Want to cut health care costs by $70 billion? Take urban climate action

Cities could prevent hundreds of thousands of premature deaths annually, according to a new report from researchers at the Yale School of Public Health (YSPH), Resilient Cities Network, the Sustainable Markets Initiative, and Mode Economics. The same actions would save billions in health care costs and reduce millions of tons of carbon emissions. And the benefits would be greatest for vulnerable groups, including children, older adults, and low-income populations.

The report, “The Case for Action: The power of prevention to support health in a changing climate,” responds to a report from last year warning that cities around the world are woefully unprepared for the potentially life-threatening impact of climate change.

YSPH's Dr. Jeannette Ickovics, PhD, Samuel and Liselotte Herman Professor of Social and Behavioral Sciences and Director of the Yale Program on Climate Change and Urban Health, served as the primary scientific advisor for the latest report.

Dr. Ickovics recently talked with Colin Poitras about the findings.

Dr. Jeannette Ickovics (JI): This new report is a call to action. We looked at the impact of specific interventions across 11,000 cities and developed what we feel is a compelling, data-based case for preventative interventions. It provides global decision-makers with a detailed roadmap outlining how specific interventions could reduce climate-related mortality by double digits.

Cities are home to more than half the world’s population. While they can offer economic opportunities and access to better health care, their density and design also increase exposure to health risks such as air pollution, heat stress, and sedentary lifestyles. Public financing to address these concerns has been limited.

By investing in prevention – rather than absorbing the rising costs of climate-related illnesses and mortality – cities can advance health equity, protect their most vulnerable populations, and dramatically reduce carbon emissions. It’s a triple win.

JI: We found simple low-cost interventions and prevention planning would have a significant impact on public health. Our recommended interventions aren’t complicated. Building cooler roofs and expanding urban greenspace can reduce temperatures by 4°C, while incentives promoting public and active transportation can reduce exposure to fine particle air pollution by 10%.

According to our models, measures like creating heat emergency plans and expanding access to clean water and proper sanitation would prevent more than 700,000 additional deaths annually by 2030. They would also save an estimated $70 billion in global health care costs due to reduced treatment needs and lower carbon emissions by 15.6 million metric tons due to reduced medical care.

Improving awareness and education about good hygiene and closing gaps in services can also have a substantial impact. We found that adoption of our recommendations could reduce heat- and pollution-related deaths by 15%, water- and sanitation-related deaths by 13%, and lifestyle-related deaths by 5.4%. Overall, improving community response to climate change through better emergency planning and targeted action steps could prevent one in five deaths, according to our calculations. We believe our findings provide global decision-makers with the data and tools they need to prioritize interventions that deliver measurable benefits.

JI: We are currently working with leaders from 29 cities in 19 countries who share ideas and co-create, with us, tools and resources to facilitate deeper understanding, identify priorities, mobilize technical resources, and drive implementation of targeted programs and policies to enhance climate and health resilience. These 29 cities—led by Lagos, Manchester, England (UK), Mexico City, and Rio de Janeiro—will be among the first to implement solutions that we identified in the report. From here, we hope to scale up to more cities in the Resilient Cities Network. Despite the political and financial challenges, I remain hopeful because we are working together in a multi-sector partnership and harnessing our collective strength to protect health, promote equity, and ensure a sustainable future for all.