Editing IPCC:AR6/WGII/Cross-Chapter-Paper-4 (section)

=== CCP4.3.5 Human Health and Cultural Heritage ===

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Warming is projected to impact human health, mostly through increased intensity, frequency and duration of heat waves ( ''high confidence'' ) ( [[#Guerreiro--2018|Guerreiro et al., 2018]] ; [[#Jacob--2018|Jacob et al., 2018]] ; [[#Rohat--2019|Rohat et al., 2019]] ; [[#Smid--2019|Smid et al., 2019]] ). Under current socioeconomic conditions, 53–93 million more people could be exposed to high or very high heat stress in northern Mediterranean by 2050 ( [[#Rohat--2019|Rohat et al., 2019]] ) and heat-related excess mortality could increase by more than six-fold above 3°C GWL ( [[#Gasparrini--2017|Gasparrini et al., 2017]] ). In MENA countries, the mortality risk of the elderly in 2100 could be 8–20 times higher under RCP8.5 compared to 1951–2005, and still 3–7 times higher under RCP4.5 ( [[#Ahmadalipour--2018|Ahmadalipour and Moradkhani, 2018]] ). Deaths attributable to high temperatures in the northern Mediterranean could increase by 18–20,000 in 2050 (50,000 in 2100) under RCP8.5 (1.4 and 2.6 times lower under RCP4.5) ( [[#Kendrovski--2017|Kendrovski et al., 2017]] ).

Climate change and variability may also influence the emergence of vector-, food- and water-borne diseases ( [[#Negev--2015|Negev et al., 2015]] ). Under RCP8.5, the epidemic potential of dengue fever in Southern Europe is projected to increase by 2100 ( [[#Liu-Helmersson--2019|Liu-Helmersson et al., 2019]] ), as well as the risk of infections by West Nile virus in 2050 under A1B ( [[#Semenza--2016|Semenza et al., 2016]] ). Climate-induced diseases could reduce labour productivity in the region by 2060, particularly in MENA countries ( [[#Dellink--2019|Dellink et al., 2019]] ). Overall, there is still uncertainty in projections of the future severity and distribution of diseases because of climate change due to the complex interactions between hosts, pathogens and vectors. Reductions in fruit and vegetable consumption as a result of climate change on food availability could lead to more than 20,000 deaths in 2050 under RCP8.5 from diseases caused by malnutrition ( [[#Springmann--2016|Springmann et al., 2016]] ).

Extreme high temperatures, hot days and nights and consequently cooling degree days will ''likely'' increase ( ''high confidence'' ) ( [[#Spinoni--2018a|Spinoni et al., 2018a]] ; [[#Coppola--2021|Coppola et al., 2021]] ), with specific cooling needs in cities possibly increasing by 50–278% under 2°C GWL and 134–375% beyond 3°C GWL ( [[#Cellura--2018|Cellura et al., 2018]] ). Urban heat island effects will further increase cooling needs ( [[#Salvati--2017|Salvati et al., 2017]] ; [[#Zinzi--2017|Zinzi and Carnielo, 2017]] ). Higher temperatures will increase thermal and chemical stress on materials used in many ancient buildings and sculptures, such as marble, stone and masonry ( [[#Bonazza--2009|Bonazza et al., 2009]] ; [[#Leissner--2015|Leissner et al., 2015]] ).

Many studies project a decrease of climatic comfort for tourism in the Mediterranean by 2071 to 2100, particularly during summer ( [[#Grillakis--2016|Grillakis et al., 2016]] ; [[#Jacob--2018|Jacob et al., 2018]] ; [[#Braki--2019|Braki and Anagnostopoulou, 2019]] ). There is adaptive potential in the extension of the period with favourable climatic conditions for urban tourism in northern Mediterranean cities ( [[#Scott--2016|Scott et al., 2016]] ). Water scarcity may create additional constraints for tourism ( [[#Köberl--2016|Köberl et al., 2016]] ).

Cultural heritage sites in the region face risks from coastal flooding, with 37 out of 49 cultural World Heritage sites today facing risk from a 100-year flood, and 42 of them from coastal erosion ( [[#Reimann--2018b|Reimann et al., 2018b]] ). Sea level rise will increase these risks ( ''high confidence'' ) ( [[#Lionello--2012|Lionello, 2012]] ; [[#Rizzi--2017|Rizzi et al., 2017]] ; [[#Reimann--2018b|Reimann et al., 2018b]] ; [[#Ravanelli--2019|Ravanelli et al., 2019]] ; [[#Tagliapietra--2019|Tagliapietra et al., 2019]] ). By 2100, 47 of the 49 United Nations Educational, Scientific and Cultural Organization (UNESCO) sites are projected to be at risk from coastal flooding or erosion ( [[#Reimann--2018b|Reimann et al., 2018b]] ). Beyond 2100, sea levels are committed to rise further and represent an existential threat for the high number of coastal cultural heritage located in the Mediterranean (WGI AR6 Chapter 9, Fox-Kemper et al., 2021; Chapter 13; Cross-Chapter Box SLR in Chapter 3; [[#Marzeion--2014|Marzeion and Levermann, 2014]] ).

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