Interdisciplinary study from Virginia Commonwealth University reveals healthcare costs of extreme heat – VCU News

A new report by an interdisciplinary group of Virginia Commonwealth University faculty, staff and students and published by the Center for American Progress sheds light on the links between overheating and harm to health. The report, titled “Health Care Costs of Extreme Heat,” sets the stage for a discussion of the impact of heat by recalling recent heat events that collectively harmed and treated thousands of people.

The researchers used data available in Virginia to estimate the increase in health care utilization associated with extreme heat, such as emergency department visits, hospitalizations and health care costs for those services that were established. Daily climate data collected from 15 weather stations serving Virginia showed that an average of 80 days of heat events occurred each summer from 2016 to 2020. Based on insurance claims data from the Virginia All-Payer Claims (APC) database, The researchers calculated that the thermal events for each summer result in:

  • Nearly 400 additional ambulatory care visits for heat-related illness.
  • Nearly 7,000 additional emergency department visits, including more than 4,600 visits for heat-related or heat-related illness.
  • Nearly 2,000 additional heat-related hospital admissions, most of them due to heat-related illnesses.

Researchers found that heat event days would be responsible for nearly 235,000 emergency department visits and more than 56,000 hospitalizations for heat-related or heat-related illnesses, adding nearly $1 billion in costs each summer.

said Stephen Wolf, MD, a professor in the department of family medicine and population health at Virginia Commonwealth University School of Medicine and one of the report’s co-authors. “Unless we take action to mitigate the effects of climate change, thermal events are expected to continue to increase, dealing an even greater blow to public health.”

Wolf is a senior fellow at the Center for American Progress and director emeritus of the VCU Center for Community and Health.

Heat has a negative effect

Hot summer days have always posed a risk of health complications, but climate change is causing more periods of extreme heat.

said Stephen Fung, PhD, director of the Ph.D. Program in Integrative Life Sciences at VCU and a professor in the Department of Chemical Engineering and Life Sciences in the VCU College of Engineering, who co-authored the report. to fester. “

The adverse health effects of extreme heat include heat-related illnesses due to dehydration as well as heat exhaustion and heatstroke. Extreme heat also affects people with heart disease, lung disease, and other chronic problems, whose health can deteriorate further when exposed to hot weather conditions. These people are often seen in the outpatient clinic or emergency department, and if they are sick enough, they are admitted to the hospital.

“These health care visits were our outcome measures, looking at how the increased incidence of extreme heat events is negatively affecting our collective health and the health care system,” Wolf said. “We then applied federal data on the average cost of emergency room visits and hospitalization to estimate the total cost to the nation of approximately $1 billion per year associated with extreme heat.”

“There are environmental, personal and community factors that either build resilience or put people in communities at risk,” said Alex Christ, MD, professor in the Department of Family Medicine and Population Health at Virginia Commonwealth University School of Medicine. a report. “Understanding these factors can shape how we approach health care, the environment, and politics.”

The report’s authors recommend that leaders tackle the root cause of the problem, which is climate change itself, by prioritizing reducing greenhouse gas emissions. The authors also suggest that leaders work to make communities more resilient to extreme heat. This includes making changes to their infrastructure and implementing initiatives that reduce exposure to extreme heat, such as planting trees and expanding green spaces, designing buildings to absorb less heat, and increasing shade.

A multidisciplinary effort

The study was conducted by harnessing the skills and experience of researchers from various VCU schools and academic centers. Christ said the interdisciplinary effort is exciting because it brought together researchers from different fields to better understand one of the biggest issues facing society today.

“Our colleagues in the environmental sciences are experienced with tools that collect data on thermal events or tell us about the fine particles polluting our atmosphere,” Crist said. “At medical school, we know the health effects of heat, air quality, and water quality. We also have access to data like the Virginia APC database so we can understand how health care delivery and health outcomes are affected by environmental factors. We combined these two worlds to be able to create this data and analysis.” .

“The collaborative nature of the VCU team was remarkable, with researchers coming from different fields and discussions ranging from details of the raw data to conceptual goals and policy recommendations,” Fung added. “It helped us all understand the importance of this issue and the need for careful analysis that can help raise awareness.”

Other members of the research team include Adam Funk and Mai Nguyen, PhD students in biostatistics in the College of Medicine, who worked in close collaboration with Joe Morena, PhD, a postdoc in the College of Humanities and Sciences in the Department of Biology at VCU. . They conducted their analysis under the guidance of Fung and Roy Sabo, PhD, associate professor in the College of Medicine’s Department of Biostatistics.

Evan French, a data scientist at Virginia Commonwealth University’s Center for Clinical and Translational Research, provided assistance with accessing the Virginia APC database, while Derek Chapman, Ph.D., interim director of the VCU Center for Community and Health, supported data analysis.

The report also highlights the work of another collaborator, Jeremy Hoffman, Ph.D., climate and earth scientist and director of climate justice and impact at Groundwork USA and faculty member of the L.A. School and Virginia Commonwealth University Environmental Studies Center. Hoffman mapped heat islands within the Richmond area, revealing that neighborhoods that were painted red in the 1930s, still mostly poorer communities of color, experience more exposure to extreme heat than whiter, wealthier neighborhoods. Hoffman produced this work with Fung and citizen scientists from his former position at the Science Museum of Virginia.

A number of grants and centers at VCU supported this research effort. The Wright Center provided funding to researchers to collect data for this study. Krist and Greg Jarman, PhD, an environmental scientist and director at the VCU Rice Rivers Center, are principal investigators for a $150,000 grant from the VCU Breakthrough Fund, which supports multidisciplinary teams to design unique, innovative, and large-scale approaches to humanity’s greatest challenges. Most of this funding went to support the work of Morena and the students involved in the project.

search methods

Garman said one of the challenges the group faced was figuring out how to integrate the very different types of data used by health professionals vs. Ecologists. For example, data on respiratory health outcomes are collected at very different time and spatial scales, and with different methods and assumptions, than data on ozone concentrations in the atmosphere.

“These different datasets must be combined in order to confidently answer the complex but important questions about the potential effects of ground-level ozone on the incidence of asthma in disadvantaged urban communities during the summer months,” Jarman said. “An early success of our distinguished collaboration, which led to this extreme heat analysis, was the fusion of public health data and atmospheric sciences by a group of research-trained, doctoral physicians at Virginia Commonwealth University.”

Garman sees the report as a compelling example of the important work a large research university can accomplish when disciplinary silos are eliminated and scholars from units as diverse as medicine, engineering, and environmental sciences collaborate in the same intellectual space.

The research team noted that all participants were cooperative learners.

“We’ve combined these uniquely powerful datasets that can allow us to ask whole sets of questions that we haven’t been able to answer before,” Crist said. “This increased analysis of health events due to environmental exposure is not something we’ve really done before. We are now applying this approach to a range of topics, such as exposure to poor air quality and its impact on asthma and COPD. This collaboration has helped us to be able to conduct A whole new body of research.”

The researchers credit Funk with doing the heavy lifting in terms of statistics, integrating the various datasets, performing the required calculations, and visualizing how spikes in thermal events correlate with spikes in healthcare visits.

“Whether it’s analyzing heat, air or water, we have new upside ideas from everything you’ve seen,” Funk said. “It’s really cool to be able to put all these pieces together, put them together like a puzzle and see a picture that we haven’t seen before. We’re learning so much from each other and with each other at the same time.”

The research team is now working to publish the report in a scientific journal, with plans to identify the communities most affected by the heat events.