An Unsustainable Life: The Impact of Heat on Health and the Economy of Bangladesh

Table of Contents

• Front Cover 1
• Contents 5
• Acknowledgments 9
• About the Authors 11
• Main Messages 13
• Executive Summary 17
• Abbreviations 27
• Part 1: Background and Context 29
• Chapter 1 Background and Introduction 31
• Global and local context: Heat and health 31
• Impact of heat on human health and productivity: Economic implications 33
• Objectives and purposes of the report 36
• Approval and quality assurance processes 36
• Notes 37
• References 37
• Chapter 2 Frequency of Extreme Heat in Bangladesh: 1976–2023 39
• Introduction 39
• The heat index: Definition and relevance 39
• Heat and temperature patterns for Bangladesh (national averages) 40
• Heat And Temperature Patterns For Dhaka 45
• Notes 49
• References 49
• Part 2 Data and Findings from the Household Survey 51
• Chapter 3 Data and Methods 53
• Introduction 53
• Household panel data 53
• Analytical techniques 58
• Respondent and climate profile 60
• Limitations 65
• Notes 65
• References 65
• Chapter 4 Heat and Physical Health 69
• Introduction 69
• Prevalence of select short-term physical health conditions and seasonality 69
• Correlates of heat exhaustion, diarrhea, and persistent cough 75
• Chapter 5: Heat and Mental Health Conditions 79
• Introduction 79
• Prevalence of mental health conditions and seasonality 79
• Associations of heat with depression, anxiety, and emotional regulation 82
• Chapter 6 Heat and Productivity Losses 87
• Introduction 87
• Loss of productivity and seasonality 87
• Associations of heat with productivity loss 90
• Annualized impact at the national level 92
• Part 3: The Way Forward 95
• Chapter 7: Conclusions and Recommendations 97
• Conclusions 97
• Recommendations 98
• References 102
• Appendix A Operationalizing the Definitions of Heat Exhaustion and Heat Stroke 103
• Appendix B Localization of Temperature Data 105
• Appendix C Daily Temperature Range by Survey Round 107
• Figures 18
• Figure ES.1 Average annual increments of maximum temperature and the heat index for Bangladesh, 1980–2023 18
• Figure ES.2 Increases in the heat index in Dhaka, 1980-2023 19
• Figure ES.3 Heat-attributable loss to the economy 20
• Figure ES.4 Association between additional days exposed to temperature ranges and selected health conditions 21
• Figure 1.1 Exposure to health-threatening heat, measured as average number of days per year 32
• Figure 2.1 Annual maximum temperature and heat index for Bangladesh (national average), 1976-2023 41
• Figure 2.2 Average annual increments of maximum temperature and heat index for Bangladesh, 2015-23 41
• Figure 2.3 Warmest zones of Bangladesh, measured by heat index, 1980 and 2023 42
• Figure 2.4 Monthly variation of the heat index for Bangladesh, 2023 compared with 1980 45
• Figure 2.5 Increases in average maximum temperature and the heat index for Dhaka, 1976-2023 46
• Figure 2.6 Monthly variation of the heat index for Dhaka, 2023 compared with 1980 47
• Figure 2.7 Increases in the heat index per year, Dhaka compared with the national average 47
• Figure 2.8 Change in vegetation in Dhaka, 1989-2020 48
• Figure 3.1 Demographic profile at baseline, January 2024 61
• Figure 3.2 Education status baseline, January 2024 62
• Figure 3.3 Usual activity status at baseline, January 2024 63
• Figure 3.4 Days per temperature bin/range over the month preceding each survey round in January and and May 2024 64
• Figure 4.1 Prevalence of heat-related illnesses, by location 70
• Figure 4.2 Distribution of symptoms used to construct heat exhaustion and heat stroke 71
• Figure 4.3 Prevalence of heat-related illnesses, by age group 73
• Figure 4.4 Prevalence of heat-related illnesses, by gender 74
• Figure 4.5 Prevalence of heat-related illnesses, by socioeconomic status 75
• Figure 4.6 Correlates of physical health conditions 76
• Figure 5.1 Prevalence of mental health condition illnesses, by location 80
• Figure 5.2 Prevalence of depression and anxiety across demographic characteristics 81
• Figure 5.3 Prevalence of depression and anxiety across socioeconomic status 82
• Figure 5.4 Correlates of mental health outcomes 83
• Figure 6.1 Prevalence of average days of productivity lost due to physical and mental health conditions, by location 88
• Figure 6.2 Average days of productivity lost due to physical and mental health conditions, by demographic characteristic 89
• Figure 6.3 Average days of productivity lost due to physical and mental health conditions across socioeconomic status and usual activity 89
• Figure 6.4 Factors associated with days of productivity lost 91
• Figure 6.5 Annualized cost to productivity loss to the gross domestic product due to physical and mental health conditions 93
• Figure 6.6 Absolute annualized cost to the gross domestic product 94
• Figure 6.7 Cost as a percentage of the gross domestic product (real 2023) 94
• Figure B.1 A domain with irregularly spaced sample points and a location of interest X0 105
• Figure C.1 Daily temperature range, by survey round 107
• Maps 43
• Map 2.1 Variation in the heat index across Bangladesh: 1980 and 2023 43
• Map 3.1 Distribution of the urban and rural primary sampling units 54
• Tables 24
• Table ES.1 Matrix of policy options 24
• Table 2.1 Heat index classification 40
• Table 3.1 Sample distribution of the study 55
• Table A.1 Scoring mechanism used to ascertain the probability of a respondent experiencing heat exhaustion or a heat stroke during two weeks before each survey round 103