The impact of climate and demographic changes on future mortality in Brussels, Belgium

City populations are particularly vulnerable to climate change, but it is difficult to reliably estimate the impact on health due to the lack of high-resolution data. We used recently developed regional climate model projections at kilometre resolution combined with demographic projections to estimate the future mortality burden associated with temperatures in the region of Brussels, Belgium.

The study incorporated a time-series analysis.

Based on quasi-Poisson regression with distributed-lag non-linear models for the historical temperature-mortality relationship, we derive the mortality burden for the near (2020-2044) and mid (2045-2069) future and disaggregated the contributions of demographic and climate changes.

The cold-related attributable fraction of deaths is expected to decrease from 6.22% (95% empirical confidence interval: 1.76%; 10.52%) in 1994-2019 to 5.17% (1.08%; 9.09%) in 2045-2069, whereas for heat, this fraction will increase from 1.02% (0.59%; 1.47%) to 1.83% (0.82%; 2.96%), with contributions of both climate and demographic changes. In stratified analyses by age, we found that because of demographic changes, the number of cold-attributable deaths will increase for people aged above 85 years, with 6815 (95% empirical confidence interval: 1424; 12,003) deaths expected in 2045-2069 compared to 5245 (1462; 8867) deaths in 1994-2019. For people aged below 65 years, on the other hand, the number of heat-related deaths will decrease from 456 (265; 658) to 344 (154; 561) deaths.

Public health policies that especially target the elderly and the summer-time period are needed to limit the impact of climate change on health.