Analysis of heat and mortality in Spain, 2015-2024, used high-resolution mortality surveillance and meteorological data. Multiple heat metrics were evaluated at different spatial scales during heatwaves. Extreme temperature and cumulative exposure explained most of the variability in heatwave mortality. Heat-attributable mortality rose 15% (95% CI 6.7-24.3%) nationally per 1 °C of mean heatwave daily maximum temperature. At provincial level the increase was 24% (95% CI 15.3-33.4%); heat-attributable deaths fell 3.9-5.8% annually after temperature adjustment. Forecasts substantially overestimated the exceptional heatwaves of 2025, the main limitation.
Why it is interesting: Quantifies the mortality gradient per degree of heatwave temperature and shows heat-attributable deaths falling year on year. The fitted models were tested against the exceptional 2025 season.
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