Trends in Socioeconomic Inequalities in Heat Related Mortality in Barcelona, 1994–2023
Abstract
Background: Numerous studies on the association between high temperatures and mortality identify the Mediterranean region as particularly vulnerable to the health effects of heat. Although there is research on social inequalities in this relationship, studies examining their temporal evolution remain scarce. Therefore, the main objective of this study is to analyse changes in social inequalities in the relationship between heat and mortality in Barcelona from 1994 to 2023.
Methods: Daily mortality from natural causes in Barcelona was examined, stratified by sex (women and men), age ((65–84 and ≥85 years), educational level (low and high), and subperiods (1994–2003, 2004–2013, 2014–2023). Exposure was measured using daily mean temperature from the Fabra Observatory. A time-series study using quasi-Poisson regression and distributed lag non-linear models (DLNM) estimated the association and impact of heat in each group. Relative and absolute inequality metrics were calculated to assess their evolution over time.
Results: A clear association between heat and mortality was observed across all groups. Women, individuals aged ≥85 years, and those with lower educational levels were the most affected. Both risk and impact decreased during the second sub‑period and increased again in the third, although without reaching initial levels. Inequalities have persisted over time, with increasing disparities among women according to educational level.
Conclusions: Stratification and the use of different metrics allowed for the identification of the most affected groups, which are consistent with existing literature. Results indicate a recent rebound in heat‑related impacts and the persistence of social inequalities, highlighting the need to incorporate socioeconomic determinants into public health surveillance to design more equitable and effective climate‑change adaptation policies.
Speakers/Panellists: Francesca De’Donato
Lazio Regional Health Service - ASL Roma 1, Rome, Italy
Ana Diez-Roux
Department of Epidemiology and Biostatistics, Drexel University, Dornsife School of Public Health, Philadelphia, USA
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BibTeX
@article{urcelaymateos2026trends,
title = {{Trends in Socioeconomic Inequalities in Heat Related Mortality in Barcelona, 1994–2023}},
author = {A Urcelay-Mateos and L Oliveras and A Gómez Gutiérrez and M Quijal-Zamorano and M Marí- Dell’Olmo},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.487},
url = {https://doi.org/10.1093/eurpub/ckag169.487},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Trends in Socioeconomic Inequalities in Heat Related Mortality in Barcelona, 1994–2023
AU - A Urcelay-Mateos
AU - L Oliveras
AU - A Gómez Gutiérrez
AU - M Quijal-Zamorano
AU - M Marí- Dell’Olmo
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.487
UR - https://doi.org/10.1093/eurpub/ckag169.487
AB - Background: Numerous studies on the association between high temperatures and mortality identify the Mediterranean region as particularly vulnerable to the health effects of heat. Although there is research on social inequalities in this relationship, studies examining their temporal evolution remain scarce. Therefore, the main objective of this study is to analyse changes in social inequalities in the relationship between heat and mortality in Barcelona from 1994 to 2023. Methods: Daily mortality from natural causes in Barcelona was examined, stratified by sex (women and men), age ((65–84 and ≥85 years), educational level (low and high), and subperiods (1994–2003, 2004–2013, 2014–2023). Exposure was measured using daily mean temperature from the Fabra Observatory. A time-series study using quasi-Poisson regression and distributed lag non-linear models (DLNM) estimated the association and impact of heat in each group. Relative and absolute inequality metrics were calculated to assess their evolution over time. Results: A clear association between heat and mortality was observed across all groups. Women, individuals aged ≥85 years, and those with lower educational levels were the most affected. Both risk and impact decreased during the second sub‑period and increased again in the third, although without reaching initial levels. Inequalities have persisted over time, with increasing disparities among women according to educational level. Conclusions: Stratification and the use of different metrics allowed for the identification of the most affected groups, which are consistent with existing literature. Results indicate a recent rebound in heat‑related impacts and the persistence of social inequalities, highlighting the need to incorporate socioeconomic determinants into public health surveillance to design more equitable and effective climate‑change adaptation policies. Speakers/Panellists: Francesca De’Donato Lazio Regional Health Service - ASL Roma 1, Rome, Italy Ana Diez-Roux Department of Epidemiology and Biostatistics, Drexel University, Dornsife School of Public Health, Philadelphia, USA
SN - 1101-1262
SN - 1464-360X
ER -