**4. Embedding Scientific Evidence into Adaptation Practice**

The final set of papers address possible adaptation and planning responses to the effects of climate change on health. For example, Orru et al. [21] argue that resilience in the face of climate change is necessarily driven by the functioning of health systems and the drivers which shape system effectiveness. The authors use an example of the Estonian health system, and find that the health impacts of climate change have not been mainstreamed into policy. There is currently an opportunity to combine information from various sources, on health systems, the environment and vulnerability, although this prospect has not been embraced fully due to various reasons, including lack of knowledge and understanding of extreme events and how to incorporate projected risks into policy, and unclear division of responsibility [21]. Careful resource planning is an important consideration for the health sector, especially in the face of an increased risk of extreme weather events. Papadakis et al. [22]

analyse emergency ambulance calls during episodes of extreme temperatures in London, UK, and propose a statistical physics based method to more accurately estimate the true burden on the health system during these events, which has potential for the ambulance service to more efficiently manage resources [22].

In the Netherlands, the issue of the urgent need for additional housing within existing urban boundaries is addressed [23]. Koopmans et al. test a range of urban planning strategies and their potential impacts on heat stress up to 2050, in the Hague. In particular, the impact of urban fabric on the urban heat island intensity is considered, and it was found that increasing vegetation fraction is a critical parameter in reducing excess heat stress in denser neighbourhoods, even if high rise buildings are preserved. However, the effects of climate change are thought to be likely to overwhelm the effects of increased urban densification in future [23].

Taylor et al. [24] use building models to quantify indoor temperatures in different dwelling types, and investigate the potential impacts on heat-related mortality of a range of adaptation measures under future climate change scenarios. Adaptation measures included mitigation of heat, improved energy efficiency, and changes in occupant behaviour, finding that external shutters provided the greatest benefits in terms of reducing heat-related mortality (by around 40%) and closed windows led to increased risk (of 29–64%) [24]. The authors highlight the importance of appropriate building design to both save energy and reduce heat-related mortality, especially for dwelling types associated with heat-vulnerable populations.
