Impacts of future urban expansion on summer climate and heat-related human health in eastern China

China is the largest and most rapidly urbanizing nation in the world, and is projected to add an additional 200 million city dwellers by the end of 2030. While this rapid urbanization will lead to vast expansion of built-up areas, the possible climate effect and associated human health impact remain poorly understood. Using a coupled urban-atmospheric model, we first examine potential effects of three urban expansion scenarios to 2030 on summer climate in eastern China. Our simulations indicate extensive warming up to 5 °C, 3 °C, and 2 °C in regard to low- (> 0%), high- (> 75%), and 100% probability urban growth scenarios, respectively. The partitioning of available energy largely explains the changes in 2-m air temperatures, and increased sensible heat flux with higher roughness length of the underlying urban surface is responsible for the increase of nighttime planetary boundary layer height. In the extreme case (the low-probability expansion pathway), the agglomeration of impervious surfaces substantially reduces low-level atmospheric moisture, consequently resulting in large-scale precipitation reduction. However, the effect of near-surface warming far exceeds that of moisture reduction and imposes non-negligible thermal loads on urban residents. Our study, using a scenario-based approach that accounts for the full range of urban growth uncertainty by 2030, helps better evaluate possible regional climate effects and associated human health outcomes in the most rapidly urbanizing areas of China, and has practical implications for the development of sustainable urban regions that are resilient to changes in both mean and extreme conditions.