Brief communication: 'Multi-hazard-to-health-outcome' (MH<sub>2</sub>O) pathways: the known, the unknown, and ten most urgent priorities.

Moore, Harriet; Liang, Qiuhua; Bosher, Lee; Atanbori, John; Gussy, Mark; Madbhatkal, Amogh; Swift, Joe; Phull, Jaspreet; Guy, Kirsten; Collinson, Lynsey; Penny, Andy; Athanassiadou, Maria; Milczewska, Kaja; Amankwaa, Ebenezer; Kennedy, Lucy; Hanna, Edward; Sutton, Gregory; Hill, Bartholomew; Hopkirk, Colin

doi:10.5194/egusphere-2025-4062

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https://doi.org/10.5194/egusphere-2025-4062

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30 Oct 2025

| 30 Oct 2025

Status: this preprint is open for discussion and under review for Natural Hazards and Earth System Sciences (NHESS).

Brief communication: 'Multi-hazard-to-health-outcome' (MH₂O) pathways: the known, the unknown, and ten most urgent priorities.

Harriet Moore, Qiuhua Liang, Lee Bosher, John Atanbori, Mark Gussy, Amogh Madbhatkal, Joe Swift, Jaspreet Phull, Kirsten Guy, Lynsey Collinson, Andy Penny, Maria Athanassiadou, Kaja Milczewska, Ebenezer Amankwaa, Lucy Kennedy, Edward Hanna, Gregory Sutton, Bartholomew Hill, and Colin Hopkirk

Abstract. Climate-driven hazards like heat and flooding have complex impacts on human health. Most research considers the impact of individual hazards (e.g., heatwaves) on discrete health outcomes (e.g., heatstroke). However, climate-driven hazards often precipitate additional hazards with cumulative health impacts, such as the compound effect of drought and heatwaves on the physical and mental health of farming communities. Little is known about ‘multi-hazard-to-health-outcome’ (MH₂O) pathways. We engaged multi-sectorial and international stakeholders through the newly established MH₂O Working Group and report our co-developed ten most urgent priorities for guiding research, policy and practice towards preparing our global One Community for future uncertainty.

Received: 20 Aug 2025 – Discussion started: 30 Oct 2025

Publisher's note: Copernicus Publications remains neutral with regard to jurisdictional claims made in the text, published maps, institutional affiliations, or any other geographical representation in this paper. While Copernicus Publications makes every effort to include appropriate place names, the final responsibility lies with the authors. Views expressed in the text are those of the authors and do not necessarily reflect the views of the publisher.

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RC1:
'Comment on egusphere-2025-4062', Anonymous Referee #1, 21 Nov 2025 reply
Overall comment
I very much enjoyed reading this brief communication. It is well written and it brings forward a very important research avenue. I strongly suggest the authors to strengthen the multi-hazard risk element of their manuscript. A lot of work is done in this field, especially in recent years; also in bridging to diseases and health impacts, which is currently less recognized in the manuscript.
General comments
While the manuscript seems to focus on “climate-driven hazards like heat and flood” many of the examples mention earthquakes and volcanic eruptions. I found this a bit confusing as these are not climate-driven.

I also wondered what search terms were used. Many people working in the field of (multi-) natural hazards and disasters won’t refer to them as “environmental hazards”. Moreover, within the field of multi-hazards, a lot of other terminology is used (e.g. cascading hazards (see Pescaroli et al 2018), consecutive disasters (De Ruiter et al 2020), etc etc).

In line 61 (but also P2 of Table 1), I wondered whether the authors truly meant (climate) mitigation or if they actually meant adaptation and/or risk reduction?

Part of the argument made in this paper was also made in:
Mora et al. 2022

Sairam & De Ruiter (2025; also published in EGUsphere).

Line 56 – 70: the authors could also refer to recent reports by the WHO and UNDRR and that make a similar pledge.

Some sentences could use a bit more careful phrasing such as “while environmental scientists consider flooding and drought”. Maybe the term (socio-)hydrologists is more accurate?

Line 70: the authors could consider reaching out to similar groups such as the RiskKAN working group on disasters, diseases and health (see also P4 of Table 1).

literature
Instead of Bixler et al (L. 37) (and some of the subsequent references) there are a lot of studies that support this more broadly than a study that looks at a local case in Texas… I suggest the authors reflect a bit better on the field of multi-hazard risk. Eg but by no means limited to:
AghaKouchak et al 2014, 2018

Claassen et al., 2023, 2025

De Ridder et al 2020

De Ruiter et al 2020

Gill & Malamud 2014, 2017

Kappes et al. 2012

Quintal et al (in discussion – egusphere)

Scolobig et al. 2017

Thieken et al. 2021

Ward et al 2022

Zscheischler et al 2017, 2018

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Citation: https://doi.org/10.5194/egusphere-2025-4062-RC1

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Short summary

Climate change will increase the frequency of extreme weather events like floods, droughts and storms. These hazards have impacts on human health. Some hazards, like storms, cause additional hazards like flooding. Little is known about the compound effects of multiple hazards on health, or how impacts vary between communities and areas. We present ten urgent research priorities related to the impact of multiple hazards on health to guide future decision-making towards climate resilience.


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Brief communication: 'Multi-hazard-to-health-outcome' (MH2O) pathways: the known, the unknown, and ten most urgent priorities.

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Brief communication: 'Multi-hazard-to-health-outcome' (MH₂O) pathways: the known, the unknown, and ten most urgent priorities.