How extreme heat is killing Europe’s elderly
The human toll of last year’s scorching summer conditions has been laid bare in new research which estimates that more than 61,000 people died in Europe from the record-breaking 2022 heatwaves, with the highest loss of life recorded among the over-80s.
In Britain, up to 3,469 people are believed to have died from the high temperatures – the highest number in any given year.
Such a large number of heat-related European deaths has not been recorded since the summer months of 2003, when more than 70,000 people perished – in what, to this day, remains the continent’s most catastrophic natural disaster of the 21st century.
Yet these mass mortality events may soon become a thing of the near future as global temperatures continue to rise, according to the research from the Barcelona Institute for Global Health (ISGlobal).
Published in Nature Medicine, the study estimates that, in the absence of an effective adaptive response, Europe will face an average of more than 68,000 premature deaths each summer by 2030 and more than 94,000 by 2040.
In light of such frightening projections, there is an “urgent need to reassess and substantially strengthen [heat] prevention plans,” says Dr Hicham Achebak, one of the paper’s lead authors.
Should countries fail to do so, it will be the elderly of Europe who pay the price.
The findings of Dr Achebak and his colleagues show that people aged 80 and over accounted for more than half of last summer’s heat-related deaths (36,848), with older women especially vulnerable.
Indeed, the analysis suggests that, overall, 63 per cent more women than men died due to the heat, with the highest incidence in the Mediterranean region.
For the elderly, increased vulnerability can be explained by several factors.
“First, as people age, their bodies become less efficient at regulating temperature and adapting to heat stress,” says Dr Raquel Nunes, Assistant Professor in Environmental Change and Public Health, at Warwick Medical School.
This makes it harder for older individuals to move heat from the core to the skin and maintain a stable internal temperature during hot conditions. Once the body can no longer cool itself, death can come in a matter of hours.
“Second, older people are more likely to have pre-existing health conditions, such as cardiovascular diseases or respiratory problems, which can be exacerbated by heat,” says Dr Nunes.
A largely ‘Mediterranean problem’
There are also the issues of living alone and limited mobility, which can hinder an elderly person’s access to cold places, placing them at heightened risk during a heat wave, she adds.
As to why more women died last summer than men, previous research has pointed to physiological differences and sociocultural factors.
But the researchers from ISGlobal “also found that differences in age structure between men and women partly explained the higher risk for women at advanced ages.” In essence, fewer older men are around to fall victim to the consequences of high temperatures.
For now, at least, the risk of death posed by extreme heat is largely a “Mediterranean problem,” says Dr Joan Ballester, an associate research professor at ISGlobal.
He highlights that the highest mortality rates recorded during last year’s heatwaves were in Italy (295 deaths per million), Greece (280), Spain (237) and Portugal (211). Britain, with 52 deaths per million, did not make it into the top 10.
In absolute numbers, Italy topped the list again, with 18,010 deaths, followed by Spain (11,324) and Germany (8,173). The UK experienced 3,469 heat-related fatalities, according to the research. (The UK Health Security Agency puts the figure at 2,985.) In all four countries, temperatures surpassed 40C last summer – and they were not alone.
For much of Europe, last summer was one characterised by oppressive heat waves, droughts and forest fires that wreaked havoc across the continent.
In Britain, the thermostat pushed beyond 40C for the first time ever, bringing the nation – ill-equipped for such high temperatures – to a grinding halt as roads melted, houses caught alight, and water supplies dried up.
According to the EU’s Copernicus Climate Change Service, the summer of 2022 was Europe’s hottest ever. Overall, last year was the world’s fifth warmest since at least 1850, with the previous eight years being the hottest on record.
It’s because of this concerning upward trend that 2022 – and its tragic impact on human life – cannot be viewed through the same lens as 2003, which is regarded as somewhat of a climatic anomaly.
“The summer of 2003 was an exceptionally rare phenomenon, even when taking into account the anthropogenic warming observed until then,” says Dr Ballester.
“In contrast, the temperatures recorded in the summer of 2022 cannot be considered exceptional, in the sense that they could have been predicted by following the temperature series of previous years, and that they show that warming has accelerated over the last decade.”
This acceleration has proven particularly acute in Europe, where temperatures have increased by more than twice the global average over the last 30 years.
Whereas many parts of the world are used to extreme temperatures, and have adapted accordingly, there is a distinct lack of heat resilience in Europe, experts say.
“Europe is not that super prepared,” says Roop Singh, a Climate Risk Advisor at the Red Cross Climate Centre. “A lot of the countries have typically had a moderate climate, so there’s not a lot of air conditions, homes aren’t prepared for heat – they have big windows to allow sun in, which is great for winter, but less so for summer.”
British houses are particularly unsuited for warm weather. More than a third of housing stock in England was built before 1945, including a fifth before 1919 – when heatwaves were a rarity and the overriding concern was keeping in the warmth.
Victorian-era architecture, an overuse of glass in newly-developed properties, unsuitable housing insulation, and poorly-designed housing and flat conversions, among other factors, are all to blame.
‘Insufficient’ heat adaptation strategies
Even in relatively normal summers, 20 per cent of homes in England are already vulnerable to overheating.
“Heat-proofing our houses is so important,” says Ms Singh. “A lot of [heat-attributable] deaths are people at home. It’s not something we often see visually.”
Following the 2003 heatwave, several European countries developed prevention strategies for combating extreme summers.
In the UK, a heatwave plan was first rolled out in 2014. It aims to prepare for, alert people to, and prevent, the major avoidable effects on health during periods of severe heat. As with other European plans, it outlines a structured reaction to different urgency levels.
But the fact that more than 61,000 people in Europe died of heat stress last summer, “even though, unlike in 2003, many countries already had active prevention plans in place, suggests that the adaptation strategies currently available may still be insufficient,” says Dr Achebak.
Scientists have urged governments to strengthen and broaden out their heat resilience programmes.
Dr Nunes stresses the importance of public awareness campaigns, heat warning systems, ensuring access to cooling centres, home visits and social support, housing adaptions, smart urban planning and green space designs, and healthcare outreach programmes.
Something as simple as planting trees alongside a road can make a significant difference. Research from Switzerland shows that the cooling effect of trees reduces the surface temperature of European cities in the summer by up to 12C in parts of the continent.
“National governments, relevant agencies, and other bodies need to be called upon to increase the effectiveness of heat prevention and adaptation plans,” says Dr Nunes, with specific consideration given to “targeting at-risk older individuals”.
Even after the experience of 2003, last summer showed that Europe isn’t prepared for what is to come as the planet further warms. Without immediate, meaningful action, tens of thousands of lives could be lost every year to the heat – each death an avoidable tragedy.
“I think there’s definitely a risk we’re going to see an increase globally in mortality because of rising temperatures,” says Ms Singh. “We need to be better prepared.”
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