How extreme heat affects the healthcare industry

Extreme heat is much more than a nuisance that raises your electricity bill: It can be deadly, causing heat stroke, heart disease, respiratory disorders, and many other heat-related illnesses. It’s a health equity issue, too, as low-income people and communities of color most frequently lack access to resources to keep cool, like air conditioning or shaded areas. And it takes a huge financial toll on the healthcare system.

Extreme heat costs the industry $1 billion every summer, according to researchers from Virginia Commonwealth University (VCU) and nonpartisan policy institute the Center for American Progress, who analyzed health insurance claims in Virginia between 2016 and 2020 and extrapolated that data nationally—and that’s probably an underestimation.

“I would think it’s very safe to say that number is gonna go up substantially this year. Because there are many more events now in 2023 than there were in 2016 to 2020, when we did this analysis,” Alex Krist, a family practice physician, professor at VCU, and co-author of the study, told Healthcare Brew.

Plus, the researchers only accounted for insured patients who went to a hospital. But there are plenty of others affected by extreme heat, Krist said.

Costly visits

Excess emergency room visits are one way extreme heat drives up healthcare costs.

The researchers estimated extreme heat causes about 235,000 emergency room visits and more than 56,000 hospital admissions across the US every year.

Those visits aren’t cheap. The average hospitalization due to a heat-related illness cost $5,359 between 2001 and 2010, according to a 2016 study.

Those visits can be for more than just physical symptoms. Studies have shown that heat waves are associated with an increase in emergency room visits for mood and behavioral disorders, according to a report from Jill Rosenthal, director of public health policy at the Center for American Progress.

“We need to be prepared to be able to handle more people in the emergency room and in the hospital who are coming in with heat-related illnesses,” Krist said.

Heat exacerbates health disparities

Some communities are better equipped to handle extreme heat events, according to Krist, like those in which most houses have air conditioning and there are lots of shady spaces or cooling centers. As a result of institutional racism like redlining, people of color frequently live in neighborhoods that lack these resources, Rosenthal said. They are also less likely to have access to healthcare facilities and health insurance, she added.

Some jobs also put people at a higher risk of extreme heat exposure, like those that take place outside or in buildings without air conditioning, Rosenthal noted. Low-income earners are more likely to have outdoor jobs, according to the World Bank.

“Climate changes are going to make health inequities even worse for people in communities that we serve,” Krist said.

Healthcare’s carbon footprint

Global climate change causes extreme heat events, and the healthcare industry directly contributes to climate change through its large carbon footprint. Specifically, the industry produces an estimated 8.5% of all national carbon emissions, according to a 2021 study published in the New England Journal of Medicine.

Those emissions come from the energy required to run healthcare facilities, as well as healthcare’s supply chain, which accounts for 71% of the sector’s carbon emissions, according to a 2019 study from Health Care Without Harm, an international nongovernmental organization.

“There are efforts in a lot of industries to find ways to reduce carbon emissions, and the healthcare system is woefully behind in that way,” Rosenthal said.

The intersection of climate change and patient care

With extreme heat driving up healthcare costs and exacerbating health inequities, providers will have to start taking climate change into account when treating patients, Krist said.

“For an outpatient doctor like me, I might have to understand the community I serve and [whether] my community [is] at a greater risk,” he said. “Which of my patients am I more worried about? Should I proactively talk to them about how to protect themselves?”

“Throughout my career, I’ve never really had to think about climate as a factor influencing my patients’ health,” he added. “We’re at a new time now, where we have to start routinely, as healthcare providers, thinking about the intersection of climate and our patient’s health.”