Valuation and perception of the costs of climate change on health.

BACKGROUND AND AIMS: Climate change affects our societies and lives through our economies, our livelihoods, and our health. Economic losses of climate change are estimated at $23 trillion, largely through externalities due to premature mortality, healthcare expenditure, and health-related work losses. Even if there are established methods to quantify the health economic burden, there is limited information on how people perceive this information. The current study aimed to examine different health cost evaluation methods and observe perceptions of stakeholders in the climate change context. METHOD: The participatory research approach of the World Café with 41 participants was applied to explore four topics associated with valuing the costs of climate change. The data were analyzed following an inductive approach. RESULTS: Despite the willingness-to-pay approach being widely applied, many experts see actual healthcare costs as a more explicit indicator of costs; however, this approach might underestimate actual costs. Participants experienced difficulties accepting and understanding cost estimates that indicated very high externalities as a percentage of gross domestic product. The cost-effectiveness of mitigation and adaptation measures was also challenged by a concern that while the costs of such measures are incurred now, the benefits do not come to fruition until later, for example, when building bike lanes or dams. CONCLUSIONS: Policies should favor environmentally friendly activities such as making cycling more convenient in cities with the health benefits presented in monetary terms, while limiting car driving. Moreover, the public might better understand the costs of climate change via tools that map how solutions influence different sectors and outlining the costs in evaluating the benefits for health and the environment.

Private vs. public emergency visits for mental health due to heat: An indirect socioeconomic assessment of heat vulnerability and healthcare access, in Curitiba, Brazil.

Few studies have explored the influence of socioeconomic status (SES) on the heat vulnerability of mental health (MH) patients. As individual socioeconomic data was unavailable, we aimed to fill this gap by using the healthcare system type as a proxy for SES. Brazilian national statistics indicate that public patients have lower SES than private. Therefore, we compared the risk of emergency department visits (EDVs) for MH between patients from both healthcare types. EDVs for MH disorders from all nine public (101,452 visits) and one large private facility (154,954) in Curitiba were assessed (2017-2021). Daily mean temperature was gathered and weighed from 3 stations. Distributed-lag non-linear model with quasi-Poisson (maximum 10-lags) was used to assess the risk. We stratified by private and public, age, and gender under moderate and extreme heat. Additionally, we calculated the attributable fraction (AF), which translates individual risks into population-representative burdens - especially useful for public policies. Random-effects meta-regression pooled the risk estimates between healthcare systems. Public patients showed significant risks immediately as temperatures started to increase. Their cumulative relative risk (RR) of MH-EDV was 7.5 % higher than the private patients (Q-Test 26.2 %) under moderate heat, suggesting their particular heat vulnerability. Differently, private patients showed significant risks only under extreme heat, when their RR became 4.3 % higher than public (Q-Test 6.2 %). These findings suggest that private patients have a relatively greater adaptation capacity to heat. However, when faced with extreme heat, their current adaptation means were potentially insufficient, so they needed and could access healthcare freely, unlike their public counterparts. MH patients would benefit from measures to reduce heat vulnerability and access barriers, increasing equity between the healthcare systems in Brazil. AF of EDVs due to extreme heat was 0.33 % (95%CI 0.16;0.50) for the total sample (859 EDVs). This corroborates that such broad population-level policies are urgently needed as climate change progresses.

Evaluation of daily Laurus nobilis tea consumption on anxiety and stress biomarkers in healthy volunteers.

Laurus nobilis is known in the field of herbal medicine and in vitro studies for its antibacterial, antifungal, anti- diabetes, and anti-inflammatory beneficial effects. Laurus nobilis tea consumption was investigated with regard to its effects on anxiety and stress in healthy individuals, measured by subjective tools and by plasmatic cortisol levels. The study included thirty healthy Tunisian volunteers aged between 20 and 57 years consuming Laurus nobilis infusion, prepared from 5g of dried Laurus nobilis leaves in 100 ml boiled water, once a day during 10 days. Plasma concentrations of serum cortisol were measured before Laurus nobilis consumption and at the end of the experiment. Laurus nobilis tea consumption significantly decreased the concentration of plasmatic cortisol ([cortisol] D0= 93.5± 43.01ng/mL, D11=72.23± 25.37, p=0.001). A statistically significant decrease in PSS and STAI scores (p=0.006 and p=0.002 respectively) was also noted.These findings highlight the decrease in blood cortisol levels, which means a possible positive effect on reducing the risk of stress related-diseases in healthy volunteers consuming Laurus nobilis tea. However, more powerful studies with extended treatment periods are required.