By-degree Health and Economic Impacts of Lyme Disease, Eastern and Midwestern United States.

Lyme disease (LD) is the most common vector-borne disease in the United States (U.S.). This paper assesses how climate change may influence LD incidence in the eastern and upper Midwestern U.S. and the associated economic burden. We estimated future Ixodes scapularis habitat suitability and LD incidence with a by-degree approach using variables from an ensemble of multiple climate models. We then applied estimates for present-day and projected habitat suitability for I. scapularis, present-day presence of Borrelia burgdorferi, and projected climatological variables to model reported LD incidence at the county level among adults, children, and the total population. Finally, we applied an estimate of healthcare expenses to project economic impacts. We show an overall increase in LD cases with regional variation. We estimate an increase in incidence in New England and the upper Midwestern U.S. and a concurrent decrease in incidence in Virginia and North Carolina. At 3°C of national warming from the 1986-2015 baseline climate, we project approximately 55,000 LD cases, a 38-percent increase from present-day estimates. At 6°C of warming, our most extreme scenario, we project approximately 92,000 LD cases in the region, an increase of 145 percent relative to current levels. Annual LD-related healthcare expenses at 3°C of warming are estimated to be $236 million (2021 dollars), approximately 38 percent greater than present-day. These results may inform decision-makers tasked with addressing climate risks, the public, and healthcare professionals preparing for treatment and prevention of LD.

Improving reduced complexity model assessment and usability.

Reduced complexity climate models are useful tools with practical policy applications, yet evaluation of their performance and application is nascent. We call for stakeholder-driven development and assessment to address user needs, including provision of open-source code and guidance to inform model selection and application.

Erratum: "Projecting Age-Stratified Risk of Exposure to Inland Flooding and Wildfire Smoke in the United States under Two Climate Scenarios".

[This corrects the article DOI: https://doi.org/10.1289/EHP2594.].

Projecting Age-Stratified Risk of Exposure to Inland Flooding and Wildfire Smoke in the United States under Two Climate Scenarios.

BACKGROUND: The public health community readily recognizes flooding and wildfires as climate-related health hazards, but few studies quantify changes in risk of exposure, particularly for vulnerable children and older adults. OBJECTIVES: This study quantifies future populations potentially exposed to inland flooding and wildfire smoke under two climate scenarios, highlighting the populations in particularly vulnerable age groups (≤4 y old and ≥65 y old). METHODS: Spatially explicit projections of inland flooding and wildfire under two representative concentration pathways (RCP8.5 and RCP4.5) are integrated with static (2010) and dynamic (2050 and 2090) age-stratified projections of future contiguous U.S. populations at the county level. RESULTS: In both 2050 and 2090, an additional one-third of the population will live in areas affected by larger and more frequent inland flooding under RCP8.5 than under RCP4.5. Approximately 15 million children and 25 million older adults could avoid this increased risk of flood exposure each year by 2090 under a moderate mitigation scenario (RCP4.5 compared with RCP8.5). We also find reduced exposure to wildfire smoke under the moderate mitigation scenario. Nearly 1 million young children and 1.7 million older adults would avoid exposure to wildfire smoke each year under RCP4.5 than under RCP8.5 by the end of the century. CONCLUSIONS: By integrating climate-driven hazard and population projections, newly created county-level exposure maps identify locations of potential significant future public health risk. These potential exposure results can help inform actions to prevent and prepare for associated future adverse health outcomes, particularly for vulnerable children and older adults. https://doi.org/10.1289/EHP2594.