Nordeng Zuzana, Kriit Hedi K, Poltimäe Helen, Aunan Kristin, Dahl Miriam S, Jevtic Marija, Matkovic Vlatka, Sandanger Gunnell, Orru Hans
Norwegian Institute of Public Health, Oslo, Norway.
Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
Scand J Public Health. 2025 Mar;53(2):149-155. doi: 10.1177/14034948241247614. Epub 2024 Jun 14.
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.
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.
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.
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.
气候变化通过经济、生计和健康影响我们的社会与生活。气候变化造成的经济损失估计达23万亿美元，主要源于过早死亡、医疗支出及与健康相关的工作损失所带来的外部效应。即便已有量化健康经济负担的既定方法，但关于人们如何看待这些信息的资料却很有限。本研究旨在考察不同的健康成本评估方法，并观察气候变化背景下利益相关者的看法。
采用世界咖啡屋参与式研究方法，41名参与者共同探讨与气候变化成本评估相关的四个主题。数据分析采用归纳法。
尽管支付意愿法被广泛应用，但许多专家认为实际医疗成本是更明确的成本指标；然而，这种方法可能低估实际成本。参与者在接受和理解成本估计方面存在困难，这些估计表明外部效应占国内生产总值的比例非常高。缓解和适应措施的成本效益也受到质疑，原因在于人们担心这些措施的成本现在就已产生，而效益要到以后才会显现，比如建设自行车道或水坝时。
政策应支持环保活动，如在城市中让骑行更便捷，并以货币形式呈现健康效益，同时限制汽车驾驶。此外，通过绘制解决方案如何影响不同部门以及概述评估对健康和环境效益时的成本等工具，公众可能会更好地理解气候变化的成本。
