Essays on the impact of the environment on healthcare & health

Abstract

Climate change poses one of the biggest threats to global health and economic growth in this century. Amongst a host of issues, it will perpetuate and amplify the volatility of weather-related disasters whilst jeopardising the availability of clean air. Therefore, countries have begun to increase their investments and preparations for the diverse consequences of these environmental changes. Due to the unpredictability of extreme weather events, health policymakers require accurate estimates of how hospitalisations are influenced by sudden changes demand for care. I first investigate the role of extreme temperatures across population subgroups in England between 2001 and 2012. I find evidence of heterogeneous effects of extreme temperatures across disease, age, and socioeconomic status. The ramifications of a changing environment continues beyond its interactions with the health system. So I extend my analysis to begin exploring how a transport policy and, by extension, pollution influence individuals' sleep quantity and quality in Paris. This chapter illustrates that traffic-related policies have the potential to reduce traffic whilst increasing the number of minutes individuals sleep. It exploits a quasi-experimental design, as a common obstacle in social science research is ascertaining the level of air pollution observed at a certain point. Therefore, my final chapter presents a modified, yet accessible, approach to the exposure assignment of air pollution to enable better identification of pollution impacts. This approach is compared against a standard exposure assessment technique, inverse distance weighting, to understand the consequent repercussions of exposure misassignment on downstream health analysis. I find evidence that the impacts of the technique used are sensitive to the air pollutant considered and can influence the statistical significance and effect estimate of downstream analysis. This thesis, thus, contributes to the evidence on the influence of climate change-related environmental shocks on health, health aspects, and health systems. The results presented here can help inform mitigation strategies and help policymakers design future health interventions.