
their health and human biology. Finally, biocultural anthropologists are well-positioned to take a 
holistic view of the impacts of climate change on mental health, including asking how 
uncertainty about our climatic future is affecting hope, anxiety, and depression. 
 
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Table 1: Future research questions for human biologists to explore in relation to climate 
change domains 
Climate 
domains 
Examples of questions Suggested 
references 
Extreme 
heat/heatwaves 
What are the human and non-human environmental 
limits to heat? At what limit does heat stress increase 
risk of cardiovascular and kidney damage? 
(Pradhan et al., 
2019; Wolf et al., 
2023) 
 How does extreme heat experienced in utero affect 
human water needs, thirst perception, and sweat gland 
distribution? 
(Best et al., 2019; 
Rosinger, 2020) 
 How does extreme heat affect cognitive processes? (Martin et al., 2019) 
 How do humans and animals conserve body water 
during heat stress? How does variation in 
morphological traits, like hair, skin, and nose shape 
provide protection or create potential mismatch to 
changing temperatures? 
(Lasisi, 2021; 
Turner, 2020) 
 How is extreme heat and humidity affecting sleep 
physiology and circadian health? 
(Okamoto-Mizuno 
& Mizuno, 2012) 
Extreme cold/ 
changes in 
snow and ice-
cover 
How do extreme cold and changes in exposures to 
cold temperatures affect metabolism and physiology? 
How do exposures in utero to cold/changes in 
temperatures affect brown adipose tissue 
development? 
(Leonard, 2018; 
Steegmann Jr., 2007) 
(Levy et al., 2021; 
Niclou & Ocobock, 
2022) 
 How does permafrost and economic expansion affect 
exposures to emerging and re-emerging diseases and 
cardiometabolic and chronic diseases? 
(Snodgrass, 2013; 
Wu et al., 2022) 
 How do changes in cold, snow, and ice affect mental 
health and well-being of indigenous populations in the 
arctic? 
(Cunsolo Willox et 
al., 2015; Ocobock 
et al., 2023) 
Extreme 
storms: 
Hurricanes/ 
cyclones 
How do extreme storms affect stress and stress 
physiology? What are their short- and long-term 
impacts on human biology? How do extreme storms 
affect pregnancy and birth outcomes? 
(Howells, this issue; 
Parayiwa, this issue). 
 How do extreme storms affect coping strategies, like 
migration, water sharing, and shifts in hydration 
(Anne C. Pisor & 
James Holland 
Jones, 2021; Roque 
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strategies, and what are the implications for disease 
transmission and health? 
et al., 2021; Stoler et 
al., 2021) 
 How do extreme events affect mitochondrial function, 
methylation changes, and aging? 
(Watowich et al., 
2022) 
Drought/water 
scarcity 
How are drought and water scarcity affecting food 
systems, water and food insecurity and 
preferences/strategies? Can stable isotopes map 
changes in dietary and hydration strategies? 
(Prall & Scelza, 
2023; Reitsema, 
2015) 
 How is drought experienced in utero affecting fetal 
programming and stunting/birth outcomes? 
(Ross & Desai, 
2005) 
 How does drought affect biomarkers of inflammation, 
immune function, methylation, and disease? 
(Fujita et al., 2022; 
Straight et al., 2022) 
Wildfires How do wildfires affect pulmonary function? 
How do wildfires affect stress and cognitive 
performance? 
(Wen & Burke, 
2022) 
Wildfires-heat What are the synergistic ways extreme heat and 
wildfires affect water and air quality and health? 
What are the synergistic ways extreme heat and 
wildfires affect food availability, food insecurity, and 
water insecurity? 
(Hohner et al., 2019; 
Kpienbaareh & 
Luginaah, 2019; 
Proctor et al., 2020) 
Salinization of 
water sources 
How does salinization of water sources and soil due to 
climate change affect risk of non-communicable 
diseases? How is it associated with birth outcomes, 
pre-eclampsia, hypertension, and kidney damage? 
How does salinization of water sources affect 
perceptions of drinking water sources and water 
insecurity? 
(Gurmessa et al., 
2022; Kaushal et al., 
2021; Rahman et al., 
2019; Rakib et al., 
2019; Rosinger, 
Bethancourt, 
Swanson, et al., 
2021) 
Rising sea 
levels 
How are rising sea-levels affecting health and food 
and water availability in coastal populations? 
(Khan et al., 2011; 
Nunn, 2013) 
Climate 
change 
How is uncertainty about climatic extremes and 
climate change affecting mental health, anxiety, and 
depression? How is sense of loss of ecosystems 
affecting mental health? 
(Berry et al., 2010; 
S. Cooper et al., 
2019; Cunsolo & 
Ellis, 2018) 
 
 
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Within all of this future work, there needs to be a focus on marginalized populations. Exposures 
to and consequences of extreme climatic events are often the result of environmental injustice 
and legacies of policy which mean that the effects are felt most heavily by racially minoritized, 
indigenous, and lower income populations. 
 
3.1 Methodological tools for climate-human biology research 
Several interdisciplinary methods are particularly useful to link climate-related exposures to 
health and human biology. Here, I highlight five methods on the climatic event exposure side: 
1. The use of large-scale climatic databases, like the National Climate Data Center and 
Climate Hazards Group InfraRed Precipitation with Station data (CHIRPS) are necessary 
to link ambient conditions, including rainfall, drought, and extreme cold and hot 
temperatures for studies of human biology. This type of data integration for long-term 
studies, especially during pregnancy and early childhood can help us better understand 
the impacts on birth outcomes and childhood nutrition (Freudenreich et al., 2022; Randell 
et al., 2020; Thiede & Gray, 2020; Thiede & Strube, 2020). 
2. Integration and use of environmental health methods, including water quality (Wutich et 
al., 2020) and air quality (including particulate matter) (Awokola et al., 2020; Clements 
et al., 2017; Wen & Burke, 2022) will provide a way to understand changes in the water 
and air to which people are exposed. Systematic collection of these types of data will 
allow for analyses of how they are changing over time and affected by extreme events, 
like flooding or drought, to impacthealth and human biology. 
3. In tracking how heat and cold stress are affecting health, being able to assess 
microclimate exposures will be critical. Using small, portable weather stations in field 
sites, like the Kestrel 5400 Heat Stress Tracker, can provide real-time changes in ambient 
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conditions, including temperature, relative humidity, wind speed, solar radiation, heat 
index, and wet bulb globe temperature to link to physiological variables being measured. 
4. The use of climate chambers is a more expensive, yet gold-standard measure of ensuring 
exposures to precise climatic conditions, including both heat and humidity as well as 
cold. These experimental methods are providing a way to understand human 
environmental limits (Vecellio et al., 2022; Wolf et al., 2023) and to test biogeographical 
rules in relation to different climatic conditions (Maddux, Cowgill, & Ocobock, in 
process). 
5. Finally, the use of mapping and GIS software will help to assess differential impacts of 
extreme climatic events ranging from extreme flooding to hurricanes to extreme heat with 
respect to social disparities and environmental injustice. Mapping their spatial relation to 
health outcomes will demonstrate how risk differs by intersecting marginalities like low 
socioeconomic status and race/ethnicity (Sanders et al., 2022). 
 
Next, on the human biology and health outcome side of the equation, a range of well-known 
along with novel methods can be useful to measure the effects of climate change exposures: 
1. Retrospective minimally invasive biomarkers can be linked to the timing of climatic 
exposures. For example, several studies have used hair and nail cortisol concentration to 
examine chronic stress retrospectively in relation to other events (Binz et al., 2018; Horan 
et al., 2022; Jankovic-Rankovic et al., 2020; Rosinger, Bethancourt, Young, et al., 2021; 
Stalder et al., 2017). Other studies have shown how different timescales from 1 week, 3 
months, and 20 months can be used to understand recent patterns of infection and 
immune function with C-reactive protein, immunoglobulin E, and immunoglobulin G 
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(Urlacher et al., 2018). Both of these methods can be applied to exposures of extreme 
climatic events – as is demonstrated by Howells and colleagues (2023) in this issue. 
Regardless of biomarker, care must be made to link the measure to the timing of the 
exposure to the biomarker being measured. 
2. Point-of-care (POC) biomarkers, including urinalysis, lipids panels, iron, glucose, and 
many others can provide detailed analyses on many human biology and health outcomes 
of interest (Madimenos et al., 2022). POC biomarkers can be useful in the field during a 
rapid assessment following an extreme climatic event to assess acute impacts – as is 
demonstrated by Rosinger et al., (2023) in this issue. These POC biomarkers have the 
added benefit providing the results in real-time to the studied population. 
3. Integration of administrative, mortality, health-record, and birth-record data can provide 
large sample sizes to test ecological patterns in relation to specific climatic events 
(Parayiwa et al., 2022, this issue). For example, linking birth records to water quality 
over time can test the question of how shocks to water systems and water quality affect 
pregnancy outcomes, like pre-eclampsia (Thompson et al., 2022). 
4. Experiential scales are important to use for understanding how lived experiences related 
to “too much”, “not enough”, “too dirty”, and “not the right type” of water and food are 
affected by extreme climatic events. Measuring water insecurity (for example with the 
HWISE scale)(Young et al., 2019) and food insecurity (for example with the HFIAS 
scale)(Coates et al., 2007) in rapid assessments following hurricanes, flooding, drought, 
and heatwaves will further our understanding of the full impact of these events on well-
being (Rosinger, 2018; Rosinger et al., 2023). 
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5. The implementation of novel wearable biosensors which track physiological processes in 
sweat, tears, saliva, blood, and exhaled air can provide high resolution micro-level human 
biology and physiological data on the effects of ambient conditions (Yang & Gao, 2019; 
Zhang et al., 2020). For example, examining skin blood flow and fetal placental blood 
flow non-invasively to study how heat stress affects pregnant agricultural workers will 
increase our understanding of the effects of hotter temperatures (Bonell et al., 2020; 
Bonell et al., 2022; Chaseling et al., 2020). Integration and work with biomechanical 
engineers in this space will yield promising insights. 
6. Finally, the use of model organisms, including non-human primates and murine models 
in relation to climatic event exposures can help unpack physiological and biological 
mechanisms and long-term implications in shorter timespans. For example, studying how 
extreme climatic events affect cellular damage and aging (Watowich et al., 2022). 
 
4. Conclusion 
Overall, the collection of papers in this special issue make an important contribution to our 
understanding of how human biology and population health are affected by extreme climatic 
events. A central cross-cutting theme is that these extreme climatic events affect water and food 
insecurity. Climate change is a water and food problem. 
 
Human biologists offer a unique and important perspective to the study of the impacts of climate 
change for a combination of theoretical, methodological, and applied reasons. Expertise with 
evolutionary and DOHaD theory will help advance understanding of how climatic shocks affect 
human biology not only acutely but in the long-durée across generations. Practically, human 
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biologists have many methodological tools needed to contribute in novel ways, including non-
invasive biomarkers, survey research, interviews, and observational techniques. Implementation 
of additional climatic exposure methods along with methods from adjacent fields of 
environmental health, biomechanical engineering, and electronic medical records will further 
open up opportunities for addressing novel questions. Finally, human biologists work in the field 
with hard-to-reach and often marginalized populations, with long-term research studies. By 
adding environmental data collection to ongoing studies, particularly in community-engaged 
ways to incorporate their needs and priorities for research and action,human biologists can make 
unique contributions to studying the impacts of climate change. 
 
I hope this article and special issue encourages more work by human biologists into studying and 
linking the impact of environment and climatic events on human biology and health. Adding to 
the body of evidence of the detrimental effects of climate change on human biology will 
hopefully further spur policy and required action to mitigate a dire climatic future. 
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