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Sarofim, Marcus C.

Publications and source records attributed to Sarofim, Marcus C..

Economic Valuation of Coccidioidomycosis (Valley Fever) Projections in the United States in Response to Climate Change

Coccidioidomycosis, or valley fever, is an infectious fungal disease currently endemic to the southwestern United States. Symptoms of valley fever range in severity from flu-like illness to severe morbidity and mortality. Warming temperatures and changes in precipitation patterns may cause the area of endemicity to expand northward throughout the western United States, putting more people at risk for contracting valley fever. This may increase the health and economic burdens from this disease. We developed an approach to describe the relationship between climate conditions and valley fever incidence using historical data and generated projections of future incidence in response to both climate change and population trends using the Climate Change Impacts and Risk Analysis (CIRA) framework developed by the U.S. Environmental Protection Agency. We also developed a method to estimate economic impacts of valley fever that is based on case counts. For our 2000–15 baseline time period, we estimated annual medical costs, lost income, and economic welfare losses for valley fever in the United States were 400,000 USD per case, and the annual average total cost was 3.9 billion USD per year. For a high greenhouse gas emission scenario and accounting for population growth, we found that total annual costs for valley fever may increase up to 164% by year 2050 and up to 380% by 2090. By the end of the twenty-first century, valley fever may cost 620,000 USD per case and the annual average total cost may reach $18.5 billion per year. This work contributes to the broader effort to monetize climate change–attributable damages in the United States.

54 ENVIRONMENTAL SCIENCES↗

Temperature-Related Death and Illness

Based on present-day sensitivity to heat, an increase of thousands to tens of thousands of premature heat-related deaths in the summer and a decrease of premature cold-related deaths in the winter are projected each year as a result of climate change by the end of the century. Future adaptation will very likely reduce these impacts (see Changing Tolerance to Extreme Heat Finding). The reduction in cold-related deaths is projected to be smaller than the increase in heat-related deaths in most regions. Days that are hotter than usual in the summer or colder than usual in the winter are both associated with increased illness and death. Mortality effects are observed even for small differences from seasonal average temperatures. Because small temperature differences occur much more frequently than large temperature differences, not accounting for the effect of these small differences would lead to underestimating the future impact of climate change. An increase in population tolerance to extreme heat has been observed over time. Changes in this tolerance have been associated with increased use of air conditioning, improved social responses, and or physiological acclimatization, among other factors. Expected future increases in this tolerance will reduce the projected increase in deaths from heat. Older adults and children have a higher risk of dying or becoming ill due to extreme heat. People working outdoors, the socially isolated and economically disadvantaged, those with chronic illnesses, as well as some communities of color, are also especially vulnerable to death or illness.

winter↗

Projections of Temperature-Attributable Premature Deaths in 209 U.S. Cities Using a Cluster-Based Poisson Approach

Background: A warming climate will affect future temperature-attributable premature deaths. This analysis is the first to project these deaths at a near national scale for the United States using city and month-specific temperature-mortality relationships. Methods: We used Poisson regressions to model temperature-attributable premature mortality as a function of daily average temperature in 209 U.S. cities by month. We used climate data to group cities into clusters and applied an Empirical Bayes adjustment to improve model stability and calculate cluster-based month-specific temperature-mortality functions. Using data from two climate models, we calculated future daily average temperatures in each city under Representative Concentration Pathway 6.0. Holding population constant at 2010 levels, we combined the temperature data and cluster-based temperature-mortality functions to project city-specific temperature-attributable premature deaths for multiple future years which correspond to a single reporting year. Results within the reporting periods are then averaged to account for potential climate variability and reported as a change from a 1990 baseline in the future reporting years of 2030, 2050 and 2100. Results: We found temperature-mortality relationships that vary by location and time of year. In general, the largest mortality response during hotter months (April - September) was in July in cities with cooler average conditions. The largest mortality response during colder months (October-March) was at the beginning (October) and end (March) of the period. Using data from two global climate models, we projected a net increase in premature deaths, aggregated across all 209 cities, in all future periods compared to 1990. However, the magnitude and sign of the change varied by cluster and city. Conclusions: We found increasing future premature deaths across the 209 modeled U.S. cities using two climate model projections, based on constant temperature-mortality relationships from 1997 to 2006 without any future adaptation. However, results varied by location, with some locations showing net reductions in premature temperature-attributable deaths with climate change.

Schwartz, Joel D.↗