Abstract for: Beyond Climate Vulnerability: How Health Shapes and Is Shaped by Climate Change and Adaptation

Climate change poses escalating threats to human health and wellbeing, prompting the adoption of adaptation interventions across multiple sectors. However, most studies focus on uni-directional causality in variable dyads. Thus, the feedback mechanisms linking adaptation strategies, health outcomes, and climate change risk remain poorly understood, yet hide potential unintended consequences and dangerous reinforcing mechanisms. This study explores these systemic interconnections to inform more resilient adaptation policy. Using a systems thinking approach, we developed a qualitative Causal Loop Diagram (CLD) to map the interrelationships between climate change risk, adaptation interventions (e.g., infrastructure, nature-based solutions), and human health and wellbeing outcomes. The diagram was constructed through a structured literature synthesis of 82 peer-reviewed studies and policy reports, focusing on feedback mechanisms and potential unintended consequences. We identify key balancing loops through which adaptation reduces health burdens and climate risk (e.g., via healthcare demand, critical infrastructure protection, climate hazard, exposure, and vulnerability), alongside reinforcing loops that amplify risk (e.g., health-driven vulnerability, maladaptive reliance on emission-intensive technologies). The analysis highlights the risk of “Fixes That Fail” patterns, where short-term adaptations exacerbate long-term systemic fragility. The study reframes traditional climate-health analyses by incorporating a bi-directional perspective, highlighting how health not only suffers but also shapes adaptive capacity. Systems thinking reveals how narrowly focused interventions can unintentionally reinforce systemic risks. We revise the “Fixes That Fail” archetype to show how maladaptive responses intensify hazards, while integrative strategies foster resilience. The CLD provides a foundation for designing systemic, health-sensitive, and sustainability-oriented adaptation interventions. summarizing, rewording