Environmental health indicators are helpful for tracking and communicating complex health trends, informing science and policy decisions, and evaluating public health actions. When provided on a national scale, they can help inform the general public, policymakers, and public health professionals about important trends in exposures and how well public health systems are preventing those exposures from causing adverse health outcomes. There is a growing need to understand national trends in exposures and health outcomes associated with climate change and the effectiveness of climate adaptation strategies for health. To date, most indicators for health implications of climate change have been designed as independent, individual metrics. This approach fails to take into account how exposure-outcome pathways for climate-attributable health outcomes involve multiple, interconnected components. We propose reframing climate change and health indicators as a linked system of indicators, which can be described as follows: upstream climate drivers affect environmental states, which then determine human exposures, which ultimately lead to health outcomes; these climate-related risks are modified by population vulnerabilities and adaptation strategies. We apply this new conceptual framework to three illustrative climate-sensitive health outcomes and associated exposure-outcome pathways: pollen allergies and asthma, West Nile virus infection, and vibriosis.

环境健康指标有助于跟踪和传达复杂的健康趋势、为科学和政策决策提供信息以及评估公共卫生行动。当在全国范围内提供时，它们可以帮助向公众、政策制定者和公共卫生专业人员通报暴露的重要趋势以及公共卫生系统如何有效地防止这些暴露造成不良健康结果。人们越来越需要了解与气候变化相关的暴露和健康结果的国家趋势以及气候适应战略对健康的有效性。迄今为止，大多数气候变化对健康影响的指标都被设计为独立的、单独的指标。这种方法未能考虑气候归因健康结果的暴露结果路径如何涉及多个相互关联的组成部分。我们建议将气候变化和健康指标重新构建为一个相互关联的指标体系，可以描述如下：上游气候驱动因素影响环境状态，然后环境状态决定人类暴露，最终导致健康结果；这些与气候相关的风险因人口脆弱性和适应战略而改变。我们将这个新的概念框架应用于三个说明性的气候敏感健康结果和相关的暴露结果途径：花粉过敏和哮喘、西尼罗河病毒感染和弧菌病。