Heat Vulnerability Index highlights risk areas for old people in London

13 September 2016 Consultancy.uk

The reality of global warming is fast hitting cities in their pockets as resilience planning and mitigation are becoming costly priorities. A new report considers London’s vulnerability to heat, based on an analysis of the city’s environment coupled with social data about its most vulnerable people – allowing policy makers and planners to create ways of dealing with high climate pressures.

Cities around the world are turning their attention to the very real and increasingly expensive consequences of human induced climate change. While carpe diem signifies the current pressing need to sort out the issues around human induced climate change from the scientific community, politicians tasked with the development and implementation of policies appear to be childishly sitting on their hands, while businesses appear only interested in themselves.

Future Cities infographic

According to a new study from Arup, cities around the world, whose populations continue to grow on the back of urbanisation, will see an increased impact of climate events as the global climate changes. Particularly coastal cities will face burdens as sea levels rise, once in a life-time storms become more frequent and acidification takes its toll on marine life. Cities like London too will face mounting challenges, as a mixture of environmental and social factors come to bite.

The report from Arup and partners, including University College London, King’s College London, ClimateUK, HelpAge International and Satellite Applications Catapult, titled ‘Seasonal health and resilience for ageing urban populations and environments’, explores the effect of two major trends on the health of people within cities: the changing climate, which increases the frequency and severity of events, and changing demographics, relating to more old and vulnerable people in less space.

The changes in climate around London are projected to see a third of summer days exceed the heatwave threshold by 2050, while by 2080, the chances are that heatwaves, similar to the one in 2003, may occur every second year. The UK population is also set to age, with the population of people over the age of 65 in London set to increase by 46% by 2030 while those aged over 90 is set to double in the same period – globally, by 2050, 22% of the world will be aged over 65. Heatwaves can be severely detrimental to the health of vulnerable, particularly old, people. The 2003 ten day heatwave killed 2,000 people across the UK, while the three day heatwave in 2009 saw almost 300 people succumb to the heat.

Land cover and heat map

London heat and vulnerability

As part of the study, the consultancy firm and its partners developed comprehensive maps of various conditions in the studied cities, London, New York and Shanghai. These maps provide an overlay of areas which are particularly affected by conditions – such as heat and flooding.

For London the maps provide insight into the areas that see the most and the least warming during heatwave events by mapping temperature against the features of a city, including green spaces, water bodies and built-up areas as well as the areas with the highest heat profiles – the city is 69% built up area. According to the study, areas around green spaces and near water bodies tend to be the coolest, while large areas of built environment tend to be the hottest (also known as the Urban Heat Island effect). 

Vulernability factors

The consultancy firm also considered demographic conditions for the cities. For London the firm used census information to map various factors related to vulnerability of people within various areas of the city. Factor 1 include population density, rented housing and persons speaking no English; factor 2 involved mapping out areas in which people with bad and very bad health tend to reside; and factor 3 considers housing that lacks central heating. Factor 1 was given the most weighting, followed by factor 2 and 3.

Heat Vulnerability Index

Heat Vulnerability Index

Combining the environmental and city feature data with social data related to vulnerable people, results in a ‘Heat Vulnerability Index’ (HVI). The HVI gives insight into which areas of the city will have the highest levels of vulnerable people give a heat related event in the city. According to the analysis, the most areas of highest vulnerability are London Boroughs of Hackney, Islington and Tower Hamlets while the lowest values are found in Bromley, Richmond upon Thames and Sutton. Central and North East London tends to be the area with the most vulnerable people to heat events. Similar maps can be created for flooding and other events to aid development of resilience measures.

Polly Turton, Environmental Consultant at Arup, says, “The combination of climate change, rapid urbanisation and ageing populations is increasing the impact of extreme weather events, such as heat waves, experienced by global cities like London. We all – planners, urban designers, engineers, property developers and politicians – have an opportunity to help vulnerable members of our communities cope with increasing heat waves. Measures don’t need to be expensive – but we need to take action now. For example, something as simple as planting more trees now will provide vital shade for communities and significant cooling benefits in decades to come.”

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Medicine economic model creates negative health outcomes

26 March 2019 Consultancy.uk

Profit-driven production of antibiotics has held back the development of vital medical breakthroughs, according to a new report. Analysis from a leading strategy consultancy suggests that a change in economic model and new incentives could prompt pharmaceutical giants to develop cures to major diseases, which could be affordable at scale.

The much maligned pharmaceutical industry has long been criticised for its failure to focus on deep seated issues in public health. For instance, there is increasing concern around microbial resistance, with some bacteria now resistant to all known antibiotics. Combating that requires new antibiotics – but drug companies see little profit in the field, and therefore have not seriously invested in it. Another instance of concern is a focus on treating symptoms rather than curing the diseases themselves, with such treatments requiring long-term payment to mitigate symptoms, rather than one-time cures being delivered.

Cases like the so-called “Pharma Bro” Martin Shkreli – who received widespread criticism when his company obtained the manufacturing license for the antiparasitic drug Daraprim and raised its price by a factor of 56 (from US$13.5 to $750 per pill – underline the failing of this system to meet the needs of society. New analysis from Boston Consulting Group (BCG) seeks to challenge the current economic model and its inherent failures in favour of a model that creates greater social good while also generating steady reliable returns for pharma companies. The analysis appears in the firm’s ‘Aligning Economic Incentives to Eradicate Diseases’ report.

Different pricing model makes cures more accessible

One example is Hepatitis C. The disease is massively damaging to human life, with considerable negative impacts on patients and society. Treatments have existed for decades, which manage the virus but did not cure it. These treatments had significant side effects however, which saw people not complete rounds – which then resulted in expensive emergency care and secondary health costs.

In 2013 a treatment was developed that effectively cured the virus in 8-12 weeks. The treatment has few side effects and works in most patients. However, five years later fewer than 10% of people globally with the virus have had the cure – largely because of prohibitive costs. The ambition to remove this disease and its large negative drag on the lives of millions by 2030 is becoming increasingly unlikely. The issue is cost.

The current economic model used by pharmaceutical companies mean that early adopters pay sky high prices as the company seeks to recoup costs, with the price eventually coming down to levels at which a larger segment can afford to access the drug – before its generic releases sees mass uptake. This model creates considerable initial barriers, and long-term social costs.

The report subsequently proposes a different pricing model that would see the price of a new drug kept at a constant level for its lifetime but have that level set considerably lower than the current model - which is focused on recouping costs immediately. Under the firm’s model, within 12 years of the Hepatitis C drug’s discovery, up to 96% of the population could be cured, at a cost 30% lower than the UN model and with a cure rate almost 50 percentage points higher than the base model.

The PLA scenario has better social outcomes than the traditional model

A change in model would, according to the firm’s analysis for HCP, triple the number of patients cured within 2 years, reduce the number of liver disease deaths by 60%, reduce total costs to payers by 30% (due to fewer additional costs on healthcare systems), while creating higher and more predictable revenue streams for pharma companies.

“There are many barriers to curing this population, but the dilemma created by current pricing models is one of the biggest,” said Dave Matthews, a BCG Principal and study co-author. The firm adds, “The dilemma results because a high price per patient makes treating everyone prohibitively expensive while an affordable price is too low for pharmaceutical companies to earn back their investments.”

Matthews concluded, “Switching to a population-based model such as the PLA not only makes the cure affordable, but also creates strong motivation to identify, diagnose, and treat as many patients as possible before the license expires.”

Related: Ten year deal activity in pharmaceuticals industry stands at $2.4 trillion.