LONDON, UNITED KINGDOM - DECEMBER 11: Citizens walk on a snow-covered road during snowfall in ... [+]
The summer of 2022 will long be remembered as a season of tumultuous weather. For much of the globe, scorching and seemingly-unending heatwaves made life uncomfortable and presented a serious health risk. The temperatures were so high that wildfires broke out in Britain – events more typical of hotter, drier climates, such as those of California in the U.S. and regions within Australia. Meanwhile, in Pakistan, extreme flooding led to unimaginable destruction and loss of life.
All of this was caused by extreme weather, a direct consequence of climate change. The worst, for many, may be yet to come – as global temperatures reach new lows, those most vulnerable are put at risk by the cold.
This, in turn, will put pressure on healthcare systems, as extreme weather of any kind has long been recognised as a risk to personal wellbeing. As the conflict in Ukraine continues, so too does the squeeze on energy prices, and if people can’t afford to heat their homes, the health of those most vulnerable will inevitably suffer. Extreme cold makes the winter months look gloomier and will place further pressure on healthcare systems often already overstretched, including Britain’s National Health Service (NHS).
The impacts of extreme weather brought about by climate change rarely affect all communities in equal measure. This issue was brought to light in a large study that I published earlier this year, alongside my colleagues at Imperial College Business School and Harvard University: Dr Dheeya Rizmie, Professor Marisa Miraldo and Professor Rifat Atun. We examined the impact of extreme temperatures on hospital admissions in England over 11 years.
Analysing all NHS data on emergency hospital admissions recorded between 2001 and 2012, our research revealed that, whether in cases of significant heat or cold, the elderly, children below the age of five, and people from low-income backgrounds were more likely to be admitted to hospital during periods of extreme temperature shocks.
Examining the effects of extreme temperatures on a range of temperature-sensitive conditions such as respiratory and circulatory diseases, we found that the extreme cold had an effect often even larger on emergency hospitalisations than extreme heat. These extra patients put significant pressure on hospital resources that were already very stretched.
To put things in perspective, the average annual admissions related to temperature extremes represent about 10% of total beds in some hospitals, in addition to their already strained level of activity. In a healthcare system often working at full capacity, investing in prevention is an essential step in our adaptation to climate change.
These extreme temperature-related admissions led to increased costs that averaged at £20.8M annually over the study period. The size of Public Health England’s budget for environmental hazards and emergency preparedness, however, was just £18.2M in 2017. As temperatures peak at greater extremities more frequently with climate change, more funding is needed to prepare for the inevitable increase in climate variability.
The outlook for 2023 is gloomy. The energy crisis and soaring inflation are making the most vulnerable people in society even worse off. Insufficient access to food and the lack of basic necessities, combined with cold and poorly insulated homes, will add to the hardships many people are facing over the winter months.
Without targeted and efficient policies, the NHS is likely to face record hospital admissions this winter. The government and some local authorities have implemented or announced additional support as a response to the current economic situation. These policy interventions are essential to address the root of the problem but are unlikely to be sufficient. After the recent pandemic, we all know what it means to have a healthcare system that can’t cope with the flow of emergency admissions. Therefore, investing to protect the vulnerable populations is key to ensuring the resilience of public services.
Our study focused on one aspect of this issue, which was to model extreme temperatures relating to hospital admissions for certain health conditions. There are other health conditions that are affected indirectly by extreme weather that we haven’t accounted for and, inevitably, there are countless premature deaths that sadly occur each winter because of the cold. These bleak facts highlight the harsh realities of living with unpredictable weather patterns, brought about by climate change.
It is time that governments do more to drastically reduce their countries’ emissions to limit the damage being caused to our planet. Schemes which aim to mitigate against the impact of climate change require large investments, and extra support to the most vulnerable, who have often contributed the least towards climate change but are affected the most. It is not just a discussion for the Conference of the Parties (COP) on climate, but a reality that countries urgently need to address.
In the meantime, extreme weather will likely become more frequent and widespread. While we cannot control the weather and the consequent fallout of its extremities, we can do our best to ensure that health equity is available to all.
This article was authored by Dr Laure de Preux, Assistant Professor at Imperial College Business School.
