Adaptation Technology Choice and Implications for Heat-Related Health Risk

This paper investigates the consequences of inequality in access to heat adaptation, examining the effectiveness of alternative cooling technologies in mitigating mortality associated with extreme heat in India for the period 2014-2019. Our empirical results highlight a critical trade-off in heat adaptation. Air conditioning is highly effective in moderating heat-related mortality, but it is expensive, with generally low ownership that tends to be restricted to high-income cities. Conversely, many Indian households, including low-income ones, purchase evaporative coolers, which are much cheaper but do not provide robust protection against humid heat. Exploring the mechanisms, we show that coolers' limited effectiveness is due to their inability to operate in the humid ambient conditions that prevail over the Indian subcontinent for much of the year, and the small amount of indoor temperatures reduction they provide. Our findings provide the first evidence that income-driven differences in adaptation technology choice translate into unequal health risks under rising heat exposure, potentially reinforcing existing socioeconomic disparities.