Risk of mortality and disease attributable to the heat stress index and its variability during heat waves: An observational study on the city of Madrid

Abstract

In recent years, global ambient temperatures have reached alarming levels, mainly due to global warming caused by climate change, pollution, and significant population growth. High temperatures have been linked to increased mortality and a higher risk of contracting various diseases, resulting in substantial healthcare costs for many governments and citizens who are unable to cope. As a result, it is critical to implement policies to mitigate these effects and improve people's lives. This research addresses the impact of high temperatures on human health, focusing on the relationship between urban morphological characteristics (Proportion of vegetation (VP) and Urban Index (UI), Heat Stress Index (HSI) and the risk of different cancers (prostate, breast, stomach, lung and colorectal) and diseases (dementia, stroke, suicides and chronic obstructive pulmonary disease (COPD)) in the different Local Climate Zones (LCZ) of Madrid, using Landsat 8 and 9 images and the UrbClim climate model. The main findings show that compact or high-density land cover zones exhibit a higher risk of contracting the examined diseases than open or low-density regions. This circumstance is motivated by the fact that such areas have less vegetation cover and experience higher rates of heat stress. Findings indicated that the lack of vegetation in compact and high-density areas reduces the ability to minimize extreme temperatures and heat, which is associated with a variety of health problems. This study provides valuable knowledge about the relationship between vegetation, HSI, and health in the different LCZs, providing a solid basis for sustainable urban planning strategies that improve the standard of living of the inhabitants not only of the city of Madrid but of the rest of the cities on the planet. © 2025 Elsevier Ltd