Projected Temperature-Related Mortality in the Czech Republic Under Climate and Demographic Change with Adaptation Scenarios

Future temperature-related mortality in the Czech Republic is projected to change under the combined influence of climate change and population ageing. This study quantifies cold- and heat-attributable mortality across 14 regions using daily temperature and mortality data from 1994-2020 and age-specific exposure-response functions. The analysis presents the latest results developed within CROSSEU’s Heat Case Storyline, focusing on future heat- and cold-related health risks. Future mortality burdens were projected by combining EURO-CORDEX regional climate model simulations under RCP4.5 and RCP8.5 with population projections based on Shared Socioeconomic Pathways (SSPs) from the Wittgenstein Centre. Estimates were produced under two analytical frameworks: a climate-only scenario assuming a constant population structure and a combined climate-demographic scenario incorporating changes in population size and age composition.

To account for potential adaptation to heat, an adaptation framework was defined based on historically observed changes in the Minimum Mortality Temperature (MMT) and exposure-response functions, reflecting shifts in population vulnerability over time. Within this framework, four heat adaptation pathways were specified for each SSP, corresponding to (i) no adaptation, (ii) limited adaptation associated with a 10% attenuation of heat-related risk, (iii) strong adaptation corresponding to a 50% risk reduction, and (iv) near-complete adaptation corresponding to a 90% reduction. These adaptation pathways are conceptually linked to changes in MMT and ERFs but are not quantified in the present analysis and will be evaluated in subsequent work. 

All quantitative results presented here assume no or constant adaptation to temperature. Under the climate-only scenario (RCP8.5, late century), the annual cold-attributable fraction (AF) is projected to decline slightly, while the heat-related AF increases modestly. When population ageing is incorporated, the cold AF increases by approximately 4.5%, and the heat AF rises by around 1%. Relative to historical levels, national cold-related mortality increases by approximately 48%, and heat-related mortality increases by approximately 50% under the combined climate-demographic scenario. Comparisons with a constant-population framework indicate that population ageing is associated with an additional 45-50% increase in future temperature-attributable mortality.

Overall, the results illustrate how projected temperature-related mortality depends on assumptions about future climate, demographic change, and population vulnerability, underscoring the importance of integrating climatic and demographic processes in long-term health impact assessments.