# The Impact of Temperature and Pollution on Mortality, Morbidity, and Health Care Cost Among the Elderly

> **NIH NIH R01** · NATIONAL BUREAU OF ECONOMIC RESEARCH · 2020 · $322,998

## Abstract

OTHER PROJECT INFORMATION – Project Summary/Abstract
The Impact of Weather and Pollution on Mortality, Morbidity, and Health Care Cost
 Each year, the Medicare program spends around half a trillion dollars on providing healthcare for the
elderly. Growth in health care expenditure is placing growing pressure on the Medicare Trust Fund, and
accurate projections of future health care needs and spending are necessary to properly plan for the future
needs of the aging population. The prospect of climate change affecting weather and pollution makes these
links even more policy-relevant.
 Previous studies of environmental impacts on health have largely focused on mortality and hospital
admissions. Other important outcomes, such as the physical and mental health of survivors and the cost of
medical utilization following extreme events, have been limited, primarily due to a lack of appropriate data. This
project will document the impact of temperature and pollution on elder health and health care use in the U.S.
by linking, for the first time, individual-level medical treatment histories derived from Medicare claims with
temperature and pollution data for the years 1992 through 2011. These data permit identifying which groups
are particularly vulnerable to environmental shocks and quantifying the cost of medical utilization in response
to temperature or pollution changes, a cost of climate change that has been previously unmeasured. We will
document the extent to which individuals adapt to prevailing local conditions (e.g., heat or pollution), mitigating
the impact of environmental shocks. Linking the Medicare and environmental data to demographic data and
housing characteristics, we will investigate how income and housing characteristics such as air conditioning
modify the relationship between environment and health. We will also make use of two new sources of quasi-
experimental variation in pollution—smoke from wildfires and variation in local wind conditions—that help
overcome the limitations of observational studies and allow us to estimate the causal impact of pollution on
health and cost outcomes.
 Specifically, this project will pursue four goals: (1) Produce large-scale and comprehensive evidence on
the causal relationship between temperature/pollution and mortality, morbidity, and Medicare costs; (2) Identify
which elderly subpopulations (e.g., the poor, very aged or those living with disabilities or chronic illness) are the
most vulnerable to extreme events and measure the number of life-years lost in an extreme event rather than
just raw mortality counts; (3) Investigate the role of adaptation in modifying the environment-health relationship;
and (4) Estimate the impact that climate change will have on elderly health and Medicare spending. This study
will achieve these goals by compiling a novel dataset with two decades of daily temperature and pollution
levels in an individual's zip code of residence linked to detailed measures of individual-...

## Key facts

- **NIH application ID:** 9979724
- **Project number:** 5R01AG053350-05
- **Recipient organization:** NATIONAL BUREAU OF ECONOMIC RESEARCH
- **Principal Investigator:** NOLAN H MILLER
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $322,998
- **Award type:** 5
- **Project period:** 2016-09-01 → 2023-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9979724

## Citation

> US National Institutes of Health, RePORTER application 9979724, The Impact of Temperature and Pollution on Mortality, Morbidity, and Health Care Cost Among the Elderly (5R01AG053350-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9979724. Licensed CC0.

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