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The Impact of Climate Change and Other Catastrophes on the U.S. Health Infrastructure

Background and Purpose

The strength of the United States health delivery system was tested during the recent COVID pandemic. The system survived, but at a cost. The number of excess deaths in the United States has been estimated to be over a million people[1]. Another study showed that 32.8% of all Americans showed elevated levels of depression as a result of the pandemic[2]. Pandemics, however, are not the only challenge faced by the health delivery system. Extreme heat results in excess deaths, wildfires negatively impact patients with asthma, and hurricanes can disrupt the delivery system for days, even weeks. These types of events ae expected to increase in frequency and intensity. This begs the questions “is the U.S. health infrastructure strong enough to withstand these challenges?” and “what is being done now to mitigate the impact and/or to adjust to the changes?”.

Research Objective

The Society of Actuaries Research Institute Catastrophe & Climate Strategic Research Program Steering Committee [The Committee] is seeking researchers to provide a framework for further discussions on the ability of the U.S. to deliver quality care in light of the many challenges expected to be caused by climate change and catastrophes like the pandemic. The target audience includes policymakers, analysts, and the scientific community. The following are examples of proposed topics that may be addressed:

  • A brief description of the current U.S. healthcare system, including its on-going challenges, like provider shortages and the mental health crisis.
  • An analysis of trends in frequency and severity for climate change impacted events (such as hurricanes and wildfires) and other catastrophes (such as, pandemic or earthquakes).
  • A description of the impact of climate change and other catastrophes on health, especially that of vulnerable populations like people with chronic diseases, people in urban and rural areas, the elderly, and low-income individuals.
  • A description of the current and proposed efforts to mitigate and/or adjust to these challenges.
  • A quantitative framework for identifying and measuring the cost and risks associated with the impact of climate change and other catastrophes within a one-year timeframe and over time.
  • A description of techniques for measuring the effectiveness of efforts to mitigate and/or prepare for climate change and other catastrophes.
  • The impact on actuarial practice, including techniques for developing actuarial assumptions, measuring the associated opportunities and risks on an annual basis and over time.
  • Strategies for creating awareness among actuaries, risk managers, and other key stakeholders.
  • Systemic resilience to disaster events, for example, earthquakes, power system disruptions.
  • How do we ensure we increase capacity in the healthcare system in the right areas? How can system effectively respond to change in demand?
  • Incorporate the effects of loss prevention before an event and loss recovery strategy after the event.
  • Resources and recommendations for further study.

Note that the list above is not meant to be exhaustive but merely examples of proposed topics that may be researched.

Letter of Intent

Parties that wish to participate must submit a brief Letter of Intent (LOI) providing the following information:

  1. List the topic addressed in the research.
  2. The proposed title of the report and purpose of the research.
  3. Literature review of prior research (both actuarial and non-actuarial work) and its findings.
  4. A description of the research project (data and specific methods) and how it might be used by practicing health actuaries now or in the future.
  5. A description of the expected deliverables, tools or other resources
  6. A rough estimate of the funding requirements, the ability of the applicant(s) to access any data needed.
  7. The qualifications (including any actuarial designations and any relevant experience in industry) of the applicant(s)
  8. A timeframe for completion of the research.
  9. LOIs will be no more than 2 pages, with no less than 1-inch margins, no less than 11- point font, and no less than a space and a half. Quality of writing in the LOI will be a decision factor.

Letters should be submitted to Research-CC@soa.org by the end of the day on May 29, 2024. We anticipate that decisions on whether an applicant will be invited to submit a full proposal based on the LOI will be communicated by June 21, 2024.

Full Proposal Requirements

Parties who are invited to submit a full proposal would then provide the following information:

  1. Resumes of the researcher(s), including any graduate student(s) expected to participate, indicating how their background, education and experience bear on their qualifications to undertake the research. If more than one researcher is involved, a single individual should be designated as the lead researcher and primary contact. The person submitting the proposal must be authorized to speak on behalf of all the researchers as well as for the firm or institution on whose behalf the proposal is submitted.

  2. An outline of the approach to be used (e.g. literature search, model, etc.), emphasizing issues that require special consideration. Details should be given regarding the techniques to be used, collateral material to be consulted, and possible limitations of the analysis.

  3. A description of the expected deliverables and any supporting data, tools or other resources.

  4. Cost estimates for the research, including computer time, salaries, report preparation, material costs, etc. Such estimates can be in the form of hourly rates, but in such cases, time estimates should also be included. Any guarantees as to total cost should be given and will be considered in the evaluation of the proposal. While cost will be a factor in the evaluation of the proposal, it will not necessarily be the decisive factor.

    Please note that as a policy, the SOA Research Institute generally does not provide funding to cover academic institution overhead expenses.

    As a guide for developing the project budget, please review the Historical Project Cost Guide (see Appendix)

  5. A schedule for completion of the research, identifying key dates or time frames for research completion and report submissions. The Committee is interested in completing this project in a timely manner. Suggestions in the proposal for ensuring timely delivery, such as fee adjustments, are encouraged.

  6. Other related factors that give evidence of a proposer's capabilities to perform in a superior fashion should be detailed.

Full Proposals should be submitted to Research-CC@soa.org by the end of the day on July 24, 2024. We anticipate that decisions on whether a proposal is chosen will be communicated by August 19, 2024.

Selection Process

The Committee will appoint a Project Oversight Group (POG) to oversee the project. The Committee is responsible for recommending the proposal to be funded. Input from other knowledgeable individuals also may be sought, but the Committee will make the final recommendation, subject to Society of Actuaries Research Institute (SOA) leadership approval. An SOA staff research actuary will provide staff actuarial support.

Questions

Any questions regarding this RFP should be directed to Research-CC@soa.org .

Conditions

The selection of a proposal is conditioned upon and not considered final until a Letter of Agreement is executed by both the Society of Actuaries Research Institute and the researcher.

The Society of Actuaries Research Institute reserves the right to not award a contract for this research. Reasons for not awarding a contract could include, but are not limited to, a lack of acceptable proposals or a finding that insufficient funds are available. The Society of Actuaries Research Institute also reserves the right to redirect the project as is deemed advisable.

The Society of Actuaries Research Institute plans to hold the copyright to the research and to publish the results with appropriate credit given to the researcher(s).

The Society of Actuaries Research Institute may choose to seek public exposure or media attention for the research. By submitting a proposal, you agree to cooperate with the [Society of Actuaries/sponsoring entity] in publicizing or promoting the research and responding to media requests.

The Society of Actuaries may also choose to market and promote the research to members, candidates and other interested parties. You agree to perform promotional communication requested by the Society of Actuaries Research Institute, which may include, but is not limited to, leading a webcast on the research, presenting the research at an SOA meeting, and/or writing an article on the research for an SOA newsletter.

Conflict of Interest

You agree to disclose any of your material business, financial and organizational interests and affiliations which are or may be construed to be reasonably related to the interest, activities and programs of the Society of Actuaries Research Institute.

Appendix

The cost ranges below are intended as a guide for budgeting project costs for proposals in response to SOA Research Institute Request for Proposals (RFP). Please note these figures span the 33rd to 66th percentiles for all projects as well as projects that involve a specific approach (lit review, survey, etc.). They are based on historical costs over several recent years. Expected costs for some RFPs may fall outside these ranges depending on the nature of the work and resources required for completion.

All Contracted Projects

This category includes all contracted projects that the Institute has undertaken within the last several years.

The 33rd-66th percentile project costs range is $25,000 - $50,000.

Literature Reviews

This category includes projects that involved only a literature review or the cost for the portion of a larger project that included a literature review.

The 33rd-66th percentile project costs range is $15,000 - $20,000.

Surveys

This category includes all projects that had a survey as their primary component.

The 33rd-66th percentile project costs range is $28,000 - $55,000.

Endnotes

[1] Hidden death toll of COVID-19 pandemic revealed (msn.com)

[2] Depression Rates Tripled and Symptoms Intensified during First Year of COVID | SPH (bu.edu)