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https://doi.org/10.5194/egusphere-2026-678
© Author(s) 2026. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
https://doi.org/10.5194/egusphere-2026-678
© Author(s) 2026. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
12 Feb 2026
| 12 Feb 2026
Status: this preprint is open for discussion and under review for Natural Hazards and Earth System Sciences (NHESS).
Brief communication: Drought economic assessments must include human health impacts
Abstract. The economic valuation of drought-related health interventions reveals that ensuring groundwater access during severe droughts could avert significant losses in Northeast Brazil. Estimated benefits from reduced diarrhea hospitalizations and mortality total 9.92 % of local GDP. When scaled to state level, avoidable losses may reach USD 1.15 billion, which are comparable to the economic drought’s impacts on productive sectors, such as agriculture, livestock, and industry, underscoring the macroeconomic relevance of investing in resilient water infrastructure in a health-promoting perspective.
How to cite. Costa, A. C., da Silva, F. G. F., Moreira, R. P., Martins, E. S. P. R., Agostinho, L. L. F., and van Oel, P. R.: Brief communication: Drought economic assessments must include human health impacts, EGUsphere [preprint], https://doi.org/10.5194/egusphere-2026-678, 2026.
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Status: open (until 01 Apr 2026)
Comment types: AC – author | RC – referee | CC – community | EC – editor | CEC – chief editor
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RC1: 'Comment on egusphere-2026-678', Raquel Guimaraes, 23 Feb 2026
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I found this paper very interesting and timely. The topic is highly relevant, especially because economic drought assessments still tend to prioritise productive sectors while giving limited attention to health outcomes. The manuscript is clearly written, policy relevant, and based on an accessible modelling strategy. In my view, it makes a valuable contribution and can be accepted with minor revisions.The paper argues that drought economic assessments usually focus on productive sectors such as agriculture and industry, while neglecting health impacts. Using data from Ceará in Northeast Brazil during the 2012–2020 drought, the authors show that access to groundwater significantly reduced diarrhea hospitalizations and related deaths. They estimate that, in the ten municipalities studied, the economic benefits of avoided morbidity and mortality correspond to almost 10% of local GDP, and when extrapolated to the state level, avoidable losses may reach around USD 800 million, with upper estimates above USD 1 billion. The study concludes that investments in reliable water supply are not only important for public health, but also highly relevant from a macroeconomic perspective, and that the true costs of drought are underestimated when health effects are excluded.Regarding Eq. 1, although the equation has been published in De Souza et al. (2025), it would be helpful to briefly restate the rationale for its application in this study and clarify its transferability to the current estimation exercise. The manuscript should also specify the time horizon of the variables (e.g., monthly or annual) and reflect this explicitly, for example through subscripts. In addition, the number of observations used in the estimation should be clearly indicated (is it a panel estimation?), and the implications of relying on ten municipalities should be discussed more explicitly in terms of external validity.It would also be important to clarify whether potential lagged effects between diarrhea hospitalizations and mortality were considered. For example, if deaths occur with some delay after hospitalization or during prolonged drought exposure, a purely contemporaneous specification may underestimate or misattribute part of the health impact. Even a short discussion of possible lag structures would strengthen the epidemiological interpretation.Moreover, the analysis implicitly assumes that hospitalization and mortality data are of good quality and fully representative. A brief discussion on data reliability would be valuable. For instance, are there concerns regarding underreporting, differences in access to hospital services, or variation in reporting quality across municipalities? In drought-affected and resource-constrained areas, some cases may not reach formal health facilities, which could lead to measurement error and potential underestimation of impacts. Reflecting on these aspects would increase transparency regarding the robustness of the estimates.In the Results section, the reported economic estimates would benefit from a clearer indication of their temporal scale (annual totals, cumulative over 2012–2020, etc.), which would facilitate interpretation and comparison. Finally, the statement that the total economic impact of drought is likely substantially greater than the reported values should be balanced by acknowledging potential sources of overestimation. For example, if the selected municipalities correspond to areas with particularly high disease incidence, selection effects may limit representativeness. A more explicit discussion of temporal scale, sample size, representativeness, and data quality would further strengthen the robustness and interpretability of what is otherwise a strong and policy-relevant contribution.ReplyCitation: https://doi.org/
10.5194/egusphere-2026-678-RC1
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Alexandre C. Costa
CORRESPONDING AUTHOR
Water Resources Management Group, Wageningen University, Wageningen, PB, The Netherlands
Engineering and Sustainable Development Institute, University for International Integration of the Afro-Brazilian Lusophony, Redenção, Ceara, Brazil
Francisco G. F. da Silva
Economy Graduate Program, Federal University of Ceara, Fortaleza, Ceara, Brazil
Rafaella P. Moreira
Health Sciences Institute, University for International Integration of the Afro-Brazilian Lusophony, Redenção, Ceara, Brazil
Eduardo S. P. R. Martins
Posgraduate Program in Civil Engineering, Federal University of Ceara, Fortaleza, Ceara, Brazil
Luewton L. F. Agostinho
Water Technology Research Group, NHL Stenden University of Applied Sciences, Leeuwarden, The Netherlands
Pieter R. van Oel
Water Resources Management Group, Wageningen University, Wageningen, PB, The Netherlands
Short summary
Many studies highlight drought impacts on productive sectors, such as agriculture and navigation, but economic consequences for human health remain understudied. We conducted an economic valuation of drought-related health interventions in Brazil, showing that ensuring groundwater access during severe droughts can avert substantial losses. Estimated benefits from reduced diarrhea hospitalizations total 9.92 % of local GDP, with avoidable losses reaching USD 1.15 billion at the state level.
Many studies highlight drought impacts on productive sectors, such as agriculture and...