Global, regional, and national burden of heatwave-related mortality from 1990 to 2019: A three-stage modelling study

PLoS Med. 2024 May 14;21(5):e1004364. doi: 10.1371/journal.pmed.1004364. eCollection 2024 May.

Abstract

Background: The regional disparity of heatwave-related mortality over a long period has not been sufficiently assessed across the globe, impeding the localisation of adaptation planning and risk management towards climate change. We quantified the global mortality burden associated with heatwaves at a spatial resolution of 0.5°×0.5° and the temporal change from 1990 to 2019.

Methods and findings: We collected data on daily deaths and temperature from 750 locations of 43 countries or regions, and 5 meta-predictors in 0.5°×0.5° resolution across the world. Heatwaves were defined as location-specific daily mean temperature ≥95th percentiles of year-round temperature range with duration ≥2 days. We first estimated the location-specific heatwave-mortality association. Secondly, a multivariate meta-regression was fitted between location-specific associations and 5 meta-predictors, which was in the third stage used with grid cell-specific meta-predictors to predict grid cell-specific association. Heatwave-related excess deaths were calculated for each grid and aggregated. During 1990 to 2019, 0.94% (95% CI: 0.68-1.19) of deaths [i.e., 153,078 cases (95% eCI: 109,950-194,227)] per warm season were estimated to be from heatwaves, accounting for 236 (95% eCI: 170-300) deaths per 10 million residents. The ratio between heatwave-related excess deaths and all premature deaths per warm season remained relatively unchanged over the 30 years, while the number of heatwave-related excess deaths per 10 million residents per warm season declined by 7.2% per decade in comparison to the 30-year average. Locations with the highest heatwave-related death ratio and rate were in Southern and Eastern Europe or areas had polar and alpine climates, and/or their residents had high incomes. The temporal change of heatwave-related mortality burden showed geographic disparities, such that locations with tropical climate or low incomes were observed with the greatest decline. The main limitation of this study was the lack of data from certain regions, e.g., Arabian Peninsula and South Asia.

Conclusions: Heatwaves were associated with substantial mortality burden that varied spatiotemporally over the globe in the past 30 years. The findings indicate the potential benefit of governmental actions to enhance health sector adaptation and resilience, accounting for inequalities across communities.

MeSH terms

  • Climate Change*
  • Extreme Heat* / adverse effects
  • Global Health / trends
  • Hot Temperature / adverse effects
  • Humans
  • Mortality / trends
  • Seasons

Grants and funding

QZ was supported by National Natural Science Foundation of China (42205179), Natural Science Foundation of Shandong Province in China (ZR2021QH318), Shandong Excellent Young Scientists Fund Program (Overseas) (2022HWYQ-055), Taishan Scholar Foundation of Shandong Province (tsqn202306063); SL was supported by an Emerging Leader Fellowship of the Australian National Health and Medical Research Council (GNT2009866); AG was supported by the Medical Research Council UK (grant ID MR V034162/1) and EU’s Horizon 2020 project, Exhaustion (grant ID 820655); ST was supported by the Science and Technology Commission of Shanghai Municipality (grant number 18411951600); AU was supported by Czech Science Foundation (project number 22-24920S); FdD was supported by EU’s Horizon 2020 project, Exhaustion (grant ID 820655); PHNS was supported by the São Paulo Research Foundation (FAPESP); YG was supported by Leader Fellowship of the Australian National Health and Medical Research Council (GNT2008813); VH received funding from the EU’s Horizon 2020 Marie Skłodowska-Curie Actions program (Grant Agreement No.: 101032087); AMVC acknowledges funding from the Swiss National Science Foundation (TMSGI3_211626). The funders had no role in considering the study design or in the collection, analysis, interpretation of data, writing of the report, or decision to submit the article for publication.