How Can Europe Reduce Heat Deaths Amid Rising Temperatures?

Medscape

12 hours ago

The Pan-European Commission on Climate and Health has released an open letter urging action against the escalating health crisis in Europe and Central Asia that is stemming from climate change.
Europe is the fastest-warming region in the world, warming up twice as fast as the global average. While 2024 was the hottest year on record for continental Europe, 2025 is already on its way to surpassing it. T emperatures rose above 30 ˚C for an unprecedented 22 days in Scandinavia, while Spain and Portugal experienced heat exceeding 46 ˚C in June.
Such temperature rises have had a deleterious impact on health; data show that heat-related mortality has increased by more than 30% in the last two decades in Europe. This trend is showing no signs of slowing down. An analysis by Imperial College London , London, England, reported that 1500 of the 2300 heat deaths in the week between June 23 and July 2, 2025, were a direct result of climate change-related temperature rises of 1-4 °C.
Excess heat can exacerbate underlying health issues like c ardiovascular disease, diabetes, mental health conditions, and asthma , and increase the risk for accidents and the transmission of some infectious diseases. Older people, young children, and pregnant women are at particular risk.
'In the summer of 2022, 60,000-70,000 [people] died in Europe because of heat,' Julie Berckmans, PhD, European Environment Agency (EEA) climate risk and adaptation expert, told Medscape Medical News . 'In 2023, it was 47,000 people. These numbers could increase substantially in the coming decades. To avoid this, effective actions have to be implemented to protect vulnerable people.'
A man cools off at a fountain in St.Peter's Square at the Vatican on August 13, 2025. Italy faced extreme heat in August as temperatures above 40 °C gripped the country.
Heat-Health Actions Plans (HHAPs)
In their letter, the Pan-European Commission on Climate and Health highlighted the need for HHAPs to save lives and prevent further climate decline.
HHAPs provide a framework for reducing the health impacts of extreme heat. They focus on eight core elements: a governing structure for heat-health action, warning systems, care for vulnerable populations, heat-health communications planning, health system resilience, reduced heat exposure, surveillance, and a process for review and improvement, Vladimir Kendrovski, MD, PhD, World Health Organization (WHO)/Europe technical officer for climate change and health, told Medscape Medical News .
At present, 21 of the 38 countries belonging to the EEA network, Eionet, have HHAPs in place. While this is encouraging, said Kendrovski, accelerating their development and implementation across Europe remains a 'critical priority.'
Many countries began to implement HHAPs in response to the 2003 heatwave — the hottest period in continental Europe since at least 1540, claiming more than 70,000 lives. France and Italy , for example, saw significant declines in heat-related deaths after implementing preventative measures like warning system s, information campaigns for the public , and a ir conditioning equipment and emergency protocols for health centers and retirement homes.
Some measures, however, are more widespread than others. Kendrovski noted that a survey of member states in the region found that long-term urban planning and real-time surveillance, monitoring, and evaluation are still lacking.
Andreas Hoy, PhD, senior expert and climate scientist at the Stockholm Environment Institute Tallinn, in Tallinn, Estonia, noted that the technical components of early meteorological warning systems have been significantly updated in recent years, thus enabling better warning systems. However, he added, an absence of formal standards has led to wide variations in HHAP structures, objectives, and execution.
'This inconsistency often produces fragmented efforts and leaves major gaps in funding, vulnerability assessments, and long-term resilience planning,' he said.
Lateral Public Health
While improved infrastructure is important, community engagement is key toward ensuring it is used properly to ultimately reduce deaths, Jan Semenza, PhD, project manager at the Department of Epidemiology and Global Health at Umeå University, Umeå, Sweden, told Medscape Medical News .
Toward this end, he recommends a 'lateral' as opposed to 'vertical' approach to public health : rather than eliminating one health threat at a time, such as polio through vaccination campaigns, lateral approaches enhance community cohesion for a more self-organized and thus agile collective response to disasters, including heatwaves.
Measures may include community-based surveillance, health education, and projects like establishing urban gardens to cool air through transpiration or painting roofs green to reduce rooftop temperatures.
'One thing we found from our research in Chicago,' said Semenza, 'is that people who have social connections, participate in church communities, or even have a pet that allows you to go outside and connect with people — these are the ones that are more likely to survive. If you're isolated, nobody looks after you.'
Semenza added that urban planning should also be taken into account and recommended the creation of more green spaces to offset heating from cement and concrete.
More Solutions
Hoy noted that while long-term solutions aimed at reducing greenhouse gas emissions to prevent further heating are necessary, public awareness campaigns are still needed in the short-term to help people stay safe during heatwaves.
'Providing clear and simple guidance on how to stay safe during a heatwave can save lives: such as staying hydrated, seeking shade, and looking out for elderly neighbors, friends, and family members,' he told Medscape Medical News .
In terms of immediate solutions, Ilona M. Otto, PhD, deputy director at the Wegener Center for Climate and Global Change at the University of Graz, Graz, Austria, recommends using public spaces and buildings, such as libraries, as cooling centers, in addition to providing access to drinking stations, improved insulation, and assistance to vulnerable people living alone.
Regulations for working conditions may also need to be adjusted, she said, to ensure that those working in difficult conditions can take more breaks, have more access to water, and perhaps stop working at the hottest times of the day.
Healthcare professionals also have a key role in implementing HHAPs, Rachel Lowe, PhD, Catalan Institution for Research and Advanced Studies Research Professor at the Barcelona Supercomputing Center, told Medscape Medical News.
'Health professionals can detect and treat heat-sensitive and climate-related illnesses early and educate patients on prevention. They also play a key role in public awareness, surveillance, and advocating for greener, more resilient health systems that can withstand climate pressures and reduce the carbon footprint of the health sector,' she said.
The WHO Regional Office for Europe is currently developing new guidance for HHAPs, which is expected to be published in Spring 2026.
Berckmans, Kendrovski, Lowe, and Semenza reported no relevant financial relationships. Otto noted that a part of her work has been carried out within the HIGH Horizons project , funded by the European Union's Horizon Research and Innovation programme. Their project partner, London School of Hygiene & Tropical Medicine, is funded by UK Research & Innovation. Hoy declined to disclose any relevant financial relationships.