A new report from the public policy research group Center for American Progress estimates extreme heat will create $1 billion in health care-related costs in the United States this summer. The analysis, provided exclusively to Grist, projects that excessive heat will spur nearly 235,000 emergency department visits and more than 56,000 hospital admissions for conditions related to increased body temperature across the country this summer.
“As the number of heat-event days increases, the probability that people are going to get rushed to the emergency room or get hospitalized increases,” said Steven Woolf, a senior fellow at the Center for American Progress, a professor of family medicine and population health at Virginia Commonwealth University School of Medicine, and a coauthor of the report. “We were interested in trying to quantify how big a risk that is.”
Woolf and a cohort of academics, scientists, and doctors from Virginia Commonwealth University analyzed health insurance claims in Virginia during the 80 extreme heat days that occurred in the state, on average, every summer from 2016 and 2020. The claims were filed for emergency room visits, hospital admissions and other medical care. They used that data to determine how many Virginians sought a doctor’s help during these heat waves compared to other days. The authors tallied up “heat-related illnesses,” defined as including heat cramps, heat exhaustion and heat stroke, as well as “heat-adjacent illness” — dehydration, rapid pulse, dizziness or fainting.
In Virginia, extreme heat spurred some 400 outpatient care visits for heat-related illness, 4,600 emergency room visits for heat-related or heat-adjacent illness and 2,000 heat-related hospital admissions each summer. These are likely underestimates, the report’s authors noted, since many patients with higher body weight or organ diseases such as heart disease, for example, experience complications during heat waves that could be classified as heat-adjacent illnesses but are rarely formally diagnosed as such by their physicians. And many victims of extreme heat don’t seek medical care at all, which further obscures the true burden of heat-related illness.
The authors extrapolated from Virginia’s data to reach the conclusion that extreme heat will inflate health care costs across the nation by $1 billion every summer for the foreseeable future, an estimate Woolf said will probably shift as the breadth of research on this topic expands. The authors also found that the burden of extreme heat will be shouldered unequally by Americans. The costs will be felt most acutely in low-income and historically marginalized communities, where access to cooling resources such as air conditioning is patchy and green spaces are scarce. “People who live in nice neighborhoods, who have air-conditioned homes and tree-lined streets with plenty of shade,” Woolf said, “are protected from the heat in a way that doesn’t occur in a different part of town where there’s not much shade and people are less likely to either have air conditioning and fans or to have the resources to pay the electrical bills.”
These inequities point to a slew of possible solutions, starting with a recognition on behalf of local and state governments that neighborhoods need to become more resilient to the effects of extreme heat. Many cities are already adapting to protect people from climate change, Woolf said, including using building and roofing materials that reflect heat, passing laws that subsidize power bills for low-income residents, and planting trees — a relatively low-cost intervention that is surprisingly effective at bringing down street-level temperatures. Local emergency management officials could also better forecast extreme heat so people have time to prepare, and public health officials could offer clearer communication about the symptoms of heat illness.
Justin S. Mankin — an assistant professor in Dartmouth University’s geography department who was not involved in this report but who published a separate study last year on the economic impact of heatwaves in the U.S. — acknowledged that the report is part of an essential effort to quantify the health care burden associated with extreme heat. But he said the methods the report’s authors used don’t paint a complete picture, noting that a more comprehensive assessment of the economic toll of heat would have also accounted for the costs that pile up in the “weeks, months, and even years after an extreme event,” not only while the event is happening, as the report does.
“I’d like to see more rigorous estimates of these costs using more sophisticated approaches,” Mankin said. A more complete analysis would have looked at insurance claims from every state, instead of nationally extrapolating from Virginia’s data. The problem is that many states don’t have what’s called an all-claims database, which is a full and public accounting of all of the emergency room visits and hospitalizations that occur in a given year. “If we had that for all 50 states, we could do this analysis for the whole country,” Woolf said.
The report, Woolf noted, also doesn’t take into account heat’s effect on businesses, infrastructure, schools and other aspects of American life. He called for more research on this topic. “The collective implications of severe weather are really rather intimidating,” he said. “They just strengthen the arguments for us needing to do something about climate change and to be proactive about it.”
