A new study has revealed that economic inequality is responsible for more than 100,000 additional deaths each year from heat and cold across Europe. The research, conducted by the Barcelona Institute for Global Health, found that reducing inequality to the level of Europe's most equal region, Slovenia, could cut temperature-related mortality by up to 30%, saving approximately 109,866 lives annually.
Findings in Context
The findings come as the EU's Copernicus monitoring project reported that last month was the third-hottest April on record globally, with some countries like Spain experiencing their hottest April ever. The return of El Niño, which may be unusually strong, has heightened fears of a brutal European summer in 2026.
The study linked high death tolls from heat and cold to several indicators of hardship, including poverty and the inability to heat homes. Researchers found that reducing severe material and social deprivation across the continent to the level of central Switzerland, the least deprived region, would result in 59,000 fewer temperature-related deaths. Conversely, increasing deprivation to the level of south-east Romania, the most deprived region, would lead to 101,000 more deaths.
First of Its Kind
This research is the first to quantify the impact of socioeconomic troubles on lives lost during Europe's cold winters and hot summers. The authors argue that their findings strengthen the case for targeting short-term relief to vulnerable groups and addressing structural inequality in the long term.
Blanca Paniello-Castillo, lead author and biomedical scientist at the Barcelona Institute for Global Health, said: "If the equity perspective would be more included in policies – European, national, local, whatever – we would be hitting two goals at the same time."
How Heat and Cold Affect Health
Extreme temperatures stress the body, making it more susceptible to disease and less able to fight infections. Mortality rises sharply when temperatures deviate from a comfortable range, particularly among the elderly and those with pre-existing health conditions.
The analysis examined daily mortality data from 654 European regions between 2000 and 2019. By modelling the health burden under best and worst economic indicator scenarios, the researchers estimated "attributable deaths."
Regional Disparities
The study found that richer regions experienced fewer cold-related deaths, likely due to better-insulated homes, superior healthcare, and lower energy poverty. However, these regions saw more heat-related deaths, possibly due to the urban heat island effect, where cities with more wealth suffer higher temperatures from asphalt and lack of green space.
The researchers consistently observed that high temperature-related mortality was associated with the Gini index (measuring income inequality), difficulties in keeping homes warm, and material and social deprivation. Air conditioning penetration was not explicitly included as a variable.
Expert Reactions
Usama Bilal, an epidemiologist at Drexel University's Dornsife School of Public Health, who was not involved in the study, praised its quality and robust methods. However, he noted potential limitations in separating poverty from climatic factors, given the correlation between warmer climates and poverty in Europe, excluding Eastern Europe.
Currently, cold poses a greater threat to human health than heat, but scientists project this will reverse as global heating continues. Last month, scientists reported that temperatures in Europe have risen by 0.56°C per decade since the mid-1990s, faster than any other continent, due to fossil fuel pollution.
The findings follow warnings from the EU's scientific advisers that the continent is failing to adapt adequately to climate shifts. Malcolm Mistry, an epidemiologist at the London School of Hygiene and Tropical Medicine, who was also not involved, said the results should inform climate adaptation policies and may be conservative. He noted that fuel poverty rates, an important determinant identified in the study, rose sharply across many European countries after 2021-22, suggesting the estimated burden may be higher under current conditions.
