The effect of absolute versus relative temperature on health and the role of social care.

We investigate the effect of extreme temperatures on mortality and emergency hospital admissions, and whether local social care allows to mitigate their adverse effects. We merge monthly administrative data on mortality and hospital discharge from Italian municipalities for the period 2001-2015 with daily data on local weather conditions, and yearly data on disaggregated municipal expenditure. We compare two different measures of temperature shocks, one using the conventional approach based on absolute levels (without accounting for regional heterogeneity) and the other based on deviations from local mean temperatures. The former approach shows noisy evidence of an increase in mortality due to extremely hot days while the latter approach shows a large increase in mortality and hospital admissions for cardiovascular and respiratory diseases due to both cold and hot days. These effects are mostly driven by the oldest age group and partially by young children. Then, we report evidence of a mitigating effect of social expenditure on the impact of extremely hot and cold days on both emergency hospital admission and mortality rates. A back of the envelope calculation suggests that the additional social care expenditure is fully compensated by the benefits arising from the lower impact of temperature shocks.