ESRI research highlights impact of climate change on use of hospital services in Ireland

Despite concern about the impact of climate change on health, limited information exists on the impact climate change and temperature increases will have on health in Ireland. New research published by the Economic and Social Research Institute (ESRI) and funded by the Irish Heart Foundation and Irish Cancer Society on behalf of the Climate and Health Alliance provides evidence on the link between climate change, temperature changes and health and healthcare utilisation in Ireland.

Combining temperature data from Met Éireann with emergency inpatient hospitalisation data from the Hospital In-Patient Enquiry (HIPE) dataset this report highlights that temperature increases significantly increase hospitalisations in Ireland for temperature-related health conditions. The report also uses Met Éireann temperature data and simulations performed by the Irish Centre for High-End Computing (ICHEC) to develop Irish climate projections to project future temperatures for different Representative Concentration Pathway (RCP) climate scenarios, and examines the impact on hospitalisations of projected future temperature increases. Finally, the research provides an assessment of the potential health co-benefits of climate change mitigation actions, such as reducing greenhouse gas emissions will lead to improved air quality

Key findings

Current period

• Climate change has direct and indirect impacts on population health. Temperature increases are considered one of the principal threats to population health associated with climate change in Ireland.
• Using data from HIPE over the period 2015-2019, emergency hospital admissions for temperature-affected diseases were 8.5% higher on hot days (22–25oC compared to moderate temperature days (10–13oC) in Ireland.
• The largest increases in hospitalisations on hot days were seen for circulatory, respiratory and infectious diseases, and amongst younger people (0-14 years).
• On the hottest days where temperatures exceed 25oC, results showed potential evidence of adaptive behaviour, especially among older people, suggesting advance notice of very warm days can help people change their behaviour.

Future periods

• Mean annual temperatures are projected to increase by 1–1.6oC by 2041–2060 compared to the reference period 1981–2000, under the RCP4.5 climate scenario (the most likely scenario).
• Hospital admissions for health conditions linked with temperature are projected to increase by 12.2% during hotter weather under the most realistic scenario (RCP4.5 scenario) in the 2041–2060 period.
• Evidence from the literature estimates that under the most pessimistic climate scenario (RCP8.5), climate change could lead to 1,400 additional deaths per annum in Ireland by the end of the 21st century. Illustrating the benefits of climate mitigation actions, excess mortality is projected to be 483 under the most likely climate scenario, RCP4.5.

Dr Anne Nolan, Associate Professor at the ESRI stated: “Even in moderate climates such as Ireland, we find evidence that higher temperatures increase hospitalisation rates significantly. These results emphasise the need for policymakers in moderate climate countries including Ireland to implement adaptive measures and increase capacity to accommodate the higher hospital demand from higher temperatures, especially during the summer months.”

Dr Kelly de Bruin, Senior Research Officer at the ESRI stated: “Under the Paris Agreement, Ireland must reduce greenhouse gas emissions by 55 per cent compared to 1990 levels by 2030 and achieve net-zero emissions by 2050. Achieving these targets is essential to limit the negative effects of climate change on population health and the healthcare system .”

Emma Balmaine, CEO, Irish Heart Foundation said: “These stark new findings reveal that even in a moderate climate like Ireland, rising temperatures from climate change will lead to a substantial increase in hospitalisations. Worryingly, the most vulnerable in our society, including those with cardiovascular disease and children, will be most impacted by rising temperatures. To protect public health, it is vital that we invest in our healthcare system to ensure its resiliency and adopt immediate measures to transition to a more environmentally sustainable society”.

Averil Power, CEO, Irish Cancer Society said: “We need to see bold action from the government to prevent the very serious impact climate change will have on healthcare in Ireland in the coming years. Issues like rising temperatures and air pollution have a very real impact on people’s health and can cause an array of health issues, including cancer. This report also shows how our healthcare system is vulnerable to the harshest impacts of climate change. We’ve highlighted time and time again the many issues that already exist due to an overburdened and under- resourced health system. Already people are waiting for appointments, surgeries and cancer care. We’re now in a race against time to put proper mitigation plans in place to cut climate change and to implement effective strategies to ensure Ireland has a resilient, fully staffed and future-proofed health system.”

Notes

• The research was funded by the Irish Heart Foundation and Irish Cancer Society on behalf of the Climate and Health Alliance under a programme of research on the ‘Health Effects of Climate Change and Mitigation Actions in Ireland’ carried out at the ESRI. This work was also supported by funding from the Environmental Protection Agency under the Climate Change Advisory Council Fellowship on Adaptation.
• Representation Concentration Pathways (RCPs) represent different future trajectories of greenhouse concentrations in the atmosphere. There are four main RCPs (2.6, 4.5, 6.0, and 8.5). The four RCPs comprise a mitigation scenario (RCP2.6), two stabilisation scenarios (RCP4.5 and RCP6.0), and a scenario (RCP8.5) that has extremely high GHG emissions. In this report, the RCP2.6 scenario is referred to as the “Paris Agreement” scenario. RCP8.5 is a pathway where GHG emissions continue to grow unmitigated, the “no mitigation” pathway. RCP4.5 is referred to as the “most likely” scenario in the context of this report.