🌡️ Under the Skin: Building the Market for Heat Safety in a Warming Economy
Why the fight against extreme heat runs through insurers, employers, and the ER.
Special thanks to GigaClimate Advisor and our A&R Series author, Chris Mangieri
🥵 Extreme Heat and Health
Climate change isn’t just warming the planet; it’s assaulting the human body. The systems and infrastructure we’ve built to protect our health were designed for a stable climate that no longer exists. This is one of the biggest blind spots in the adaptation and resilience economy, and for founders, there’s a massive opportunity to build.
During the summers of 2022, 2023, and 2024, a combined 181,000 people across Europe died from heat-related illnesses, a toll sharpened by low AC deployment and an aging housing stock. While the US is better air-conditioned (90% of households have AC compared to Europe’s 20%), it’s far from immune. In the developing world, where cooling infrastructure is scarcer and health systems thinner, the burden is heaviest of all. Beyond loss of life, heat exposure erased $1.09 trillion in potential income globally in 2024, 39% of it across agriculture. Air pollution further adds to this damage; the monetized value of air pollution-related mortality reached $4.84 trillion in 2022, equivalent to 4.7% of global GDP.
But heat and air quality are only two of many ways climate change is harming human health. Vector-borne disease transmission is on the rise, with the potential of dengue fever having increased 48.5% since the 1950s. Degraded air quality is driving worsening outcomes for the 650 to 750 million adults already living with chronic illnesses such as asthma or chronic obstructive pulmonary disease. The health effects run from the acute to the chronic, affecting not just a small group of individuals but the entire health system.
The health effects of climate stress are where occupational safety was in the 1970s: everyone knew poorly run factories were killing people, but no one wanted to own the problem. There were no federal standards, no compliance obligations, and therefore no market for solutions. Then OSHA was created. Regulations generated obligation, obligation generated buyers, and buyers generated an industry. We are at a similar inflection point, and this time, OSHA is the signal. In August 2024, the US agency published its first-ever proposed federal heat standard.
The regulatory architecture is being laid right now, and states, in lieu of federal rule approval, are starting to build their own uniformed guidance, pulling global operators in many directions. Increasingly important are organizations like La Isla Network, seeking to develop and operationalize data driven best-practices for global companies operating across states and territories.
This is the first article of our four-part Health A&R series. It maps the terrain: the scale of climate-driven health impacts, why existing infrastructure can’t keep up, who’s buying the solutions, and where founders should focus.
🌡️ The Damage Report
To know where to build, you have to know where the problems lie. Climate affects human health through four primary channels; here’s the current state of play.
🔥 Heat: The Silent Mass Killer
Heat is the deadliest climate hazard on Earth, and it’s only getting hotter. Among people over 65, heat-related deaths have surged roughly 85% since the early 2000s. In the US, heat-related deaths increased by 117% between 1999 and 2023, from 1,069 to 2,325 per year, with the rate of increase sharply accelerating after 2016.
The economic impact is also severe. A September 2025 report from the World Economic Forum and BCG projects a total of $1.5 trillion in worker availability losses across food and agriculture ($740 billion), the built environment ($570 billion), and healthcare ($200 billion) between 2025 and 2050. These also aren’t projections from some distant scenario; they’re mid-range estimates for the next 25 years.
Builder Signal: OSHA’sproposed federal heat standard will create a compliance obligation for every employer in the US with outdoor or heat-exposed workers. That’s thousands of construction, agriculture, logistics, manufacturing, and warehousing employers with millions, if not tens of millions, of workers. Japan already passed a new heat safety law in June 2025, with fines and criminal liability for employers failing to protect workers during extreme heat. The EU is drafting a dedicated directive on the prevention of workplace heat risks. OSHA’s rule isn’t the beginning of this story; it’s the US finally catching up. Companies positioned to sell compliance tooling, monitoring, and worker health platforms will capture first-mover advantage.
🗺️ Infectious & Vector-Borne Disease: The Map Is Being Redrawn
Warming is redrawing the global map of infectious diseases. Malaria-carrying mosquitoes have expanded their range by roughly 6.5 meters in elevation per year and shifted poleward 4.7 km per year since 1898. Aedes aegypti (the primary mosquito that spreads dengue fever, Zika, and chikungunya) has been detected at 2,438 meters above sea level in Nepal, an altitude previously considered too cold for it to survive.
Dengue incidence is projected to rise 35% by 2050, while chikungunya surged to over 400,000 cases across 40 countries in 2024 and 2025, and the West Nile virus killed 49 people in Italy alone in summer 2025. An additional 4.7 billion people could be at risk of malaria and dengue by 2070 as the epidemic belt pushes into temperate regions. Climate change alone may intensify more than half of all known human pathogens in the coming decades.
Builder signal: Surveillance, predictive modeling, and rapid diagnostics are the critical gaps in the market today. Most countries lack integrated systems connecting climate data to epidemiological forecasting. This is an intelligence problem as much as a medical one.
💨 Air Quality & Chronic Exposure: The Slow Burn
If heat is the acute killer, degraded air quality and environmental exposure are the chronic ones. PM2.5 from wildfires caused a record 154,000 deaths in 2024, and wildfire smoke has also been linked to lower test scores among students aged 8 to 14 years.
Climate change is also lengthening pollen seasons, increasing pollen concentrations, and boosting pollen production as rising CO2 levels stimulate growth and warming temperatures extend growing seasons. Globally, 400 to 500 million adults live with chronic obstructive pulmonary disease, and over 250 million with asthma; every fraction of a degree of warming is a risk to their health.
Builder Signal: Chronic environmental exposure will create recurring demand. Unlike emergency response, air quality management and environmental exposure are a daily operational need for employers, schools, hospitals, and building operators. Products that help institutions monitor, filter, and manage air quality will find steady, subscription-like revenue.
🧠 Mental Health: The Compounding Factor
Climate anxiety, displacement, and chronic heat exposure are driving rising rates of mental health disorders. Droughts and heatwaves drove 123 million people into food insecurity in 2023 alone, with cascading psychological effects. We won’t dedicate a standalone article to this vector, but builders should recognize it as a compounding factor that runs through every primary exposure pathway of health.
Heat, infectious disease, and air quality map to three exposure pathways, each operating on a different time horizon and each demanding different solutions. The rest of this Health series is organized around them: acute thermal exposure (article 2), infectious and vector-borne disease (article 3), and chronic environmental exposure (article 4). But before we go deep on each pathway, let’s map the demand side.
🚨The Diagnosis: Why Public Health Infrastructure Can’t Keep Up
The damage above isn’t a failure of knowledge alone — it’s a failure of measurement, and then of infrastructure. Four structural problems explain why extreme heat is still treated as a weather story rather than a public health emergency.
We don’t actually have the data. The mortality numbers in every heat article - the 181,000 European deaths across 2022–24, the 2,325 US deaths in 2023 - are statistical estimates based on excess mortality, not clinical cause-of-death records. “Heat” almost never appears on a death certificate. People die of cardiac arrest, kidney failure, stroke, or an opioid overdose made fatal by dehydration, and the heat is invisible on the chart. Research groups now believe the true US toll is closer to 12,000 deaths a year - roughly five times the official count. Without clinical-grade data, we don’t understand the full physiological pathways that turn heat exposure into morbidity and mortality, we can’t price the risk, we can’t target interventions, and we can’t make a political or an ROI case.
Stationary climate assumptions. Public health models such as epidemiological baselines, hospital capacity plans, and disease surveillance thresholds were built on the assumption that historical climate patterns would hold. When a European summer kills 68,000 people, and the system’s primary response is an advisory to drink water and seek air conditioning, the infrastructure has been outrun by the problem.
Reactive, not predictive. That outdated foundation produces systems that respond after outbreaks and emergencies, not before. Only 58% of World Health Organization member states have completed a health vulnerability and adaptation assessment. Across Europe, just over a quarter of countries can forecast heat-related mortality, and fewer than half monitor heat-related deaths in near-real time. Globally, there is no unified heat early-warning system; a gap the UN has called critical but has yet to close. 1 in 12 hospitals worldwide are at risk of climate-related shutdowns, and only 54% of national health adaptation plans even assess risks to health facilities. These systems were built to be reactive, not to protect the living proactively.
Fragmented data. And even where the will to act exists, the tools don’t connect. Climate data, health records, air quality monitoring, and disease surveillance all sit in separate silos with no integration; there is no unified “climate-health operating system.” Most countries lack daily or even weekly health data granular enough to support real-time interventions. The World Economic Forum has identified interoperable climate-health data systems as one of the critical missing layers for building economic resilience; right now, those systems essentially don’t exist.
For builders, the takeaway is in the numbers and is worth repeating: less than 5% of adaptation funding goes to health, and just 0.35% of global A&R demand is currently served by health. As a result, Health A&R has seen minimal venture activity; low startup formation, limited funding, and almost no exits. For founders, that means room to define categories, but it also means educating investors on a market most haven’t mapped yet. Now that’s whitespace.
💰 Who’s Buying?
Understanding the damage is necessary but insufficient; builders need to know who will ultimately pay. Climate-driven health impacts have a broad, fragmented buyer landscape, but several segments are moving from latent demand to active purchasing.
Employers & Workforce Safety. The largest near-term buyer. OSHA’s proposed heat rule creates a compliance trigger for every employer in the US with heat-exposed workers: construction, agriculture, logistics, infrastructure, and manufacturing. This market already exists in Japan and is also developing in the EU, where workforce heat monitoring, illness prevention, and compliance tooling are immediate product categories.
Cities & Municipal Governments. Cities have front-line exposure to heat islands, air-quality emergencies, and vector-borne outbreaks. They have a high level of concern about these risks but are inadequately prepared to handle them, particularly heat exposure. While they have long procurement cycles, their large budgets are increasingly earmarked for climate resilience.
Insurers & Reinsurers. Rising climate-related health claims are forcing underwriting recalibration. Insurers need better, forward-looking risk data to price policies more accurately and to have a financial incentive to invest in prevention. Insurers and reinsurers can be both buyers of analytics products and distribution partners, incentivizing policyholders to adopt solutions. For the first wave of builders, insurers are the fastest path to real revenue, because they already have the buyer infrastructure, the actuarial appetite, and the regulatory pressure to reprice heat risk on an annual cycle.
Military. One of the world’s largest employers of outdoor workers in extreme environments. Heat-related casualties and soldier impairment during training are documented readiness problems. The military is an early, extremely well-funded beachhead customer for wearable cooling and physiological monitoring.
School Districts & Universities. Liability exposure is increasing for educational institutions managing student heat safety and classroom air quality with tools built for a different era. While they’re slow to adopt, product stickiness in this ecosystem is real.
Real Estate & Building Operators. Indoor air quality and thermal comfort are becoming competitive differentiators. Occupational health is emerging as a dimension of tenant wellness, green builder standards, and worker productivity. Monitoring and filtration will scale with the built environment itself.
Hospitals & Health Systems. Climate stress is exposing the fragility of healthcare infrastructure every day. Hospitals need solutions to ensure facility resilience, supply chain continuity, and patient safety during extreme heat and air-quality events.
🚀 Build Opportunties: GigaClimate’s POV
The extreme-heat solution stack splits into three layers. Your first question as a founder is which layer you’re in; your second is which buyer signs a check in the next 12 months. We’ve come around to the view that the fastest money in heat A&R isn’t just in the devices people wear - it’s in the contracts employers, cities, and facility operators sign.
Areas where we see significant, immediate opportunities for impact:
🛡️ Layer 1: Exposure Reduction. The “shield” layer - products that physically stand between people and heat. Wearable cooling, heat-reflective materials, urban cooling infrastructure, climate-resilient hospital design.
Wearable cooling and thermal protection for workers
Personal physiological monitoring linked to employer dashboards
Rapid core-body cooling devices for field treatment of heat stroke
Passive cooling infrastructure: cool roofs, cool pavements, reflective materials
High-efficiency, grid-resilient cooling systems for hospitals, schools, data centers, and social housing
Pop-up and permanent cooling centers - the urban equivalent of emergency shelters
Climate-resilient building envelope retrofits at scale
🌡️ Layer 2: Detection & Intelligence. The fastest-to-deploy layer - mostly software. Early-warning systems, real-time environmental monitoring, climate-integrated health records, AI-driven heat forecasting.
Climate-health operating system: the platform that fuses environmental sensing, workforce/patient data, and predictive models into a single decision layer for employers, cities, hospitals, and insurers
Hyperlocal heat mapping and early-warning systems (neighborhood-level, not city-level)
Workplace heat monitoring and compliance tooling for the OSHA rule
📓 Layer 3: Response & Continuity. The closest analog to healthcare today - but built for a shifting baseline, not a static one. Workforce health management, climate-resilient supply chains, point-of-care diagnostics, healthcare training, and climate-indexed insurance all live here.
Parametric heat insurance for employers, municipalities, and agriculture - triggered on verified temperature or wet-bulb thresholds
Heat-risk underwriting-as-a-service for MGAs, specialty carriers, and workers’ comp books
Embedded heat coverage inside commercial lines and workers’ comp
For founders looking to build in this space, start with employers. They have immediate pain, budget authority, and a regulatory trigger that’s in motion. If you’re building in one of these spaces, we want to hear from you. Reach out to the GigaClimate team.
❓Key Questions for Builders
Every layer of the Health A&R stack has open questions that will define who wins. Here’s what we’re thinking about:
Data, Detection and Intelligence:
Who builds the climate-integrated health record that ties a patient’s cumulative heat exposure to their cardiac, renal, and mental-health trajectory - and who buys it first, a hospital system or an employer?
Can vector-borne disease surveillance become a SaaS business, or is it permanently a public goods problem?
Insurance: Is there a venture-scale business in a parametric heat product for employers, or does this category flow through existing workers’ comp carriers as a feature, not a standalone company?
Exposure Reduction: When OSHA’s heat rule is finalized, what does the “hard hat of heat safety” look like, the product that makes compliance simple for a 500-person construction firm?
Capital: Less than 5% of adaptation funding goes to health today; what unlocks additional capital?
At GigaClimate, this is the space we’re building toward: platforms that predict exposure before it becomes injury, tools that turn regulatory obligation into operational advantage, and systems that make health infrastructure adaptive rather than reactive.
The most important Health A&R companies of the next decade won’t be defined by the diseases they treat, but by the exposures they prevent and by how quickly they can move the system from response to anticipation.
In our next piece of this series, we’ll go deep on the most immediate of the three exposure pathways: acute thermal stress. The physiology of heat injury, the regulatory catalyst that’s creating a new compliance market overnight, and the builder landscape for cooling, monitoring, and workforce protection.