The Heat Will Kill You First
Europe’s New Climate Reality: Living with Extreme Heat
Historically, cold weather has claimed more lives in Europe than heat. But this is changing. As the climate warms, heat-related deaths are expected to increase, outpacing the decline in cold-related deaths.
A recent study published In Nature Medicine paints a bleak picture. Between 2015 and 2099, Europe could see an additional 2.3 million linked to extreme temperatures without bold climate action. Under the worst-case scenario, cities could suffer 5.83 million extra heat-related fatalities, far outweighing the 3.48 million reduction in cold-weather deaths.
The study, covering 854 cities in 30 countries, identifies southern cities such as Athens, Madrid, and Rome as the most vulnerable at risk. These urban centres face the "urban heat island" effect— where the concrete and asphalt of densely packed cities as well as the lack of vegetation, amplify heat far more than surrounding rural areas.
Barcelona, Madrid Marseille, Naples, Rome, Genoa, and Athens lead the list of cities with the highest projected fatalities. Meanwhile, Northern Europe may experience some relief in winter death rates, but for much of the continent, especially in the Mediterranean and Eastern Europe, the outlook is dire. Even the most optimistic climate scenarios predict that heat-related deaths will surpass reductions in cold-weather fatalities. In the most extreme projection (SSP3-7.0), climate-related deaths in Europe could experience a 49% surge by 2099.
Northern Europe would see a slight decrease in death rates, but the Mediterranean and Eastern Europe are highly vulnerable. That is the worst-case scenario, with potential of at least two-thirds achievable through preventive measures.
Researchers estimate that two-thirds of these deaths are preventable with strong mitigation and adaptation strategies. Some cities have started taking action, from expanding green spaces and planting trees, to creating cooling centers, and enforcing new planning laws to make buildings more heat-resistant.
These measures can make a significant difference—not only in preventing fatalities but also in reducing the chronic health conditions exacerbated by extreme heat, such as cardiovascular disease, mental health challenges, and even the risk of miscarriages. Climate change is not just an environmental issue—it’s a public health crisis demanding urgent attention.
With decisive action, Europe’s cities can avoid the worst. The question is, will they?
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Notes:
Estimating future heat-related and cold-related mortality under climate change, demographic and adaptation scenarios in 854 European cities (Nature Medicine, Open Access)
Climate change increases threat of heat deaths in European cities (Financial Times)