Attributing climate-related health burdens in Southeast Asia: a scoping review

Attributing health outcomes to climate-related exposures is essential for informing adaptive policy, yet Southeast Asia, one of the world's most climate-vulnerable regions, remains critically underrepresented in attribution research. To address this gap, we conducted a scoping review of studies linking climate exposures to health burdens in the region. Although growing evidence demonstrates substantial health impacts from air pollution, heat, and extreme weather, the regional research landscape remains critically imbalanced, marked by neglect of other major hazards-including floods, droughts, extreme rainfall, storms and sea-level rise-and substantial methodological fragmentation. From 5294 records screened, 77 studies met our inclusion criteria. The evidence is dominated by air pollution research, the focus of 70% of studies and linked to up to 31% of all-cause mortality and an estimated 296,000 annual deaths from wildfire smoke during El Niño events. Heat, the second most studied exposure, was associated with up to 8.61% of mortality in Bangkok. In contrast, extreme events such as heatwaves, floods and storms were least frequently investigated. These findings reveal a critical misalignment between regional climate risks and current research focus. Standardized attribution frameworks are urgently needed to support integrated climate-health modeling and guide equitable, evidence-based adaptation across Southeast Asia.