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Hundessa, S.* ; Huang, W.* ; Xu, R.* ; Yang, Z.* ; Zhao, Q.* ; Gasparrini, A.* ; Armstrong, B.* ; Bell, M.L.* ; Huber, V. ; Urban, A.* ; Coelho, M.R.* ; Sera, F.* ; Tong, S.* ; Royé, D.* ; Kyselý, J.* ; de'Donato, F.* ; Mistry, M.* ; Tobias, A.* ; Iñiguez, C.* ; Ragettli, M.S.* ; Hales, S.* ; Achilleos, S.* ; Klompmaker, J.* ; Li, S.* ; Guo, Y.*

Global excess deaths associated with heatwaves in 2023 and the contribution of human-induced climate change.

Innovation 6:101110 (2025)

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An unprecedented heatwave swept the globe in 2023, marking it one of the hottest years on record and raising concerns about its health impacts. However, a comprehensive assessment of the heatwave-related mortality and its attribution to human-induced climate change remains lacking. We aim to address this gap by analyzing high-resolution climate and mortality data from 2,013 locations across 67 countries/territories using a three-stage modeling approach. First, we estimated historical heatwave-mortality associations using a quasi-Poisson regression model with distributed lag structures, considering lag effects, seasonality, and within-week variations. Second, we pooled the estimates in meta-regression, accounting for spatial heterogeneity and potential changes in heatwave-mortality associations over time. Third, we predicted grid-specific (0.5° × 0.5°) association in 2023 and calculated the heatwave-related excess deaths, death ratio, and death rate per million people. Attribution analysis was conducted by comparing heatwave-related mortality under factual and counterfactual climate scenarios. We estimated 178,486 excess deaths (95% empirical confidence interval [eCI], 159,892−204,147) related to the 2023 heatwave, accounting for 0.73% of global deaths, corresponding to 23 deaths per million people. The highest mortality rates occurred in Southern (120, 95% eCI, 116−126), Eastern (107, 95% eCI, 100−114), and Western Europe (66, 95% eCI, 62−70), where the excess death ratio was also higher. Notably, 54.29% (95% eCI, 45.71%−61.36%) of the global heatwave-related deaths were attributable to human-induced climate change. These results underscore the urgent need for adaptive public health interventions and climate mitigation strategies to reduce future mortality burdens in the context of increasing global warming.

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