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In urban areas, environmental exposures to air pollution, extreme temperatures and noise as well as socio-economic inequalities are amplified. Urban green spaces offer dual benefits: they help mitigate climate change and improve public health by fostering connection to nature, reducing noise and air pollution, mitigating the urban heat island effect, and promoting physical activity. Within the 2023 "Cobenefici di Salute ed equità a supporto dei piani di risposta ai cambiamenti climatici in Italia" project funded by the Ministry of Health, we identified health indicators to assess climate action co-benefits, including those on cardiovascular disease mortality and morbidity, birth outcomes and mental health.

Independent effects of long and short-term exposures to non-optimal increased temperature on mortality.

Although the short-term heat effects are well-established, longer-term effects, beyond those, have recently received attention, in the context of climate change. Our study aims to investigate the potential effects of long-term exposure to non-optimal warm period temperatures on all-cause mortality in four large regions in the UK, Norway, Italy, and Greece. Daily all-cause mortality counts from 1996 to 2018 for four European NUTS-2 regions including 52-662 small areas were collected and associated with spatiotemporal temperature estimates.

Temporal change in minimum mortality temperature under changing climate: A multicountry multicommunity observational study spanning 1986-2015.

Background: The minimum mortality temperature (MMT) or MMT percentile (MMTP) is an indicator of population susceptibility to nonoptimum temperatures. MMT and MMTP change over time; however, the changing directions show region-wide heterogeneity. We examined the heterogeneity of temporal changes in MMT and MMTP across multiple communities and in multiple countries.

Meteorological factors, population immunity, and COVID-19 incidence: A global multi-city analysis.

Objectives: While COVID-19 continues to challenge the world, meteorological variables are thought to impact COVID-19 transmission. Previous studies showed evidence of negative associations between high temperature and absolute humidity on COVID-19 transmission. Our research aims to fill the knowledge gap on the modifying effect of vaccination rates and strains on the weather-COVID-19 association.

Temperature-mortality associations by age and cause: a multi-country multi-city study.

Background: Heterogeneity in temperature-mortality relationships across locations may partly result from differences in the demographic structure of populations and their cause-specific vulnerabilities. Here we conduct the largest epidemiological study to date on the association between ambient temperature and mortality by age and cause using data from 532 cities in 33 countries.

Methods: We collected daily temperature and mortality data from each country.

Effect modification of air pollution on the association between heat and mortality in five European countries.

Background: Evidence suggests that air pollution modifies the association between heat and mortality. However, most studies have been conducted in cities without rural data. This time-series study examined potential effect modification of particulate matter (PM) and ozone (O) on heat-related mortality using small-area data from five European countries, and explored the influence of area characteristics.

Heat and cause-specific cardiopulmonary mortality in Germany: a case-crossover study using small-area assessment.

Background: High temperatures have been associated with increased mortality, with evidence reported predominately in large cities and for total cardiovascular or respiratory deaths. This case-crossover study examined heat-related cause-specific cardiopulmonary mortality and vulnerability factors using small-area data from Germany.

Methods: We analyzed daily counts of cause-specific cardiopulmonary deaths from 380 German districts (2000-2016) and daily mean temperatures estimated by spatial-temporal models.

Temporal variations in the short-term effects of ambient air pollution on cardiovascular and respiratory mortality: a pooled analysis of 380 urban areas over a 22-year period.

Background: Ambient air pollution, including particulate matter (such as PM and PM) and nitrogen dioxide (NO), has been linked to increases in mortality. Whether populations' vulnerability to these pollutants has changed over time is unclear, and studies on this topic do not include multicountry analysis. We evaluated whether changes in exposure to air pollutants were associated with changes in mortality effect estimates over time.

Global, regional, and national burden of heatwave-related mortality from 1990 to 2019: A three-stage modelling study.

Background: The regional disparity of heatwave-related mortality over a long period has not been sufficiently assessed across the globe, impeding the localisation of adaptation planning and risk management towards climate change. We quantified the global mortality burden associated with heatwaves at a spatial resolution of 0.5°×0.

[Impact of heat and cold on cause -specific mortality in Italy].

Objectives: to estimate the impact of daily exposure to extreme air temperatures (heat and cold) on cause-specific mortality in Italy and to evaluate the differences in the association between urban, suburban and rural municipalities.

Design: time series analyses with two-stage approach were applied: in the first stage, multiple Poisson regression models and distributed lag non-linear models (DLNM) were used to define the association between temperature and mortality; in the second one, meta-analytic results were obtained by adopting BLUP (Best Linear Unbiased Prediction) coefficients at provincial level, which were then used to estimate the Attributable Fractions of cause-specific deaths.

Setting And Participants: cause-specific deaths from 2006to 2015 in Italy have been analysed by region and overall.

Implementation of climate adaptation in the public health sector in Europe: qualitative thematic analysis.

Background: Adaptation, to reduce the health impacts of climate change, is driven by political action, public support and events (extreme weather). National adaptation policies or strategies are limited in addressing human health risks and implementation of adaptation in the public health community is not well understood.

Aim: To identify key issues in climate change adaptation implementation for public health in Europe.

Assessing heat effects on respiratory mortality and location characteristics as modifiers of heat effects at a small area scale in Central-Northern Europe.

Background: Heat effects on respiratory mortality are known, mostly from time-series studies of city-wide data. A limited number of studies have been conducted at the national level or covering non-urban areas. Effect modification by area-level factors has not been extensively investigated.

Joint effect of heat and air pollution on mortality in 620 cities of 36 countries.

Background: The epidemiological evidence on the interaction between heat and ambient air pollution on mortality is still inconsistent.

Objectives: To investigate the interaction between heat and ambient air pollution on daily mortality in a large dataset of 620 cities from 36 countries.

Methods: We used daily data on all-cause mortality, air temperature, particulate matter ≤ 10 μm (PM), PM ≤ 2.

Assessment of short-term heat effects on cardiovascular mortality and vulnerability factors using small area data in Europe.

Background: Short-term associations between heat and cardiovascular disease (CVD) mortality have been examined mostly in large cities. However, different vulnerability and exposure levels may contribute to spatial heterogeneity. This study assessed heat effects on CVD mortality and potential vulnerability factors using data from three European countries, including urban and rural settings.

Occupational heat stress, heat-related effects and the related social and economic loss: a scoping literature review.

Introduction: While there is consistent evidence on the effects of heat on workers' health and safety, the evidence on the resulting social and economic impacts is still limited. A scoping literature review was carried out to update the knowledge about social and economic impacts related to workplace heat exposure.

Methods: The literature search was conducted in two bibliographic databases (Web of Science and PubMed), to select publications from 2010 to April 2022.

Health impact of air pollution and air temperature in Italy: evidence for policy actions.

Objectives: to estimate the impact (number of deaths and attributable fraction) of air pollution (chronic exposure to PM2.5 and NO2) and high summer temperatures (acute exposure) on mortality in Italy.

Design: observational study.

Lancet Countdown indicators for Italy: tracking progress on climate change and health.

Objectives: to provide evidence of the health impacts of climate change in Italy.

Design: descriptive study.

Setting And Participants: the indicators published in the 2022 Lancet Countdown report were adapted and refined to provide the most recent data relevant to Italy.