TY - JOUR
T1 - Estimating the urban heat-related mortality burden due to greenness
T2 - a global modelling study
AU - Wu, Yao
AU - Wen, Bo
AU - Ye, Tingting
AU - Huang, Wenzhong
AU - Liu, Yanming
AU - Gasparrini, Antonio
AU - Sera, Francesco
AU - Tong, Shilu
AU - Lavigne, Eric
AU - Roye, Dominic
AU - Achilleos, Souzana
AU - Ryti, Niilo
AU - Pascal, Mathilde
AU - Zeka, Ariana
AU - de'Donato, Francesca
AU - das Neves Pereira da Silva, Susana
AU - Madureira, Joana
AU - Mistry, Malcolm
AU - Armstrong, Ben
AU - Bell, Michelle L.
AU - Schwartz, Joel
AU - Guo, Yuming
AU - Li, Shanshan
N1 - Publisher Copyright:
© 2025 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC 4.0 license
PY - 2025/7
Y1 - 2025/7
N2 - Background: Heat exposure poses a substantial public health threat. Increasing greenness has been suggested as a mitigation strategy due to its cooling effect and potential to modify the heat–mortality association. This study aimed to comprehensively estimate the effects of increased greenness on heat-related deaths. Methods: We applied a multistage meta-analytical approach to estimate the potential reduction in global heat-related deaths by increasing greenness in the warm season in 2000–19 in 11 534 urban areas. We used the enhanced vegetation index (EVI) to indicate greenness and a random forest model to predict daily temperatures in counterfactual EVI scenarios. In the factual EVI scenarios, daily mortality and weather variables from 830 locations in 53 countries were extracted from the Multi-Country Multi-City Collaborative Research Network and used to assess heat–mortality associations. These associations were then extrapolated to each urban area under both factual and counterfactual EVI scenarios based on meta-regression models. Findings: We estimated that EVI increased by 10% would decrease the global population-weighted warm-season mean temperature by 0·08°C, EVI increased by 20% would decrease temperature by 0·14°C, and EVI increased by 30% would decrease temperature by 0·19°C. In the factual scenario, 3 153 225 (2·48%) of 127 179 341 total deaths could be attributed to heat exposure. The attributable fraction of heat-related deaths (as a fraction of total deaths) in 2000–19 would decrease by 0·67 (95% empirical CI 0·53–0·82) percentage points in the 10% scenario, 0·80 (0·63–0·97) percentage points in the 20% scenario, and 0·91 (0·72–1·10) percentage points in the 30% scenario, compared with the factual scenario. South Europe was modelled to have the largest decrease in attributable fraction of heat-related mortality. Interpretation: This modelling study suggests that increased greenness could substantially reduce the heat-related mortality burden. Preserving and expanding greenness might be potential strategies to lower ambient temperature and reduce the health impacts of heat exposure. Funding: Australian Research Council and Australian National Health and Medical Research Council.
AB - Background: Heat exposure poses a substantial public health threat. Increasing greenness has been suggested as a mitigation strategy due to its cooling effect and potential to modify the heat–mortality association. This study aimed to comprehensively estimate the effects of increased greenness on heat-related deaths. Methods: We applied a multistage meta-analytical approach to estimate the potential reduction in global heat-related deaths by increasing greenness in the warm season in 2000–19 in 11 534 urban areas. We used the enhanced vegetation index (EVI) to indicate greenness and a random forest model to predict daily temperatures in counterfactual EVI scenarios. In the factual EVI scenarios, daily mortality and weather variables from 830 locations in 53 countries were extracted from the Multi-Country Multi-City Collaborative Research Network and used to assess heat–mortality associations. These associations were then extrapolated to each urban area under both factual and counterfactual EVI scenarios based on meta-regression models. Findings: We estimated that EVI increased by 10% would decrease the global population-weighted warm-season mean temperature by 0·08°C, EVI increased by 20% would decrease temperature by 0·14°C, and EVI increased by 30% would decrease temperature by 0·19°C. In the factual scenario, 3 153 225 (2·48%) of 127 179 341 total deaths could be attributed to heat exposure. The attributable fraction of heat-related deaths (as a fraction of total deaths) in 2000–19 would decrease by 0·67 (95% empirical CI 0·53–0·82) percentage points in the 10% scenario, 0·80 (0·63–0·97) percentage points in the 20% scenario, and 0·91 (0·72–1·10) percentage points in the 30% scenario, compared with the factual scenario. South Europe was modelled to have the largest decrease in attributable fraction of heat-related mortality. Interpretation: This modelling study suggests that increased greenness could substantially reduce the heat-related mortality burden. Preserving and expanding greenness might be potential strategies to lower ambient temperature and reduce the health impacts of heat exposure. Funding: Australian Research Council and Australian National Health and Medical Research Council.
UR - https://www.scopus.com/pages/publications/105003949242
U2 - 10.1016/S2542-5196(25)00062-2
DO - 10.1016/S2542-5196(25)00062-2
M3 - Article
C2 - 40318693
AN - SCOPUS:105003949242
SN - 2542-5196
VL - 9
JO - The Lancet Planetary Health
JF - The Lancet Planetary Health
IS - 7
M1 - 101235
ER -
