Temperature and non-communicable diseases: Evidence from Indonesia's primary health care system

Health Econ. 2022 Nov;31(11):2445-2464. doi: 10.1002/hec.4590. Epub 2022 Aug 21.

Abstract

Climate change induced rising temperatures will pose a detrimental threat to decent health in the coming decades. Especially at risk are individuals with chronic diseases, since heat can exacerbate a variety of health conditions. In this article, I examine the heat-morbidity relationship in the context of Indonesia, focusing on chronic, non-communicable diseases, namely diabetes, cardiovascular and respiratory diseases. Using a novel dataset from the Indonesian national health insurance scheme Jaminan Kesehatan Nasional/Badan Penyelenggara Jaminan Sosial (BPJS) and linking it with meteorological data on the daily-district level, I estimate the causal effect of high temperatures on the daily number of primary health care visits. The results show that on a hot day all-cause visits and visits with a diagnosis of diabetes and cardiovascular diseases increase by 8%, 25% and 14%, respectively. These increases are permanent and not offset by visit displacement or 'harvesting'. Visits related to respiratory diseases seem not to be affected by high temperatures. I use several climate change scenarios to predict the increase in visits and costs by the end of the century, which all forecast a substantial financial burden for the health care system. These results might have relevance for other middle-income countries with similar climatic conditions.

Keywords: Indonesia; JKN/BPJS kesehatan; climate change; health; non-communicable diseases; temperature.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Delivery of Health Care
  • Diabetes Mellitus* / epidemiology
  • Humans
  • Indonesia / epidemiology
  • Noncommunicable Diseases* / epidemiology
  • Temperature