What public health strategy in an overheated Europe?

Description

In a Europe experiencing overheating, Europeans must develop a genuine public health strategy. This strategy should aim to prevent the health impacts of global warming, protect exposed populations, and strengthen the capacity of health systems to cope with heatwaves, emerging infectious risks, and repeated climate crises. As the climate warms further, public health must shift from a logic of ad hoc response to one of continuous preparedness.

Europe is the fastest-warming continent, and heatwaves are becoming longer, more frequent, and more dangerous for human health. According to a study entitled “Heat-related mortality in Europe during 2023 and the role of adaptation in protecting health”, and cited by the European Environment Agency, nearly 48,000 heat-related deaths were estimated across Europe in 2023. In 2024, more than 60,000 deaths are estimated to have been caused by heat (Janoš et al., 2025). Heat-related mortality could triple, and economic losses could quintuple, if Europe continues on a trajectory of 3°C warming by 2050 (García-León et al., 2021, 2024).

At the same time, European data highlight significant pressure on healthcare systems: in Portugal, daily hospital admissions increased by 19% during heatwave days between 2000 and 2018. European assessments also indicate that the overall level of policy preparedness for heat remains only moderate across Europe, notably due to heterogeneous approaches and a persistent lack of attention to social equity.

In 2024, 21 out of 38 countries in the European Economic Area had already implemented heat–health action plans, with four additional countries in the process of developing them.

Extreme heat can lead to dehydration, heat exhaustion, heatstroke, worsening of cardiovascular and respiratory diseases, as well as increased hospitalisations and deaths. It also affects the functioning of health systems themselves, as demand for care rises precisely when staff and infrastructure are already under strain. Beyond heat, climate overheating can also amplify other public health risks, such as the spread of disease vectors, deterioration of air quality, and the psychological impacts of extreme events. Public health must therefore treat climate as a major determinant of health, not only as an environmental issue.

A strong public health strategy is a core component of climate change adaptation. Adaptation aims to reduce the overall vulnerability of societies, and public health translates this into concrete actions: early warning systems, protection of vulnerable groups, housing retrofitting, urban greening, continuity of care, and adjustments to working conditions during heat periods.

The new EU Adaptation Strategy must therefore emphasise smarter, more systemic, and faster adaptation, fully aligned with the needs of the health sector and of European citizens.

How can Europe move from a fragmented and isolated response to an integrated European public health strategy in the face of climate overheating, capable of anticipating risks, protecting vulnerable populations, and transforming health systems from the European to the local level, in connection with the revision of the 2021 EU Adaptation Strategy, which established the European Climate and Health Observatory, and the Strategic Research and Innovation Agenda on Health and Climate Change published in June 2025?