Spatio-temporal variations in temperature-related mortality links and Future climate projections impacts in the Czech Republic

While earlier studies documented long-term decreasing trends in heat-related mortality in most European countries, including the Czech Republic, recent research suggest a reversal in this trend during the last decade (2010-2019). This observation supports future climate projections that suggest growing impacts of heat on mortality in Europe and for the development of targeted heat prevention measures. In the first stage of this study, we used a detailed mortality database to analyze spatio-temporal variations in temperature-mortality relationships in NUTS3 regions of the Czech Republic from 1994 to 2020. The individual database allows for the comparison of temperature-mortality links among selected population groups, categorized by sex, age, and the primary cause of death. Daily mean temperature at the regional level was obtained from the ERA5 reanalysis. We applied distributed lag non-linear models (DLNMs) within a multilevel mixed meta-regression framework to identify variations in the relative risk of temperature-related mortality among selected regions and population groups through exposure-response functions (ERFs). In the final stage, high-resolution climate projection data EURO-CORDEX, driven by RCP scenarios were employed to estimate future dynamics of heatwaves in the Czech Republic and their connection with heat-relate mortality. These projections relied on ERFs derived in the first stage to assess impacts for each region and population group. Results of the analysis enabled us to identify population groups potentially most affected by climate change. Geographical demographic, and socio-economic characteristics of the NUTS3 regions were included in the meta-regression model to identify socio-economic modifiers of the temperature-related mortality patterns. The study's findings highlighted the importance of developing regional public health initiatives, and adaptation to climate change policies to safeguard vulnerable people from the growing effects of extreme temperatures.