Table 1 Dominant discourses in the policy language referring to each of eight climate vulnerable groups (excepting CALD which was found to have no references)

Women

Belgium (2); Wales (1); Australia (1)(total =4)

Incidental references that do not form a discourse of specific vulnerability except in one reference to women and poverty [53].

People with disabilities

Wales health (4); UK health (4) Australia health (1); UK (1); Finland (1)(total =12)

Dominant discourse is of exhortation to include groups in adaptation planning and strategies, in lists of groups, only one of which is people with disabilities [49].

Older citizens

Australia health (12); Finland (10); Scotland health (4); Denmark (2); UK health (2); Germany (2); USA health (1); Belgium (1); Wales health (1); Wales (1); UK (1)(total =37)

Dominant discourse is about heatwave vulnerability i.e. vulnerability to heat and ground-level ozone, airbourne allergens, and other pollutants, with the few references to specific adaptation strategies for older citizens being limited to ‘top-down’ solutions, not ‘bottom up’ local knowledge and conditions [39].

Children

UK health (21); Australia health (16); Wales health (4); Scotland health (3) Scotland (3); Germany (2); Belgium (2); Finland (6); Australia (1); UK (1); Denmark (1); USA health (1)(total =65)

Children are predominantly referred to in lists of groups affected by heatwaves and other extreme events for which planning is required. However, there are also references to specific environmental health issues for children such as air quality and asthma (DEA, 2008) and mechanisms for achieving climate policy goals involving children, such as education (SG, 2009) for sun smart behaviour (SG, 2010), and reduction of obesity (DH, 2010). With exceptions in Wales and UK documents generally (CCHWG, 2009), most references to children do not include broader economic costs of climate change or allude to generational equity, as in the Scottish general document which is nonetheless silent on the unequal burden on the poorest children (SG, 2009). In contrast to other climate vulnerable groups, there are also allusions in these documents to a lack of knowledge about children’s ‘social environments’ and barriers to collecting data from this group (NCCARF, 2011), as part of an emphasis on using data collection mechanisms to develop the evidence base and meet specific performance indicators for health sector adaptation (DH, 2010; NCCARF, 2011). However, the dominant discourse works to normalise the view that the data are necessarily emergent as are even conceptualisations of the dynamics involved (FGG, 2008).

Socioeconomically disadvantaged groups

Germany (17); Wales (12); UK health (10); UK (6); Finland (6); Wales health (6); Scotland health (3); Scotland health (3); Australia health (2); Spain (2); Denmark (2); Belgium (2); Russia (1); Australia (1); Scotland (1)(total =71)

The dominant discourse about socioeconomically disadvantaged groups is a general language suggesting that climate change will increase poverty through its socioeconomic impacts [35], particularly in developing countries [40, 37, 53]. This discourse ostensibly argues mitigation must not increase poverty [51, 52]. It is a discourse not informed by a well-developed framework of understanding of the socioeconomic dimensions of climate change and health. Where poverty is mentioned in relation to specific climate-vulnerable groups, this is in lists of example impacts, with children more often mentioned as the most socioeconomically vulnerable group [53].

Aboriginal people

Australia health (35); UK health (11); Australia (5); Germany (3); Belgium (2); Scotland health (1); Scotland (1); Wales (1); UK (1); Finland (1)(total =64)

The dominant discourse is defined by a single country (Australia) with a focus on impacts on Aboriginal people and exhortations to consult with them and other vulnerable groups in developing research [35, 36]. This discourse works to normalise the absence of nuanced policy strategies by representing the adaptive knowledge and resilience of these groups as an unknown, albeit a priority, research question [36]. The USA document is entirely silent about Indigenous vulnerability although it refers to other groups [46].

Rural communities

UK (66); Australia health (39); Germany (19); Finland (12); UK health (10); Netherlands (10); Wales (9); Australia (5); Spain (2); Scotland (3); Wales health (4); Belgium (3); Scotland health (1) (total =183)

The dominant discourse is one of sustainable rural development for both mitigation and adaptation through management of natural assets (woodlands and water) as well as development of agricultural land use and transport infrastructure [34, 39–41, 47, 48, 51–53]. Even in the one Australian health document distinguished by its emphasis on mental health, as well as social cohesion and resilience in rural communities, this discourse is not articulated within a framework of rural health vulnerability [36], presenting limited information on rural adaptive assets (COAG, 2007).

Mental health

USA health (11); Australia health (309); Scotland health (66); Wales health (136); UK health (180); Australia (17); Spain (10); Belgium (17); Germany (31); Denmark (14); Wales (25); Finland (66); Scotland (8);UK (45); Russia (3); Netherlands (2)(total =940)

The dominant discourse about mental health most often refers to the wider set of vulnerable groups, reflecting the use of lists to refer to climate vulnerable groups in these documents. Although mental health is elaborated in most detail in the language of rural mental health effects [36], it is almost never translated into nuanced strategies for adaptation [36, 53]. This discourse tends not to be informed by any detail on different categories of mental health conditions beyond depression from extreme weather events effects such as cold, dislocation from flooding, and climate anxiety or a kind of generalised fear for the future [36, 49]. References to the mental health of Aboriginal people do not go beyond linking their holistic relationship to their land to their mental health climate vulnerability and lack detail on consultation strategies with mental health stakeholders generally [36]. With few exceptions [49], this discourse does not move beyond populist concepts of mental health climate vulnerability with little specific guidance on mental health interventions [36].