{WGII SPM footnote 29}
In urban settings, climate change has caused adverse impacts on 
human health, livelihoods and key infrastructure (high conﬁdence). 
Hot extremes including heatwaves have intensiﬁed in cities (high 
conﬁdence), where they have also worsened air pollution events 
(medium conﬁdence) and limited functioning of key infrastructure 
(high conﬁdence). Urban infrastructure, including transportation, water, 
sanitation and energy systems have been compromised by extreme 
and slow-onset events79, with resulting economic losses, disruptions of 
services and impacts to well-being (high conﬁdence). Observed impacts 
are concentrated amongst economically and socially marginalised urban 
residents, e.g., those living in informal settlements (high conﬁdence). 
Cities intensify human-caused warming locally (very high conﬁdence), 
while urbanisation also increases mean and heavy precipitation over and/or 
downwind of cities (medium conﬁdence) and resulting runoff intensity 
(high conﬁdence). {WGI SPM C.2.6; WGII SPM B.1.5, WGII Figure TS.9, 
WGII 6 ES}
Climate change has adversely affected human physical health globally 
and mental health in assessed regions (very high conﬁdence), and is 
contributing to humanitarian crises where climate hazards interact 
with high vulnerability (high conﬁdence). In all regions increases in 
extreme heat events have resulted in human mortality and morbidity 
(very high conﬁdence). The occurrence of climate-related food-borne and 
water-borne diseases has increased (very high conﬁdence). The incidence 
of vector-borne diseases has increased from range expansion and/or 
increased reproduction of disease vectors (high conﬁdence). Animal and 
human diseases, including zoonoses, are emerging in new areas (high 
conﬁdence).