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@article{Konstantinoudis:2026,
author = {Konstantinoudis, G and Vineis, P and de, Donato F and Chen, X and Xi, D and Gascoigne, C and Sodano, B},
journal = {The Lancet Regional Health. Europe},
title = {Socioeconomic and geographical disparities in heat-related mortality in Italy: a nationwide small-area study},
year = {2026}
}
TY - JOUR
AB - BackgroundSpatial variation in heat-related mortality remains poorly understood, particularly at fine geographical scales. We conducted a nationwide small-area study to examine the association between spatial variation in heat-related mortality and environmental, demographic, health, and socio-economic factors.MethodsWe obtained daily all-cause mortality data for people aged ≥65 years during the summers of 2011–2023 and linked them with municipality-level daily mean temperature estimates from the ERA5-Land reanalysis dataset. We applied a two-stage Bayesian hierarchical model to estimate small-area heat-related mortality and assess the contribution of community characteristics to spatial variability.FindingsHeat-related mortality showed marked geographical differences, with the highest rates in southern and southeastern Italy. Across municipalities, the relative risk at the 90th temperature percentile, relative to the minimum mortality temperature, ranged from 1.06 to 1.33. The heat-attributable fraction exceeded 6% in several southern municipalities, while excess mortality surpassed 80 deaths per 10,000 inhabitants in parts of the Po Valley, Tuscany, Apulia, and Sicily. National heat-attributable mortality peaked in 2022, with an estimated 17,828 deaths (95% credible intervals: 17,339, 18,285) among older adults. Municipalities with higher average temperatures, less green space, higher obesity prevalence, and more residents aged ≥ 85 years had higher heat-related mortality. Educational attainment and employment were among the strongest modifiers of spatial variation.InterpretationOur findings highlight substantial small-area differences in heat-related mortality across Italy and identify socio-economic deprivation as a key determinant of vulnerability. Heat is likely to disproportionately affect disadvantaged communities, reinforcing the need for adaptation strategies addressing social inequality.FundingImperial College Research Fellowship; Italian Mini
AU - Konstantinoudis,G
AU - Vineis,P
AU - de,Donato F
AU - Chen,X
AU - Xi,D
AU - Gascoigne,C
AU - Sodano,B
PY - 2026///
SN - 2666-7762
TI - Socioeconomic and geographical disparities in heat-related mortality in Italy: a nationwide small-area study
T2 - The Lancet Regional Health. Europe
ER -
Climate Science
Earth and Life Sciences
Energy and Low-Carbon Futures
Resources and Pollution
Economics and Finance
Health
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