Extreme heat is emerging as a direct threat to Indian household incomes and living costs, with agriculture and construction workers projected to lose the equivalent of 22.5 working days a year to heat stress by 2030, according to a new report by adelphi global.
The report, Heat, Health and Increasing Cost of Living: A Call for Action, said climate-driven heat affects household finances through two reinforcing channels: workers lose income when heat stress forces them to slow down, take longer breaks or stop work, while heat-related illness raises out-of-pocket medical expenses.
The adelphi global report, citing the recent Lancet Countdown, said India’s potential income loss from lost working hours and productivity due to extreme heat was $194 billion in 2024, equivalent to around 5% of GDP.
India is among the countries where the combined impact of heat-related work losses, high informal employment, out-of-pocket healthcare spending and weak social protection could create cascading poverty risks. The report studied eight countries: Bangladesh, Brazil, France, India, Indonesia, Italy, Nigeria and South Africa.
“Our report reveals that climate change is making us sicker and as a result, it’s also making us poorer,” said Mathilde Wilkens, report author and consultant, adelphi global. “As climate-driven heat stress puts people’s health at risk and stops them working, households are suffering a double burden of reduced incomes and increased medical expenditures.”
Double Burden
India is classified as extremely vulnerable to heat risks. Under the SSP1-RCP2.6 scenario, most of the country is projected to face high humidity-based heat risk during 2020-2039. The report links RCP2.6 to a global average temperature rise of 1.5°C by 2100, making the India findings significant even under a low-emissions pathway.
The number of hot days above 30°C in India is projected to range between 183 and 230 days annually. India already loses 4.31% of working hours across sectors every year due to heat, with losses projected to rise to 5.80% by 2030.
The stress is sharper in agriculture and construction, where outdoor physical labour is common. Working-hour losses in these sectors are already estimated at 5.87% and are projected to rise to 9.04% by 2030, translating into the annual loss of 22.5 working days.
Informality deepens the income shock. The report said 90% of women and 86% of men in India are informally employed, limiting access to paid sick leave, health insurance and formal income protection.
Across sectors, daily median income based on eight hours of paid work stood at $18.72 in purchasing-power-parity terms for women and $25.52 for men in 2025. With 23.9% of India’s population earning less than $4.20 per day, heat-linked income losses could increase the risk of households falling below the World Bank poverty line of $4.30 per day for lower-middle-income economies.
Healthcare Debt Trap
Medical costs add another burden. Out-of-pocket medical expenditure accounted for 44% of India’s total health expenditure in 2023, while annual per capita out-of-pocket spending reached $151 in PPP terms, up 194% since 2000.
The report cited anecdotal evidence that 40% of urban households and 60% of rural households experiencing heatstroke among a family member had to take loans or sell assets to pay medical bills.
Dennis Tänzler, report author and executive director, adelphi global, said governments need to “close the gap between adaptation planning and concrete action” for workers and households most exposed to heat.
The report called for linking adaptation plans to social protection, including compensation for lost working time, state-supported insurance, formal labour protections for heat-related losses and stronger public health systems.