The Heat is On: How Can Long-Term Care Systems in Europe and Central Asia Promote Climate Adaptation?

Sarah Coll-Black, Ali Hamandi, Aaron Beitman, Andrey Tretyak and Valeria Arias Salvador

No 204708, The Social Policy and Labor Discussion Paper Series from The World Bank

Abstract: This working paper explores strategies and interventions that LTC systems in ECA could adopt to strengthen the climate resilience of people with functional limitations and their caregivers. After a short section on methodology and conceptual framing, the paper introduces the IPCC climate risk framework and outlines the main climate hazards projected for ECA, noting their varying frequency and intensity across the region. It then examines how individual vulnerability shapes the impact of these hazards, with a focus on older people and people with disabilities, whose functional limitations and care needs increase their susceptibility. The analysis considers biological and health factors, social circumstances, and structural conditions that heighten vulnerability to both climate shocks and gradual changes such as rising temperatures. The paper then turns to international experience, highlighting approaches from selected OECD countries that have modified their LTC systems or introduced innovations to protect people with care needs—and, in some cases, a broader population of older people and people with disabilities from climate risks. Building on these case studies and a wider literature review, the paper identifies a set of strategies across LTC system functions t hat ECA countries could apply before, during, and after climate hazards to maintain essential care, address emerging needs, and extend support to groups not currently covered. The paper concludes with questions for further research and analysis.

Date: 2025-09-01
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