Health

Key Messages

• There are a large number of potential health impacts that could arise from climate change, directly or indirectly, including heat-related mortality and morbidity, food safety and vectorborne diseases, outdoor air pollution, deaths, injuries and wider well-being from flooding, though there are also some potential benefits (reduction in cold mortality)..There are also risks to health infrastructure and other critical infrastructure (water and power supplies) from extreme weather events.

• The ClimateCost study has assessed the potential impacts and economic costs of selected health impacts in Europe, focusing on four impacts: heat related mortality, food borne disease, coastal flooding and labour productivity. This has considered future climate and socio-economic change, including the projected increase in the elderly population.

• Heat related mortality. Under a medium to high emission (A1B) scenario, with no mitigation or adaptation, the study estimates an additional 26000 deaths/year from heat by the 2020s (2011-2040), rising to 89 thousand/year by the 2050s (2041-2070) and 127 000/year by the 2080s (2071-2100). While heat-related mortality in Europe is project to increase in all regions, there are relatively higher levels of climate change-attributable heat deaths in Southern Europe.

• The cost of these impacts varies significantly on the valuation method used for changes in the risk of fatality, specifically whether a Value of a Life Year Lost (VOLY) or a Value of a Statistical Life (VSL) is used. Using the latter, the estimated welfare costs are €31 billion/year by the 2020s (2011-2040), €103 billion/year by the 2050s (2041-2070) and €147 billion/year by the 2080s (2071-2100), but these values fall by over an order of magnitude when using the VOLY approach.

• Under an E1 stabilisation scenario, broadly equivalent to the EU 2 target, these impacts are reduced significantly (after 2040), falling to 69 thousand deaths/year by the 2050s (2041-2070) and a similar number in the 2080s (2071 2100). The equivalent economic costs are €80 billion/year by the 2050s (2041-2070), if the VSL approach is used.

• Including (autonomous) acclimatisation in the analysis reduces these impacts significantly. With acclimatisation, the estimated number of heat related deaths fall to 13 thousand/year in the 2020s, 44 thousand/year in the 2050s and 40 thousand per year in the 2080s under the A1B scenario. The equivalent values for the E1 scenario are 30 thousand/year in the 2050s and 18 thousand per year in the 2080s. The welfare costs fall in line with these estimates, though they are still very significant if the higher VSL estimate is used.

• Food borne disease. Salmonellosis is an important cause of food borne illness in Europe and is sensitive to ambient temperature. The estimates suggest that under the A1B scenario, climate change could lead to an additional 7 thousand cases/year of salmonellosis in EU27 by 2020s, rising to 13 thousand by the 2050s and 17 thousand by the 2080s, if the incidence remains at current levels, but with 5.5, 8.8 and 9.3 thousand cases/year if a baseline decline in incidence is assumed). Under the E1 scenario, these fall to around 6-7 thousand cases per year (2050s/2080s, baseline decline). The economic costs of these additional food borne illnesses has also been estimated. The welfare costs are estimated at €36 million/year in the 2020s (A1B, current baseline), rising to €68 and €89 million/year in the 2050s and 2080s respectively:(€30, 46 and 49 million/year if a decline in incidence (due to better regulation) is included.

• Mortality due to coastal flooding is associated with direct health impacts including fatalities. The study has assessed the impacts of climate change (sea level rise leading to ‘deeper’ storm surge). Climate and socio economic change is estimated to lead to 130 deaths/year in the EU by the 2050s and 650 deaths/year in the EU by the 2080s (A1B) with two thirds of these arising in Western Europe. The associated welfare costs are estimated at €151/year in the 2050s and €750 million/year by the 2080s. These fall significantly under the E1 mitigation scenario to 100 (2050s) and 185 (2080s) fatalities/year, with welfare costs of €117/year (2050s) and €214 million/year (2080s).

• Climate change is likely to cause negative impacts on labour productivity in some regions. Under the A1B scenario, Southern Europe is estimated to incur a mean loss of productivity – measured here as days lost – of 0.4% to 0.9% by the 2080s (with the range reflecting different future labour structures). Total productivity losses for Europe are estimated at €300 – 740 million/ in 2080s (A1B). These are significantly reduced under the E1 mitigation scenario to €60 – 150 million per year in 2080s.

• While these cover many of the major health impacts of climate change in Europe, there are other important potential effects,. As well as health outcomes, these also include the costs of adapting health systems infrastructure, which could be high. There are also future research priorities to assess the effectiveness of specific interventions.

• It is stressed that there is a wide range of uncertainty around all these estimates – for all four health categories above – reflecting the underlying uncertainty in emissions scenario and climate-health relationships. The need to recognise and work with this uncertainty – as part of integrated and sustainable health policies – requires an iterative and flexible approach.

• There is limited information on the costs of adaptation to avoid or reduce health impacts. Public health (community based) heat alert systems are a relatively low cost responses for addressing heat related mortality but evidence so far indicates limited effectiveness. Change to infrastructure (space cooling, building design or spatial planning) are more expensive but are likely to be required in the long term.

• For coastal flood risks, other parts of the ClimateCost study have considered technical adaptation (dikes). Coastal adaptation can reduce risks significantly; down to less than 10 deaths per year in 2080 (from 650 without adaptation), reducing residual impacts to around €5 million/year (A1B).

• There is much less information on the costs of adaptation for other risks. The limited information available suggests that many early public health based adaptation measures are relatively cost-effective, and/or have high benefit to cost ratios. However, some options (e.g. large-scale vaccination programmes, infrastructure such as cool rooms, new water treatment) increase costs significantly. As impacts evolve over time, and risks become more cross-sectoral in nature, the cost of adaptation may also rise significantly, due to the need for larger capital investment.

Citation

Kovats, S, Lloyd, S, Hunt, A and Watkiss, P. (2011). Technical Policy Briefing Note 5: The Impacts and Economic Costs on Health in Europe and the Costs and Benefits of Adaptation, Results of the EC RTD ClimateCost Project. In Watkiss, P (Editor), 2011. The ClimateCost Project. Final Report. Volume 1: Europe. Published by the Stockholm Environment Institute, Sweden, 2011. ISBN 978-91-86125-35-6.

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