Two U.S. Air Force planes fly over the ocean.
Two U.S. Air Force B2 Spirit aircraft (so-called Stealth Bombers) soar over Dover, United Kingdom, flanked by Royal Air Force F-35 jets. Although U.S. defense spending is the highest in the world, that amount is smaller than the annual health costs from extreme weather events, air pollution, heat waves, and diseases worsened by climate change. Credit: Royal Air Force, OGL v1.0

A report released at a medical conference last weekend featured one very large sum. According to the synthesis of dozens of published scientific research studies, the price of health care costs attributed to climate change and fossil fuel use is at least $820 billion each year in the United States.

The costs include expenditures associated with doctor visits, prescriptions, emergency room visits, physical therapy, allergy treatments, mental health care, and premature death. They also factor in downstream costs like lost work hours and lost wages. The costs stem either directly or indirectly from burning fossil fuels.

The Natural Resources Defense Council (NRDC), the Medical Society Consortium on Climate and Health, and Wisconsin Health Professionals for Climate Action presented the report at the annual Medical Society Consortium meeting on 22 May.

How Much Money Is That?

It’s a hard sum to fathom: $820 billion per year in the United States.

Earlier this year, Reader’s Digest made a handy list of what you can buy with $1 billion:

  • the Kansas City Royals or
  • an art combo pack from Leonardo da Vinci, Modigliani, and Picasso or
  • 57 of the most expensive cars in the world (the Pagani Zonda HP Barchetta)

Multiply any of those items by 820, and we’re getting somewhere.

Put another way, U.S. defense spending in the 2020 fiscal year hit $714 billion, according to the U.S. Government Accountability Office. Climate-driven health costs soared $106 billion above that.

Why Does It Cost So Much?

A middle-aged man with Lyme disease visited the hospital at least 30 times in 1 year seeking relief from his symptoms.

Doctors might tell patients to avoid alcohol or smoking, but it’s much harder to eschew environmental health effects. Wildfire smoke, hurricanes, Lyme disease, heat waves, West Nile virus, and oak pollen are just a few of the hazards made worse by climate change that drive up health costs.

“My job as an emergency medicine doctor is to protect my patients and keep them healthy,” said Renee Salas, a physician at Massachusetts General Hospital not involved with the report. “And climate change increasingly threatens my ability to do that.”

The report quantifies what Salas witnesses every day in the emergency room.

She’s seen a middle-aged man with Lyme disease visit the hospital at least 30 times in 1 year seeking relief from his symptoms. (Evidence shows that ticks are expanding their range due to climate change.) She’s also seen a 4-year-old girl whose mother brought her to the ER for her third asthma attack that week. The child’s condition was made worse by climate-intensified pollen and air pollution, and her single mother worried about missing yet another work shift.

The Lancet Countdown, an interdisciplinary group of 34 academic institutions and United Nations agencies, wrote in 2019 that generally, climate change will make the U.S. population sicker and lose more work hours.

Who’s Paying for It?

More than half of the adults in the United States face medical financial hardship, but most Americans shoulder some of the bill, with Medicaid and Medicare bearing the brunt of the costs. On average, $820 billion comes to $2,500 per American per year.

“In terms of financial costs related to health problems, illnesses, and injuries and premature deaths, no federal agency right now is tracking these costs,” said report author Vijay Limaye, an epidemiologist at NRDC. Because of data uncertainties, Limaye thinks that $820 billion is an underestimate.

How Can We Cut Costs?

Action now may save money—and lives—down the line, argues the report.

Wind energy saved thousands of people from premature death between 2007 and 2015.

Wind energy saved thousands of people from premature death between 2007 and 2015, according to a study from scientists at the Lawrence Berkeley National Laboratory.

Building more bike paths and sidewalks, as well as releasing fleets of zero-emission buses and trains, could reduce air pollution and boost health.

And folding climate into disaster response will help medical providers care for victims of floods, hurricanes, and wildfires most effectively.

“We face a choice: continue down this dead-end path of inaction and soaring healthcare bills,” said Limaye in a statement, “or make smart investments now in cost-effective solutions that will prevent millions of people in our country—especially the most vulnerable—from suffering injuries, illness, and premature death. The time to act is now.”

—Jenessa Duncombe (@jrdscience), Staff Writer


Duncombe, J. (2021), We spend more on climate health costs than the U.S. government spends on defense, Eos, 102, Published on 28 May 2021.

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