Degrees and dollars – Health costs associated with suboptimal ambient temperature exposure

Yang Liu, Shubhayu Saha, Brendalynn O. Hoppe, Matteo Convertino

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Suboptimal ambient temperature exposure significantly affects public health. Previous studies have primarily focused on risk assessment, with few examining the health outcomes from an economic perspective. To inform environmental health policies, we estimated the economic costs of health outcomes associated with suboptimal temperature in the Minneapolis/St. Paul Twin Cities Metropolitan Area. We used a distributed lag nonlinear model to estimate attributable fractions/cases for mortality, emergency department visits, and emergency hospitalizations at various suboptimal temperature levels. The analyses were stratified by age group (i.e., youth (0–19 years), adult (20–64 years), and senior (65+ years)). We considered both direct medical costs and loss of productivity during economic cost assessment. Results show that youth have a large number of temperature-related emergency department visits, while seniors have large numbers of temperature-related mortality and emergency hospitalizations. Exposures to extremely low and high temperatures lead to $2.70 billion [95% empirical confidence interval (eCI): $1.91 billion, $3.48 billion](costs are all based on 2016 USD value)economic costs annually. Moderately and extremely low and high temperature leads to $9.40 billion [eCI: $6.05 billion, $12.57 billion]economic costs. The majority of the economic costs are consistently attributed to cold (>75%), rather than heat exposures and to mortality (>95%), rather than morbidity. Our findings support prioritizing temperature-related health interventions designed to minimize the economic costs by targeting seniors and to reduce attributable cases by targeting youth.

Original languageEnglish (US)
Pages (from-to)702-711
Number of pages10
JournalScience of the Total Environment
StatePublished - Aug 15 2019
Externally publishedYes

Bibliographical note

Funding Information:
The research presented in this study is supported by the U.S. Centers for Disease Control and Prevention , Grant Number: 5H13EH001125-03 .

Publisher Copyright:
© 2019 Elsevier B.V.


  • Ambient exposure
  • Climate change
  • Climate health
  • Extreme heat
  • Extreme temperature
  • Urban health


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