Usama Bilal
Associate professor in the Department of Epidemiology and Biostatistics and co-director of the Urban Health Collaborative and the Center for Climate Change and Urban Health Research at Drexel University's Dornsife School of Public Health
This study is of high quality and employs robust methodologies that have become standard in research on how suboptimal temperatures affect mortality. The main limitations I see relate to the level of measurement of social variables and the fact that in Europe (and in many other places) there is a correlation between warmer climates and poverty (with the exception of Eastern Europe), which can make it difficult to separate poverty from other broader climatic factors.
The implications are very clear: this study confirms other research with a weaker empirical basis or a much narrower scope than this study, which suggests that the impacts of climate on health (and, consequently, on future risks associated with climate change) are not distributed equally and follow the same social patterns we have observed with other diseases. What is important for future studies is to better understand which specific, modifiable factors underlie these findings and could lead to public policies on climate adaptation that take these inequalities into account. For example, energy poverty, especially in winter, may be behind some of these findings.