Heat and Healthcare Utilization in the Tropics: Evidence from India

Abhishek Dureja and Tarun Jain
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Abhishek Dureja: Plaksha University
Tarun Jain: Indian Institute of Management Ahmedabad

No 3, IDEA Working Papers from International Development Economics Association (IDEA)

Abstract: We estimate the effect of physiological heat stress on tertiary healthcare utilization and its fiscal cost using the universe of claims from a statewide social health insurance program in Andhra Pradesh, a large tropical Indian state (2007-2015). Exploiting plausibly exogenous day-to-day variation in wet-bulb temperature within districts, we find that a day with wet-bulb temperature of at least 28 °C relative to a day in the reference bin [24 °C, 26 °C), raises the number of daily claims by 3.5%, total disbursements by 4%, and the likelihood that a district records an in-hospital death on a given day by 3.52 percentage points. Utilization is flat across cooler temperatures and rises steeply once wet-bulb temperature exceeds roughly 26 °C. Aggregated over a year, extreme-heat days add about 2.4% to program disbursements -- a lower bound on the fiscal burden. Dry-bulb temperature yields a gradient of the opposite sign, because the hottest ambient days fall in the dry pre-monsoon while physiological stress peaks in the humid monsoon. Studies relying on dry-bulb temperature in monsoonal settings may therefore recover sign-reversed estimates and understate the health costs of a warming climate.

Keywords: climate change; heat stress; tertiary healthcare utilization; fiscal costs; India (search for similar items in EconPapers)
JEL-codes: H4 I15 Q54 (search for similar items in EconPapers)
Date: 2026-08-11
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Persistent link: https://EconPapers.repec.org/RePEc:idd:wpaper:3

DOI: 10.5281/zenodo.21907664

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