Economic inequality is adding more than 100,000 extra deaths to Europe's already grim toll from heat and cold each year, according to new research. If the continent trimmed its inequality to match its most equal region - measured by the Gini index - temperature-related mortality would drop by as much as 30%, sparing 109,866 people annually. That's roughly the population of a small city, but with fewer ice packs and blankets needed.
The findings land as the EU's Copernicus monitoring project notes that last month was the third-hottest April on record globally, with Spain sweating through its hottest April ever. Meanwhile, the return of El Niño - potentially an unusually strong one - has experts nervously eyeing a brutal European summer in 2026.
Researchers found that high death tolls from temperature extremes were tightly linked to poverty, an inability to heat homes, and other hardships. If severe material and social deprivation across Europe were cut to the level of central Switzerland - the least deprived region - that would mean 59,000 fewer heat- and cold-related deaths. Crank it up to the level of southeast Romania, the most deprived region, and you'd see 101,000 more such deaths. The study, published in The Lancet Planetary Health, is the first to quantify how socioeconomic troubles amplify the body count during Europe's bone-chilling winters and scorching summers.
"It's a two for one," said Blanca Paniello-Castillo, a biomedical scientist at the Barcelona Institute for Global Health and lead author. "If the equity perspective would be more included in policies - European, national, local, whatever - we would be hitting two goals at the same time."
Heat and cold stress the body, leaving it more vulnerable to disease. Mortality spikes when temperatures stray from a comfortable range, especially among older or ill people. The analysis examined daily mortality data for 654 European regions from 2000 to 2019, estimating "attributable deaths" by modeling the health burden if all regions had the best and worst economic indicator values.
Rich regions, it turns out, suffer fewer cold deaths - likely thanks to insulated homes, better healthcare, and less energy poverty - but more heat deaths. Researchers suspect the urban heat island effect: wealthier cities with lots of asphalt and scant greenery turn into bake ovens. They consistently found high temperature-related mortality linked to income inequality (measured by the Gini index), difficulty keeping homes warm, and material deprivation. Air conditioning penetration wasn't explicitly included.
Usama Bilal, an epidemiologist at Drexel University not involved in the study, called the research high-quality and robust, though he noted it might struggle to separate poverty from other climatic factors. "The main limitations I see relate to the level of measurement of social variables, and the fact that in Europe - and many other places - there is a correlation between warmer climates and poverty, excluding eastern Europe."
Cold currently kills far more Europeans than heat, though scientists expect that to flip as global heating pushes temperatures higher. Last month, researchers reported that European temperatures have risen 0.56C per decade since the mid-1990s - faster than any other continent - thanks to fossil fuel pollution. This follows a warning from the EU's scientific advisers that the continent is failing to adapt to climate shifts.
Malcolm Mistry, an epidemiologist at the London School of Hygiene and Tropical Medicine not involved in the study, said the findings should shape adaptation policy - and may even be conservative. "Fuel poverty rates rose quite sharply across many European countries after 2021-22," he noted. "The estimated burden presented here may well be conservative by current standards."