Richard Purcell and Anna Spender present a selection of experts’ opinions on how climate change could affect health, care and protection, drawn from a recent IFoA Health and Care webinar
Building a risk framework
Bernd Wilke,Senior emerging risk manager, Swiss Re
From respiratory and cardiovascular issues to the increased risk of epidemics, the possible impacts of climate change on health are numerous. Then there are the social and economic impacts: increased migration, poverty, power supply disruption and even tourism decline. The topic is complex, so it is helpful to break it down.
We can start by thinking about individual risk drivers (such as wildfires), then how these might influence ecosystem services (for example air quality), and then the consequent insurance outcomes (such as increased claims for respiratory-related diseases). A framework like this can help us understand interactions between risk drivers, how they may compound to disrupt various sustainability systems, and which insurance outcomes are most likely or more significant.
Potential actions and reactions of governments and other agencies around climate change and public health should also be factored in, as these can change health outcomes. We have seen from the COVID-19 pandemic how public health restrictions and vaccines completely changed the nature of the pandemic. However, even if public health services and governments want to respond, it’s not clear that they will be able to in all situations.
We need to remember that the past cannot be extrapolated to predict future outcomes when it comes to climate change. This is a significant departure from a lot of traditional actuarial work, which relies heavily on past data to inform future modelling. This is an area where actuaries will need to develop their modelling.
The impact on health
Nicola Oliver, director, Medical Intelligence
Climate change, health and biodiversity are all related. Consider the chain of events sparked by burning fossil fuels: this creates air pollution, which over time can lead to temperature extremes. This, in turn, can increase the risk of forest fires, and thus the loss of habitat and biodiversity – which can lead to the emergence of zoonotic disease. The increased air pollution from forest fires, can also result in respiratory complications, and particles can also enter our bloodstream, potentially causing other health complications.
Let’s look at three specific areas in more detail: air pollution, extreme temperatures, and pesticides.
The short-term health effects of air pollution – such as coughing, shortness of breath and asthma – are well documented. Its long-term effects are perhaps less well understood. It has been shown that particulates could remain in our system for a long time and increase our risk of stroke and cardiovascular disease. Air pollution can also lead to higher rates of lung cancer in non-smokers. Worryingly, even if we can reduce air pollution now, the long-term effects of past pollution will likely persist for some time. From a mortality perspective, long-term exposure to air pollution is estimated to be responsible for 28,000-36,000 deaths a year in the UK alone. Notably, while air pollution is often thought of as an indirect cause of death, the first case of a death resulting directly from air pollution was recently declared in London. This means we may have underestimated the true extent of air pollution’s damage to health.
If there is no change in our use of fossil fuels, we would expect to see big increases in the number of hot days each year, and reductions in the number of cold days. That means an increase in heat-related deaths – mainly cardiovascular and from respiratory disease – and a reduction in cold-related deaths as the temperature warms on average. Of course, these impacts will be felt unevenly due to regional differences in extreme temperatures, with hotter areas likely taking a heavier toll.
The pesticides used in agriculture and pest control have wide-ranging health impacts. Pesticides can be on or absorbed by crops, or seep into watercourses. The fact that they can enter the water supply means we can all be exposed to them, even if we choose to eat or buy organic produce. Some pesticides are carcinogenic to humans and could impact cancer rates. Pesticides can also impact on biodiversity which, again, can lead to an increase in zoonotic diseases.
These three examples show that the health impacts of climate change are not just the ones we tend to think about, such as increased respiratory diseases from air pollution. There can be implications for cancer, cardiovascular and zoonotic diseases, and even dementia, reproductive complications and diabetes.
The Health and Care Climate Change Working Party
Paul Lacock, Chair, Health and Care
Climate Change Working Party
The Health and Care Climate Change Working Party was set up to explore the key climate change impacts that are relevant to health and care actuaries. We have produced an inventory of climate change impacts and risks, and considered what each might mean for the health and care environment: the risk pools, business mix, mortality, morbidity and so on. We then mapped these health and care environment impacts to typical actuarial functions. The idea is not to spoon feed, but to bring attention to what actuaries need to consider. We expect to publish this in due course.
We have also identified topics for further research, for example the impacts of climate change and associated health problems on state-funded healthcare provision. As the nature, magnitude and timing of climate change is difficult to forecast, there will also be a greater need for scenario modelling.
Climate change is a massive interdisciplinary field that draws on dozens of specialised subjects, and we cannot expect actuaries to become climate change experts. Another aspect of the working party’s focus has been to consider what support actuaries already have, and what support they will need, in taking climate change into account in their work. Some support, including various documents and guidelines, is already available from the IFoA. These should ideally be harmonised and consolidated. The working party is also considering whether a separate practice guide on climate change is needed for the Health and Care practice area to supplement the Life guide.
Where will you start?
There remains a lot more work for actuaries to do on this important topic. All of us can take our first step by using existing resources to improve our understanding of climate change and sustainability. A good place to start is the IFoA Sustainability and Lifelong Learning page (bit.ly/IFoA_SustLifelong), which includes practical guides and a curated library of information.
It’s important that more of us get involved. We encourage you to join us in in taking forward these future areas of work, and furthering our profession’s understanding and capabilities.
A recording of the IFoA webinar ‘Climate change and sustainability – the health and care discussion’ is available on the IFoA website.
Richard Purcell is a member of the IFoA Health and Care Board
Anna Spender is a member of the IFoA Health and Care Board