Can tech help keep patients safe during climate emergencies?

By Elizabeth Baca, M.D., M.P.A., managing director, and Brian Rush, manager, Deloitte Consulting LLP

The Earth is nearing the end of what could go down as the hottest summer in more than 120,000 years.¹ In addition to extreme heat throughout much of the United States, smoke from Canadian wildfires blanketed parts of the country in a sepia haze in June and July.² In the future, we expect predictive analytics and other digital technologies could be used by federal agencies, public health organizations, health plans, clinicians, and health systems to forecast climate-related health emergencies and to identify the people and communities most likely to be affected.

On August 9, the US Department of Health and Human Services (HHS) Office of Climate Change and Health Equity launched a tool to track heat-related illnesses nationally. The Heat-Related Illness EMS Activation Surveillance Dashboard is intended to tap into data generated by emergency medical services (EMS) responses and map areas of concentrated heat-related illnesses.³ The online tool was designed to help state, regional, and local governments determine where to prioritize heat-mitigation strategies, such as the planting of shade trees, development of parks, and installation of cool roofs. It could help public health officials prioritize interventions like cooling centers and outreach to at-risk populations during periods of extreme heat, according to a prepared statement from HHS. It might also be used by health systems, care teams, and health plans to identify at-risk patients and help them take preventive steps.

Climate emergencies are becoming more intense

Climate emergencies—including heatwaves, hurricanes, droughts, and wildfires—have become more frequent and intense in recent years and are having a measurable impact on health.⁴ In June, for example, wildfire smoke in New York City resulted in poor air-quality and contributed to an 84% spike in asthma-related emergency room visits.⁵ Long-term exposure to polluted air also increases the risk for colon and prostate cancer, in addition to lung cancer, according to a new study from the Harvard T.H. Chan School of Public Health in Boston.⁶ A study from the American Heart Association concluded that exposure to heavy smoke from wildfires increases the risk of out-of-hospital cardiac arrests as much as 70%.⁷ That risk, the study determined, is elevated in low-income communities. Another study suggests air pollution could even contribute to antibiotic resistance.⁸

Climate emergencies could strain health systems

A Deloitte analysis of 2019 claims data determined that heatwaves and poor air quality caused significant strain on the health care system. Heatwaves in one large US city, for example, contributed to a 19% spike in pre-term births and heat-related ER visits, and a 12% spike in renal disease ER visits. Poor air quality in another large city contributed to a 10% increase in ER visits for respiratory illnesses.

An extreme heat wave in the Pacific Northwest two years ago contributed to an estimated 1,200 premature deaths and 1,300 hospitalizations.⁹ Hospitalizations—particularly for preterm deliveries and heat-related illnesses (e.g., heat stroke, dehydration)—tend to increase during these climate change related events, according to our research. We also determined that some communities can be disproportionately affected by climate emergencies. Climate-related events can also increase anxiety and contribute to mental health disorders. Moreover, the Environmental Protection Agency (EPA) determined that climate change could have a negative effect on crop yields, which could make healthy food more expensive and less accessible to some people.¹⁰

Can early interventions help?

A few naturally occurring experiments have demonstrated how early intervention can reduce weather-related health conditions. Consider this: During the 1996 Summer Olympic Games in Atlanta, city-wide emergency room visits and hospitalizations for asthma dropped 42% among Medicaid enrollees; asthma-related care for HMO members fell 44%; and citywide hospitalizations for asthma decreased 19%. Researchers concluded that traffic controls imposed during the event caused morning peak traffic to drop by 23%. With fewer people driving cars, and more people using public transportation, ozone, carbon monoxide, and nitrogen dioxide levels all declined.¹¹

The cost of climate-change in health care

Along with being a potential threat to health and well-being, climate-change can present a number of financial challenges for the health care sector. It is an issue that chief financial officers, and other executives, should consider closely. The ability to use predictive tools to provide targeted, actionable insights could have a substantial impact on health care costs. How much do climate-related health issues cost?

• $820 billion: The total annual health care costs associated with air pollution, which contributes to 6.5 million premature deaths each year, worldwide.¹²
• $16 billion: Each year, smoke from wildfires leads to more than 6,000 respiratory hospital admissions and about 1,700 premature deaths.¹³
• $263 million: Cost associated with a 2021 heatwave in Wisconsin that contributed to two dozen deaths, 1,600 ER visits, and more than 150 hospital admissions.¹⁴
• $8.1 trillion: The estimated global financial impact of health-related issues caused by poor air quality.¹⁵ This is about 6.1% of global GDP. 

Conclusion

Air pollution, extreme summer heat, and other climate-related issues are likely to become more common. Some people—particularly socially vulnerable populations—could be at increased risk for health emergencies. Technology seems to be getting better at predicting potentially dangerous weather patterns. It might also provide a faster and more accurate analyses of satellite images that identify disaster-stricken areas in need of assistance or more precisely pinpoint urban heat islands.¹⁶ It is possible to combine this data with social vulnerability data, medical claims data, and prescription data to identify those who are at increased risk.

Armed with this targeted data, health systems, clinicians, health plans, federal agencies, and public health organizations should be more equipped to plan for resilience. As the buzz continues around digital transformation, predictive analytics, and artificial intelligence, it is important to remember that these tools could make it easier for health care stakeholders to protect the populations they serve from increasingly frequent and intense climate emergencies.

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Endnotes:

¹ July 2023 is hottest month ever recorded on Earth, Scientific American, July 27, 2023

² Air quality worsens again as Canada wildfires smoke returns to U.S., The New York Times, July 18, 2023

³ Biden-Harris Administration launches national dashboard to track heat-related illness, HHS press release, August 9, 2023

⁴ 10 facts that prove the world is in a climate emergency, WIRED, August 17, 2023

⁵ ER visits for asthma in New York City soared as wildfire smoke blanketed the region, Inside Climate News, June 14, 2023

⁶ Air pollution linked to higher risk for variety of cancers, UPI, August 10, 2023

⁷ Wildfires may fuel heart health hazards: smoke exposure increases cardiovascular risks, American Heart Association, June 7, 2023

⁸ Association between particulate matter air pollution and clinical antibiotic resistance, The Lancet, August 2023

⁹ The cost behind increasing heat domes, American Security Project, September 27, 2021

¹⁰ Climate change impacts on agriculture and food supply, US Environmental Protection Agency, December 13, 2022

¹¹ CDC study links improve air quality with decreased emergency visits of asthma, US Centers for Disease Control and Prevention, February 21, 2001

¹² Health costs from climate change top $820 billion a year, Natural Resources Defense Fund, May 20, 2021

¹³ The price of air pollution on American's health care, World Economic Forum, June 1, 2023

¹⁴ Ibid

¹⁵ The global health cost of PM2.5 air pollution, the World Bank, 2019

¹⁶ Artificial intelligence’s environmental costs and promise, Council on Foreign Relations, June 28, 2022

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Deloitte shall not be responsible for any loss sustained by any person who relies on this publication.

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