Regions with high socio-economic inequality are more susceptible to the effects of cold weather, while regions with high levels of wealth and urbanization are at greater risk during heat waves and lower risk during cold waves. This is shown by a study led by the Barcelona Institute for Global Health (ISGlobal), a center supported by the La Caixa Foundation. The result is natural healthfor the first time quantified how socio-economic inequalities influence temperature-related mortality across urban and rural populations in 32 European countries.
The health impacts of climate change are already measurable and will increase in the coming decades unless adaptation and mitigation measures are implemented. More than 180,000 heat-related deaths were recorded in Europe between 2022 and 2024, confirming that temperature is becoming an important determinant of public health. Currently, cold causes more deaths than heat, but global warming will likely reduce or even reverse this difference, putting heat exposure (both hot and cold) at the center of environmental epidemiology.
However, risks are not uniform. Due to socio-economic disparities, climate does not affect everyone equally. Environmental temperature has a disproportionate impact on disadvantaged people. Even in high-income areas, the impact varies by region and social group. Factors such as wealth distribution, housing conditions, and socio-economic structure shape vulnerability. This is the first study to assess both urban and rural data and to be representative of the entire European population.
We analyzed daily mortality data from 32 European countries, including more than 161 million deaths from 2000 to 2019, recorded within the framework of the European Research Council (ERC)-funded project EARLY-ADAPT. The aim of the study was to assess how different socio-economic indicators change the relationship between temperature and mortality in European populations. ”
Blanca Paniello-Castillo, ISGlobal researcher and lead author of the study
Social deprivation, extreme temperature risk factors
Areas with high levels of social deprivation are always more vulnerable to both heat and cold. Factors such as energy poverty, poor housing conditions, reduced access to health care, and low health literacy can all contribute to increased risk.
Indicators such as the Gini index (which measures the unequal distribution of wealth within a population), the difficulty of keeping one’s home warm, and material and social deprivation are consistently associated with mortality rates associated with rising temperatures.
This study estimates temperature-attributable mortality by comparing two hypothetical scenarios. One scenario in which all regions are in the most favorable socio-economic conditions, and the other scenario in which all regions are in the most unfavorable extreme socio-economic conditions. The difference in the number of deaths between the two scenarios is more than 300,000 in the case of not being able to keep one’s home warm, 177,000 in connection with economic inequality, and around 157,000 in the case of severe material and social poverty in Europe.
Economic prosperity protects us from the cold, but not from the heat.
Regions with higher GDP per capita and longer life expectancy have been shown to have lower cold-related mortality rates. This is likely due to better insulated housing, stronger health systems, and less energy poverty.
However, these same regions experience higher mortality during heat. This phenomenon may be explained by intense urbanization. In other words, dense cities and concentrated economic activity promote an “urban heat island” effect. In this climate phenomenon, temperatures increase in urbanized areas due to factors such as heat absorption by asphalt and lack of vegetation.
“Climate change does not affect all populations equally, so our results help assess and strengthen how socio-economic factors are integrated into adaptation policies,” explains Joanne Ballester, principal investigator and research coordinator of the EARLY-ADAPT project. “Similar studies are needed in other regions. We know that Europe is highly exposed to climate risks, but there are still few comparable studies in the Global South,” he concludes.
sauce:
Barcelona Institute for Global Health (ISGlobal)
Reference magazines:
Paniello Castillo, B. Others. (2026) Socio-economic inequality drivers of vulnerability and burden to heat- and cold-related mortality: a pan-European analysis in 654 contiguous regions. natural health. DOI: 10.1038/s44360-026-00106-0. https://www.nature.com/articles/s44360-026-00106-0
