Missing Math: Paying for the Health Costs of Climate Change

The climate crisis is inflicting costly damage to human health, but those harms are often hidden from view.

Credit: U.S. Fish and Wildlife Service

Credit: Credit: U.S. Fish and Wildlife Service

The climate crisis is inflicting costly damage to human health, but those harms are often hidden from view.


The costs of delaying robust action against climate change are more visible and obvious every day. The federal government has been tracking the economic damages of climate and weather disasters on the country since 1980, and its analysis shows that the costs of climate damages have been growing year after year, and, sadly, decade after decade. But, even as progress has been made in understanding those costs, some of the most damaging ones—those to human health and well-being—are still hard to document.

Faced with that growing reality, my colleagues and I saw a need to better account for the health costs of extreme weather events and climate change to better calculate the costs of human and community impacts, and demonstrate how our healthcare system and facilities need better investment. The climate crisis is dangerous and threatens more than just property values and infrastructure systems. A focus on the significant human dimensions of the climate problem can help to motivate more aggressive policy responses to avoid the worst costs to public health.

In work published this week in a special issue of Health Affairs, a leading journal of health policy thought and research, we explain why it’s important to account for the health costs of climate-sensitive events: to better understand the scope of climate damages to human lives and livelihoods, to ensure that health systems and hospitals can maintain operational and financial stability in the face of mounting climate threats, and to motivate more aggressive actions right now to prevent harm and costly illnesses and injuries to all of us.

Last year, we published a study that estimated $10 billion in health-related costs stemming from just a sample of climate-sensitive events in the US—including a heat wave, wildfires, air pollution and allergenic pollen, disease outbreaks of West Nile virus and Lyme disease, and Hurricane Sandy. That work confirmed the science in the 4th National Climate Assessment, an authoritative synthesis report from the federal government. Specifically, climate change will be enormously costly for our country if our leaders continue to deny its very existence or distract from its impacts.

How costly? The national climate report pointed to hundreds of billions of dollars in damages—but it’s unclear to what extent very real human suffering is included in the math. Our study estimated that Medicare and Medicaid patients shouldered a disproportionately high burden of illness costs, which aligns with the evidence indicating that older people, communities of color, and the economically marginalized face the brunt of the health risks from climate change.

Based on what we learned from our research, a fuller economic accounting of climate damages to health— in recent years but also in the years and decades to come—is important but currently challenging and complex to achieve. That’s because of many obstacles, including inadequate documentation and sharing of health data, limited staff capacity and resources in public health offices across the country, and the collaborative work needed to connect the dots between climate, health, and economics.

The recommendations included in our analysis to improve the the economic estimates of climate damages to health so that we can better understand the scope of this problem and shape health-protective solutions. These recommendations include:

Demonstrating the health benefits of a robust response to climate crisis.

Climate adaptation efforts have the potential to minimize climate-health harms and reduce associated economic damages. Health-protective adaptation interventions address climate-sensitive health threats in different ways, including developing early warning systems and health advisories; establishing public cooling centers and protocols to minimize extreme heat exposures; and building climate-resilient physical infrastructure in homes, communities, and health care systems that can withstand more severe floods, storms, and wildfires.

Valuation of the health benefits achieved by these programs should be prioritized to make those achievements more apparent to policymakers and more readily incorporated into cost-benefit assessments.

Investing in staff and local understanding of climate-worsened health harms.

Budgets and staffing needed to conduct climate-health valuation analyses are currently stretched thin in state and local health departments. Capacity building to conduct and learn from these analyses is needed beyond the academic research community, including in training health economists to analyze climate-sensitive health risks. As the COVID-19 pandemic demonstrates, poor investment, inadequate planning, and deficient alignment of public health response efforts is damaging and costly to health and economic prosperity.

Valuation of expensive health harms linked to climate-sensitive exposures could help health systems anticipate and respond to financial challenges from climate change.

Improving health surveillance systems.

In the face of complex threats to public health posed by climate change, decision-making is only as good as the information it’s based on. It’s past time to modernize our national health data systems, and as more evidence of the links between climate-sensitive exposures and health risks becomes available, it should be rapidly integrated into valuation assessments. That work should extend beyond estimates of the burden of climate-sensitive health harms on insurance systems to also describe how those expenses burden populations with limited access to health care and health insurance. More standardized data collection and dissemination processes across different levels of U.S. health agencies, from local to state, tribal, and territorial, could help create more uniform frameworks for tracking the health effects of climate change.

A sustained approach to national climate and health tracking would allow for better understanding of how climate-related health costs are trending over time, which can improve planning efforts to shore up climate protections for people who may need them the most.

The climate crisis is extremely costly, in terms of both damage to human health and the economic hardship that climate-fueled problems impose on vulnerable communities. By better capturing the reality of climate change for people and their families through inclusion of health-related costs economic models, we can make the case for climate policies that will reduce costly suffering-- now, and for years to come.

Related Blogs