The hidden health costs of climate change: Accounting for extreme heat harms to women in the global South

Global climate warming is fueling complex and compounding threats to populations worldwide, especially in the Global South where climate hazards pose an additional threat to health and well-being in communities heavily burdened by pollution [1].Extreme heat poses a particular hazard to populations in South Asia because temperatures in that region are approaching the physiological limits to human tolerability [2].While climate change-fueled extreme heat is dangerous to all, it poses particular risks to women-but the gendered dimensions of heat-related health impacts are poorly captured in current understanding of harms and policy responses to address climate-sensitive health inequities.Researchers estimate that extreme heat caused about 47,000 premature deaths in India in 2019 [1], but it is unclear the extent to which gender-specific health risks identified in other studies are considered in such national-level estimates.This limitation is a concern because finer scale data on heat-related health harms suggests that women are suffering disproportionately from heat: for example, during a May 2010 extreme heat event in Ahmedabad, India 1,344 excess deaths were recorded, with a significantly higher share of female deaths during this event [3].Even as evidence continues to emerge on the health hazards that extreme heat poses to women, the true societal costs of this growing problem, in economic terms, are not being adequately considered in climate change policies [4].Extreme temperatures inflict damage to physical and mental health, but also impose financial costs on individuals, families, communities, employers, and governments [4,5].Prior research in the United States has illuminated billion-dollar ramifications of extreme heat-related health costs linked to morbidity and mortality, including those tied to healthcare delivery, prescription medications, outpatient care needs, and lost work wages [5].However, such evidence on the health-related financial costs of extreme heat (and other climate-sensitive hazards such as floods, ozone air pollution, and certain infectious diseases) is limited in the Global South due to myriad data access challenges and gender-specific health considerations are typically excluded from economic assessments of heat-related economic risks.For example, a prominent 2020 of potential future economic productivity losses tied to extreme heat in India did not quantify heat-related health problems that could reduce worker productivity amongst women, including in informal work sectors [6].More information on the health-related financial harms of extreme heat can help to inform planning for climate change adaptation South Asia and the Global South by helping to provide robust evidence for the avoidable health harms and associated financial damage achievable through enhanced implementation of climate change adaptation projects [4].Societal