Part of the work during the first 54 months focused on creating the project database, the largest, format-homogeneous mortality dataset in Europe, combined with the best available climate, air pollution, socioeconomic and demographic data. To achieve this, we designed and implemented harmonisation protocols for successful integration of data. Many health datasets were protected under third-party intellectual property rights, so we worked with institutions to clarify legal terms and implement data access protocols. The database is being regularly updated with new datasets or real-time products (e.g. weather forecasts and climate projections), using protocols and subroutines for automatic integration and post-processing. It is now ready and being analysed.
The project has led to several publications advancing knowledge beyond the state of the art. A key achievement was estimating heat-related mortality during Europe’s record-breaking summer of 2022 (Nature Medicine): Ballester et al. found 61,672 deaths between late May and early September, with the highest numbers in Italy, Spain, and Germany, and higher rates in women and the elderly. In 2023, another exceptionally hot year, Gallo et al. applied models to data from 823 regions in 35 countries, estimating 47,690 heat-related deaths, and showing that adaptation since the year 2000 reduced this burden by ~80%, especially in older people (Nature Medicine). A recent paper by Janos et al. (Nature Medicine) uses our new standardized daily mortality database to estimate 62,775 heat-related deaths for the summer of 2024 (23.6% higher than 2023 but 8.1% lower than 2022), and demonstrated that health emergencies can be forecast with high confidence at least a week in advance. Other studies deepened understanding of climate-health risks: Zhao et al. showed short-term exposure to multiple air pollutants causes substantial, unequal mortality burdens across 31 European countries, emphasizing the need for targeted strategies. Zhao et al. highlighted how socioeconomic inequalities and uneven renewable energy adoption widened regional disparities in air pollution-related mortality. Paniello-Castillo et al. found heat-related mortality risks increased during COVID-19 in Southern and Western Europe while cold-related risks were higher pre-pandemic in other regions, underscoring the need to strengthen adaptation. Another study by Paniello-Castillo et al. showed regions with greater deprivation face higher vulnerability to both heat and cold, calling for policies that integrate social justice. Shartova et al. found urban populations in Russia may have become more vulnerable to heat compared to rural populations, indicating maladaptation in cities. Finally, Quijal-Zamorano et al. (Science Advances) demonstrated that temperature forecasts can be used to predict mortality up to 8-11 days in advance, while another paper introduced Spatial Bayesian Distributed Lag Non-Linear Models for estimating temperature-related mortality risks at small-area scales.
In the upcoming months, we will continue exploring the major determinants of human mortality across a range of relevant spatiotemporal scales, including several environmental, socioeconomic and demographic factors.
