Climate change is intensifying health pressures across Europe even as parts of the energy transition continue to advance. Heat exposure, food insecurity, infectious disease risk and labour losses are all increasing, and the burden does not fall evenly across regions or population groups. In The Lancet Public Health, the 2026 Europe report of the Lancet Countdown tracks 43 indicators across climate impacts, adaptation, mitigation, economics and public engagement. The picture is mixed. More countries now have health adaptation plans and climate services for the health sector, and renewable electricity has expanded. At the same time, extreme heat warnings are becoming more frequent, fossil fuel subsidies have reached a new high and public and political attention to health and climate has weakened in several arenas. The overall direction points to a narrowing window for action that protects health while accelerating climate policy.
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Heat, Disease and Food Risks Spread Unevenly
Heat is emerging as one of the clearest health threats. Nearly all monitored European regions recorded increases in deaths attributable to heat in 2015–24 compared with 1991–2000, with an overall mean annual rise of 52 deaths per million inhabitants. Among infants and older people, heatwave exposure increased by 254% over the same comparison periods. Hours when outdoor physical activity becomes unsafe because of heat also climbed sharply, with average annual risky hours for moderate activity up by 60.
Other climate-linked exposures are also widening. In 2023, more than 1 million additional people faced moderate or severe food insecurity compared with the 1981–2010 average because of increased heatwaves and drought exposure. In the past decade, 65.2% of European NUTS3 regions experienced an extreme-to-exceptional summer drought and 68.5% saw drought duration increase. Climatic suitability has also risen for several infectious diseases. Dengue outbreak risk increased by 297% across Europe in 2015–24 compared with 1981–2010, while West Nile virus outbreak risk rose strongly in western, southern and eastern Europe. Coastal suitability for non-cholerae Vibrio increased, including in parts of the Mediterranean. Pollen seasons now start one to two weeks earlier. Low-income households, outdoor workers and people living in poorer regions face a heavier burden through food insecurity, heat exposure, wildfire smoke and lower access to green space.
Adaptation Expands but Pressures Keep Rising
Adaptation measures are advancing, but health risks are moving faster. As of March 2025, 36 of 53 countries had conducted multisectoral health vulnerability and adaptation assessments, and the same number had developed national health adaptation plans. At city level, 174 of 209 cities and municipalities had undertaken a climate risk and vulnerability assessment in 2023, up from 75 of 118 in 2018–19. Many cities, however, still cite limited financial capacity, expertise and political priority as barriers to effective action.
Climate information services for health are now available in most countries. In 2024, 42 of 50 European countries reported that meteorological institutes provided climate services to the health sector. These services most often included data products, climate monitoring and analysis, while fewer countries provided projections and predictions tailored to health use.
The pressure behind these measures is visible in the sharp rise in heat-health alerts. Compared with 1991–2000, Europe recorded higher annual numbers of low, moderate, high and extreme heat-health warnings in 2015–24, with extreme warnings up by 318%. Southern, western, eastern and northern Europe all registered strong increases. Green space offers one route to reduce heat and air pollution exposure, and average district-level vegetation exposure rose modestly across Europe between 2000 and 2024. Yet poorer areas still have lower exposure to green space. The pattern is clear: adaptation structures are growing, but they are developing against a backdrop of intensifying heat-related emergencies and persistent inequality.
Progress on Energy Meets Policy and Engagement Gaps
Europe is making progress on some mitigation indicators. In 2023, carbon intensity and coal use both declined, while renewable electricity reached 21.5% of total European electricity generation, up from 8.4% in 2016. Clean energy investment rose to €427 billion in 2024, far above the €76 billion spent on fossil fuels. Investment in electricity networks and storage also grew strongly.
That progress is offset by several major pressures. Fossil fuel subsidies reached €444 billion in 2023, leaving net fossil fuel subsidies at €365 billion after carbon price revenue. In 12 European countries, net fossil fuel subsidies exceeded 10% of national health expenditure, and in four they were higher than the entire health budget. Residential biomass remains a major problem. It accounted for 31% of total renewable energy consumption in 2023, contributed to higher air pollution-related deaths from household burning and was linked to an 80% rise in net tree cover loss in 2014–23 compared with 2001–10. Health-care emissions fell slightly in 2022, but disability-adjusted life years linked to air pollutant exposure from health-care operations increased by 24% compared with 2010.
Economic and political signals are also troubling. Temperature change reduced labour supply by the equivalent of 24 working hours per worker per year across Europe, while southern Europe recorded lower GDP per capita growth linked to positive temperature anomalies. European donors approved $13.97 billion (€11.91 billion) for climate adaptation finance between 2020 and 2022, but only 0.07% went to health sector adaptation. Scientific output on climate and health has grown over time, yet public, political, corporate and media engagement weakened in 2023 or remained low. Climate litigation stands out as an exception, with health references appearing in more than half of European climate case documents since 2011.
Europe is cutting emissions in parts of its energy system and expanding several adaptation tools, but health risks linked to climate change are rising faster and reaching deeper into daily life. Heat, food insecurity, infectious disease exposure and economic losses are all increasing, with the strongest effects often falling on lower-income groups and harder-hit regions. Cleaner energy investment is growing, yet fossil fuel support remains high and health adaptation finance remains marginal. More decisive action now depends not only on policy delivery, but also on bringing health and climate together more consistently in public debate, political action and investment decisions.
Source: The Lancet Public Health
Image Credit: iStock
References:
Kriit H, Chen-Xu J, Semenza J et al. (2026) The 2026 Europe report of the Lancet Countdown on health and climate change: narrowing window for decisive health action. The Lancet Public Health: In Press.
