Urban populations historically experience substantial cold-related mortality
Projected changes in cold-related deaths
Climate science and epidemiology point to a general expectation that warming will reduce the frequency and severity of extreme cold, producing a decline in cold-related mortalityreduces exposure to extreme cold for urban residents.
Causes, caveats and unequal consequences
The projected reductions stem mainly from fewer days of dangerously low temperatures and milder winters. However, several interacting factors complicate the net health outcome. Population ageing increases baseline vulnerability, and demographic shifts or increased prevalence of cardiovascular disease can amplify cold sensitivity. Urban form and socioeconomic conditions matter: the urban heat island
Importantly, declines in cold-related mortality may be partly or wholly offset by rising heat-related mortality and extreme events. Studies by Antonio Gasparrini and collaborators indicate regionally variable net effects: some cities may see overall mortality decrease, others an increase, depending on adaptation, baseline climate, and public health capacity. There are also cultural and territorial nuances: northern cities with robust heating and social safety nets may benefit more than low-income urban areas in warmer countries where cold remains episodic and healthcare access is limited.
Adapting health systems, improving housing quality, and targeting resources to vulnerable urban populations are critical to ensure the projected reductions in cold-related mortality translate into real public-health gains while managing emerging heat risks, a conclusion supported by the World Health Organization and IPCC assessments.