Climate change is here, in Europe, and it kills. This is the warning of 69 contributors of the 2024 Europe report of the Lancet Countdown, published today in the Lancet Public Health. Tracking the links between climate change and health across the region, the new report explores 42 indicators which monitor the health impacts of climate change, as well as the inadequate, delayed or missed opportunities of climate action in Europe.

Climate change is not a far-in-the-future scenario

This second indicator report from the Lancet Countdown in Europe has been led by the Barcelona Supercomputing Center-Centro Nacional de Supercomputación (BSC-CNS) in collaboration with the Barcelona Institute for Global Health (ISGlobal), a centre supported by the ”la Caixa Foundation” and 40 other institutions across Europe. Indicator findings show that the negative health impacts of climate change have been increasing compared with baseline levels - with most impacts exceeding previously reported levels.

• Heat-related deaths are estimated to have risen across most of Europe, with a mean increase of 17 deaths per 100,000 inhabitants between 2003–2012 and 2013–2022.
• Risky hours for physical activity due to heat stress risk increased between 1990–2022 for both medium (e.g., cycling or football) and strenuous (e.g., rugby or mountain biking) activities, possibly resulting in reduced physical activity and therefore increasing the risk of non-communicable diseases.
• Climatic suitability for various climate-sensitive pathogens and disease vectors has increased in Europe (eg, Vibrio, West Nile virus, dengue, chikungunya, Zika, malaria, leishmaniasis, and ticks, which spread Lyme disease and other tick-borne diseases).
• Both the start and end of the pollen season have shifted for alder, birch, and olive, while the season duration remained nearly the same length across most of Europe.

“Climate change is already wreaking havoc on the lives and health of people across Europe,” says Professor Rachel Lowe, Director of the Lancet Countdown in Europe and ICREA research professor and leader of the Global Health Resilience group at the Barcelona Supercomputing Center, Spain. “Our report provides evidence of the alarming increases in climate-related health impacts across Europe, including heat-related mortality, emerging infectious diseases and food and water insecurity. The time has come for unprecedented action to limit these negative impacts on health in Europe and across the globe.”

Deepening health inequalities in a warming world

The negative climate-related health impacts and the responsibility of climate change are not equal within Europe or across the globe, often reflecting socio-economic inequalities and marginalisation. The authors reflect on aspects of inequality by highlighting at-risk groups in Europe and Europe’s responsibility for the climate crisis.

• Heat-related mortality was twice as high in women compared with men, low-income households had a substantially higher probability of experiencing food insecurity, deaths attributable to an imbalanced diet were higher among women and exposure to wildfire smoke was higher in highly deprived areas.
• Southern Europe tends to be more affected by heat-related illnesses, wildfires, food insecurity, drought, mosquito-borne diseases and leishmaniasis. In contrast, northern Europe is equally or more impacted by Vibrio and ticks, which can spread diseases like Lyme disease and tick-borne encephalitis.
• Despite climate change exacerbating existing health inequalities, the report shows little engagement with aspects of equality, equity or justice in climate and health research, policy and media, with only 10 (0.1%) references to the intersection of health and climate change recorded in the European Parliament in 2022.

“Climate change is inherently a social and environmental justice problem,” says Dr Kim van Daalen, Lancet Countdown in Europe Research Fellow, lead author of the report, and post-doctoral researcher at the Barcelona Supercomputing Center, Spain. “Looking within European countries we are seeing the most disadvantaged communities being particularly affected by the climate-related health impacts. At the same time, European countries also offshore the health impacts of our consumption elsewhere, with other parts of the world experiencing local air pollution and greenhouse gas emissions as a result of the goods and services consumed by Europe.”

• In 2021, emissions from fossil fuel combustion were 5·4 tonnes of CO₂ per person in Europe—six times that of Africa and almost three times that of Central and South America per person emissions.
• Many European countries still outsource environmental pressures elsewhere, with consumption-based CO₂ and PM_2.5 emissions exceeding production-based emissions.

A fair and healthy environmental transition

This first update of the comprehensive assessment on climate change and health in Europe emphasises that climate change is already negatively affecting people’s health across Europe, yet the signs of political action to protect citizens are slim.

• The current trajectory estimates that carbon neutrality will be reached as late as 2100, showing the road to net-zero energy systems remains woefully inadequate.
• Coal use increased to 13% of Europe’s total energy supply in 2021 compared to 12% in 2020, and 29 of the 53 WHO European region countries are still providing net subsidies for fossil fuels.
• During 2005–20, air pollution (PM_2.5) attributable deaths from fossil fuel combustion decreased by 59% in Europe, with much being due to air pollution control technologies.

“Exposure to air pollution is harming people’s health in Europe and beyond,” says Professor Cathryn Tonne, co-director of the Lancet Countdown in Europe and Research Professor at ISGlobal. “Whilst our report shows a decrease in air pollution (PM_2.5) over the past 15 years in Europe, this decrease was predominantly due to improved air pollution control technologies that decreased air pollution, but not greenhouse gas emissions. We still need appropriate policy measures that tackle air pollution and greenhouse gas emissions in parallel.”

Failure to take decisive action may exacerbate the existing climate change impacts and lead to missed opportunities for considerable health co-benefits in the short term. The authors argue that considering the impacts of climate change within and beyond Europe and Europe’s role in creating the climate crisis, Europe should commit to a fair and healthy environmental transition, which includes taking global responsibility and supporting the most affected communities.

“We are feeling the cost of delayed action already - but we also know the rewards we could reap from phasing out fossil fuels and pathways to get there,” says Prof. Rachel Lowe. “Limiting global warming to less than 1.5C degrees through a just and healthy transition would deliver life-saving benefits for people across Europe and beyond. Instead of facing ill health and threats to our livelihoods, European countries could feel the health benefits of clean air, better diets, reduced inequality and more liveable cities through urgently implementing climate policies which focus on health and wellbeing.”

About the Lancet Countdown in Europe

Established in 2021, the Lancet Countdown in Europe tracks the connections between climate change and public health across Europe, drawing on the transdisciplinary expertise of 69 contributors spanning over 40 academic and UN institutions. With the wealth of data and academic expertise available in Europe, the collaboration develops region-specific indicators to address the main challenges and opportunities of Europe’s response to climate change for health. The indicators produced by the collaboration provide information to health and climate decision-making and contribute to the European Climate and Health Observatory. In 2022, the collaboration published its first indicator report in the Lancet Public Health.

This is the second indicator report tracking progress on health and climate change in Europe, reporting on 42 indicators across five domains highlighting the negative impacts of climate change on human health, the delayed climate action of European countries, and the missed opportunities to protect or improve health through health-responsive climate action. The report will be published on 13 May in the Lancet Public Health – ahead of the 77^th World Health Assembly, 60^th sessions of the UNFCCC Subsidiary Bodies, and the European Parliament elections.

About the launch event

The virtual launch of the 2024 Lancet Countdown in Europe report will take place on 13 May 2024, 14:00-16:00 CEST. More information and registration can be found here.