U.S. Report Quantifies the Economic Burden of Fossil Fuels and Climate Change

A report from The Medical Society Consortium on Climate & Health, the Natural Resources Defense Council (NRDC), and the Wisconsin Health Professionals for Climate Action (WHPCA) has priced U.S. collective inaction on climate change at $820 billion annually. The number is described as a low-ball by the authors who suggest a far higher one as you will attest by adding the numbers up from the details that follow. Published on Thursday of last week, this report enumerates the health costs of climate change looking at:

• premature deaths from climate-related events such as flooding, extreme weather events, heat waves, drought, vector-borne diseases, etc.
• medical care for both the physical and mental health issues associated with the previous point.
• lost wages and worker productivity coming from climate-related illnesses.
• the cost of medications, prescriptions, and other medical care for climate-related illnesses.
• and the downstream long-term health costs caused by destabilizing climate events that impact individuals, families, and communities.

Why do the authors believe $820 billion is underreporting? Because the causes of death recorded by hospitals don’t necessarily include a box to tick off that includes climate change as the reason. Those most vulnerable include communities of colour, children, pregnant women, the elderly, and the Indigenous.

The use of fossil fuels is intrinsically linked to anthropogenic climate change. Emission components from the extraction, refining, transportation and combustion of coal, oil, and natural gas are causal factors: not only just because the carbon released into the atmosphere leads to more extreme weather, intense heat waves, severe droughts and wildfires which lead to deaths, disease and other health challenges, but also because the air pollution produced by sulphur and nitrogen oxides, and microscopic particulate matter suspended in the atmosphere presents an additional threat. Not to be forgotten are tailpipe emissions that produce ground-level suspended particulate matter and ozone.

Before the publishing of this report, there were mostly indirect links made to climate change when addressing increased health costs. Data was largely limited to one-off events like tornadoes, hurricanes, floods, wildfires, new insect vector-borne diseases, etc. But in this report, as you will see, we get the numbers broken down by major climate change contributors.

• Particulate Matter – from burning coal, we have associated increases in cardiovascular and respiratory conditions, lung cancer, nervous system, metabolic, reproductive and developmental disorders. Estimated health costs nationwide amount to $820 billion and the number of premature deaths in 2012 alone was 107,000.
• Ground-Level Ozone – from fossil fuel combustion, we have associated increases in asthma, cardiovascular, metabolic, nervous system, and reproductive disorders. Estimated annual costs in 2002 amounted to $7.9 billion, 795 premature deaths, and 370,000 hospital visits including ER, outpatient and hospitalizations.
• Airborne Allergens  – largely exacerbated by rising atmospheric temperatures, higher carbon dioxide concentrations, and increases in the duration and intensity of pollen seasons, is associated with increases in allergic diseases including hay fever, rhinitis, atopic dermatitis, and asthma. The cost of oak pollen alone in 2010 amounted to $11.4 million and 21,200 ER hospital visits.
• Ticks – a warming atmosphere is changing the geographic range of the tick that causes Lyme Disease. Lyme is associated with long-term neurologic, cardiac, and rheumatological consequences. A 2008 study shows costs of between $860 million and $1.6 billion and 240,000 to 440,000 new cases annually.
• Mosquitoes – a warming atmosphere is changing the geographic range and lengthening the season for mosquito-borne illnesses of which West Nile Virus is one. West Nile causes fever, neurological, and developmental abnormalities. A 2012 breakdown attributes $1.1 billion in increased healthcare costs, 89 premature deaths and over 32,000 hospital encounters including admissions, ER and outpatient visits.
• Extreme Heat – climate change doubled the number of heat waves between 1961 and 2010 in the U.S. causing hyperthermia conditions like heat stroke and contributing to cardiovascular, respiratory, cerebrovascular, perinatal and diabetes-related conditions. In 2012 in Wisconsin alone heat waves cost the healthcare system $263 million, 27 deaths, and more than 1,800 hospital and outpatient visits.
• Wildfires – attributed to rising atmospheric temperatures, drought, and the spread of insect-borne diseases negatively impacting forests, have seen significant growth in the land area burned particularly in the western half of the country. Wildfires have caused premature deaths, injuries, and contributed to respiratory and cardiovascular health conditions. Data from 2010 notes that wildfire smoke cost $16 billion, caused 1,700 premature deaths and 6,200 hospital admissions. The total cost to healthcare from California’s wildfires is still being added up.
• Extreme Weather Events – heavy rainfall, hurricanes, storms, and flooding have been responsible for trauma and death directly, as well as the exacerbation of chronic health conditions. Pathogenic food and water-borne infections follow such events and in the aftermath, the impact on survivors leads to mental health issues, as well as pregnancy complications. Hurricane Sandy in 2012 as an example produced health-related costs amounting to $3.3 billion, 273 premature deaths, and more than 13,800 hospital admissions, ER and outpatient visits. Not mentioned in the report but worth reading is an article by Maggie Fox of NBC News describing short and long-term health impacts from Hurricane Harvey which struck Houston, Texas in 2017.

If you add all the above numbers you will note they exceed the $820 billion mentioned at the beginning of this posting. And beyond these documented reported costs there are additional long-term health problems linked to food and water security which have not been calculated. Nor have long-term mental health costs been factored in from generalized anxiety or ecological grief, a new climate-change-associated anxiety syndrome on the rise.

No report would be complete without recommendations. Here are three it mentions for for consumers:

1. Use public transit rather than a car, and if you must use the latter, rideshare.
2. Walk or bicycle to destinations.
3. Eat a sustainable and healthy diet: less meat, more locally grown produce including fruit, vegetables and whole grains. A low-carbon planetary health diet would prevent 11 million deaths annually around the world.

And then it includes specific recommendations for health professionals and the healthcare community:

1. Reduce the carbon footprint of the health sector which currently produces up to 8.5% of U.S. greenhouse gas emissions annually.
2. Develop emergency preparedness protocols to address health and infrastructure damage from climate change events. That includes heat warning systems and cooling centres, and quick response capacity to wildfires, floods, hurricanes and other extreme weather events.
3. Integrate climate change into public health practice including educating patients on the three above-mentioned consumer recommendations.
4. When questioning patients and taking histories, include an environmental and occupational discussion to measure the quality of their external, and internal environments as well as lifestyle and mental well-being.
5. Understand how climate changes impact medications during heat waves, in particular, antipsychotics, beta-blockers, and antihistamines.