Wildfires blazing across North America and Australia, heatwaves scorching Europe and Asia, cyclones ravaging Africa and the Caribbean. Climate change is already here, and it’s only going to get worse. But it isn’t just hurting the planet. It’s hurting us.

Climate change is already affecting our health, a new report from The Lancet confirms, and it’s hitting children and the elderly particularly hard. Children will not only face rapid and unprecedented changes over the course of this century, but they are also the most susceptible to illnesses like dengue, diarrhea, asthma, malnutrition and more—as wildfires choke our lungs, storms and floods spread cholera, and rising temperatures bring more mosquito-borne illnesses. The health of the elderly is also disproportionately affected by the climate crisis, especially heatwaves.

The Lancet Countdown report, which has been updated every year since 2015, emphasizes what many experts have warned with increasing urgency: improving health care has to be a central part of climate change preparedness.

“The most immediate and direct impact of a changing global climate on human health is seen in the steady increase in global average temperature,” the report’s authors wrote. Every region on the planet has seen a rise in record-breaking heatwaves, which are becoming more frequent, intense, and longer-lasting. In 2018, heatwaves hit 220 million more people than they did in 1986–2005, on average. Severe heat doesn’t just make us irritable and uncomfortable. Heatwaves cause heat stroke, damage kidneys and exacerbate congestive heart failure, among other health issues.

Then there are the wildfires. Three-quarters of the globe saw an increase in fires in the past few years—especially in China and India, where a total of 38 million more people felt the growing heat from uncontrolled blazes in 2015–18. Smoke from wildfires, which can spread hundreds of miles, makes asthma, allergies and other chronic diseases much worse. Every year, seven million people die because of air pollution, which is “principally driven by fossil fuels, and exacerbated by climate change,” the report’s authors wrote.