Heat Contributed to 47,000 Deaths in Europe Last Year, but Relief Programs Helped
More than 47,000 Europeans died from heat-related causes during 2023, the world’s hottest year on record, a new report in Nature Medicine has found.
But the number could have been much higher.
Without adaptations to rising temperatures over the past two decades — including advances in health care, more widespread air-conditioning and improved public information that kept people indoors and hydrated during extreme temperatures — the death toll for Europeans experiencing the same temperatures at the start of the 21st century could have been 80 percent higher, according to the new study. For people over 80 years old, the death toll could have doubled.
“We need to consider climate change as a health issue,” said Elisa Gallo, a postdoctoral researcher at the Barcelona Institute for Global Health, a nonprofit research center, and the lead author of the study. “We still have thousands of deaths caused by heat every year, so we still have to work a lot and we have to work faster.”
Counting deaths from extreme heat is difficult, in part because death certificates don’t always reflect the role heat played in a person’s death. The study used publicly available death records in 35 countries, representing about 543 million Europeans and provided by Eurostat, the statistics office of the European Union.
The researchers used an epidemiological model to analyze the deaths alongside 2023 weekly temperature records to estimate what fraction of deaths could be attributable to heat.
“We’re quickly approaching the limits to what the human body can withstand,” said Jordan Clark, a senior policy associate at Duke University’s Heat Policy Innovation Hub who was not involved in the study. As the planet continues to warm, he said, “we’re racing against the clock.”
“We can’t adapt forever,” Dr. Clark said.
Heat waves are becoming more severe and prolonged as global temperatures increase. Ending our reliance on fossil fuels would be a core mitigation strategy, Dr. Clark said.
The last two decades had pushed people to modify their behaviors in response to heat, Dr. Gallo said. Other policy-level changes like improving urban planning, increasing green spaces, investing more in renewable energy and public transportation, and reducing greenhouse gas emissions could all contribute to adaptation.
“Adaptation has led to less deaths,” said Joan Ballester, associate research professor of climate and health at the Barcelona Institute and a co-author of the study. The term adaptation is meant very broadly, he added. It includes anything that reduces a group’s vulnerability to heat.
But pointing to the specific adaptation measures or policies that made the biggest differences is more difficult than estimating mortality, according to researchers.
In future studies, Dr. Gallo said she hopes to focus more on adaptations and differences between countries. The highest rates of heat-related deaths in the study occurred in countries that experienced the warmest temperatures over the longest period of time, including high nighttime temperatures, like Bulgaria, Spain, Cyprus, Portugal, and Italy.
“It’s really important to have more studies on evaluations of what’s actually being done, that assess the evolution of adaptation,” said Francesca de’Donato, an environmental epidemiologist at the Lazio Regional Health Service in Rome.
One of the earliest forms of adaptation in Europe was a heat-related warning system that some countries, like Italy, adopted after an exceptionally warm summer in 2003 that caused more than 70,000 excess deaths. The nation’s heat adaptation plan has been in place since 2004, based on guidance from the World Health Organization. The system directs medical and social service providers to check on patients most at risk every few days while a warning is issued. Patient registries indicate who is more vulnerable to heat based on factors like a chronic disease, age, socioeconomic status or whether someone lives alone.
A new website called Forecaster Health, created by the Barcelona Institute, provides an alert system that isolates subgroups that might be the most vulnerable by gender and age. In the future, Dr. Gallo said those warnings could be even more specific to different illnesses like cardiac disease.
Dr. de’Donato’s region of Italy has been under a heat wave since late June. She said prolonged heat waves like this one, where temperatures fail to significantly drop over multiple days in a row, can have the greatest effects on human health.
Ashley Ward, director of Duke University’s Heat Policy Innovation Hub, said the study’s timing is critical as it comes on the heels of a global call to act on extreme heat issued last month by the Secretary General of the United Nations.
“Europe is really ahead of the U.S. on many of these kinds of activities, like heat governance and early warning systems,” Dr. Ward said “The problem is growing faster than the data improvement is happening.”
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