Temperature-Related Mortality in Countries with Cold Climates: a Mapping Review

Sirinya Kaikeaw , University of Bologna
Mikhail Maksimenko, University of Bologna
Raya Muttarak, University of Bologna

Climate change disproportionately affects cold-climate regions, where increased heatwave frequency poses health risks to unadapted populations. To advance understanding, we conducted a systematic mapping review examining direct short-term temperature effects on mortality in countries covering major parts of circumpolar regions, identifying research gaps in literature published between 1990 and 2023. We systematically searched Scopus, Web of Science, and PubMed databases, retrieving 6,676 articles. articles supplemented by 1,339 articles from citation tracking, experts, etc. Following deduplication, 99 studies met inclusion criteria. The most represented countries were Sweden (n=35 studies with at least partial focus) and Canada (n=30). 67 studies examined exposure-response relationships across the temperature ranges, while 40 investigated heatwaves and coldwaves, with some studies contributing to both. Cause-specific mortality analyses predominantly focused on cardiovascular and respiratory diseases. Cold exposure was associated with greater cardiovascular than respiratory risks, while the opposite pattern was observed for heat. Ischemic heart disease mortality exceeded cerebrovascular during cold periods, and the reverse occurred during heatwaves. Key research gaps included geographic bias toward temperate zones rather than Arctic areas, where a limited number of large urban areas constrained statistical power. There were also methodological inconsistencies, particularly in definitions of extreme weather events and modeling of lag structures. Although cold-related mortality was generally found to be more detrimental, research emphasis remained disproportionately focused on heat-related effects. Overall, this review synthesized temperature-mortality evidence from countries with cold climates, revealed substantial research gaps and established foundations for future quantitative assessments.

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 Presented in Session P5. Health, Mortality, and Ageing 1