The human ecology of climate change - Climate Change: Biological and Human Aspects - page 396

therefore is not so much between an extreme event and a population's mortality rate
but the extreme event and the absolute number of susceptible individuals within that
population. If that number is high then the mortality will be high but if that number
is low then it is impossible for the mortality to be high, even if the extreme event is a
record-breaking one.
The most susceptible people in a population are likely to be
the elderly,
the infirm (which will not only include the elderly),
the poor (biologically due to poor diet, health care) and
the poor (due to lack of insulation from environmental vagaries).

Because the most susceptible within a population will suffer, although the figures in
terms of number of deaths may be high, the number of person-days of quality life
lost may actually be low. This is another manifestation of the declining mortality
from a run of extreme events, described above, that shows that only the susceptible
tend to be vulnerable to extreme winters. If someone is susceptible then they could
already be close to death, so the extreme event is bringing their death forward by
weeks or months or a year or two. Those that would in any case die within a few days
will die first, then later those that would otherwise have lived for weeks will die, and
so forth.
Although it may seem to be humanly cold and calculating, this is how rigorous
quantitative analysis needs to be conducted when attempting to calculate the costs
and benefits of climate change. It is not mortality per se that should be counted but
the number of person-days of quality life lost. For example, consider a population
whose society can afford either air conditioning for all its elderly citizens or bush
fire-fighting equipment (or flood protection or another such opportunity cost). Which
opportunity should they choose assuming the numbers of anticipated deaths from
heat stroke or fires (or whatever) were equal? The number of anticipated deaths
does not help provide an answer but the number of person-days of quality life lost
often provides a clear indication. Of course, in developed nations this dilemma need
not arise (although sometimes it does with tight civil budgets). Conversely, such
quandaries are more common in less-developed nations.
Surprising as it may seem, climate change may cause health effects simply because
the new climate is not within a population's perceptual history, and so the risks and
avoidance measures may not be recognised. If they were, adverse health effects
may be avoidable. This was brought home with the publication of research in 1998
by a team co-operating between London and Moscow (Donaldson et al., 1998).
On balance, conventional wisdom had it that the more affluent Western European
society would have lower mortality than their Russian counterparts. However, when
winter temperatures reached 0 ◦ C excess deaths were not seen in the elderly cohorts
of the Russian population, although they are known to exist in Western European
populations. The reason given is that the Russian population was used to such winters
and was prepared. Their houses were warmer and they wore more clothes. However,
for many Western European population winters of 0 to 6 ◦ C were extreme events.

The research suggests that some deaths from extreme events in affluent societies are
avoidable (Donaldson et al., 1998).

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