A Systematic Review of Older Adults' Preparedness and Mitigation Strategies: Learnings and Opportunities for a Climate Ready Future

Background: The number of older adults (60 years or older) is projected to double to 1.5 billion by 2050, making them a key audience in reducing greenhouse gas emissions. Further, older adults face heightened risks from climate change impacts, including extreme weather events. However, there is no synthesized evidence on preparedness and mitigation strategies currently employed by this group to inform broader policy and interventions. This systematic review fills this gap by examining older adults’ climate change mitigation and disaster preparedness strategies.

Methods: Ten databases were searched using keywords related to disaster preparedness, climate change mitigation, and older adults. Using Covidence, two reviewers independently screened titles and abstracts, and performed a full-text review; disagreements between reviewers were resolved by consensus with additional team members. Studies were included if they were empirical, available in English, focused on older adults, related to climate change mitigation or disaster preparedness strategies, and published between 2017 to 2021 -- the most recent five-year span with the highest number of extreme weather events. We used the National Institutes of Health critical appraisal tool to assess methodological quality and rigor.

Results: The initial search yielded 215 articles; eight articles met our inclusion criteria and spanned the U.S., Germany, Canada, Japan, and Australia. Studies used quantitative (4), qualitative (2), and mixed methods approaches (2), including one RCT and one CBPR design. While four studies focused on extreme heat, the others rendered a broader conceptualization of climate-related disaster preparedness. The quality assessment of included studies ranged from fair to good. Study samples were mostly white women, indicating a need for more intentional representation from Black, Indigenous, and People of Color communities, and gender minority older adults. Findings indicate that older adult disaster preparedness strategies are informed by access to disaster-related information, yet there are institutional and systemic barriers that limit accessibility. Further, older adults may rely on family or social networks for disaster preparedness assistance, rather than social services or institutional help, due to social stigma or a fear of vulnerability. No studies addressed climate change mitigation strategies.

Implications: This review presents the current evidence on strategies that enhance disaster preparedness among older adults, such as participatory processes and shared decision-making, peer-based approaches, and targeted disaster information campaigns. Findings indicate a need for accessible preparedness information for low-literacy audiences and in media avenues preferred by older adults. Additionally, resources should be directed toward dismantling inequities and barriers to preparedness resources among racial, ethnic, and gender minoritized groups, and those with low-literacy, lower-socioeconomic status, and socially isolated older adults. Our review also unveils a need for studies in low-and-middle income countries that bear the burden of climate change impacts. Considering the rapid growth of the older adult population and the inequitable emissions and impacts between and within countries, future studies should explore their current mitigation practices as a key step toward reducing community carbon emissions, and inform social work research, policy, and practice with this population in a changing climate.