Projecting temperature-related mortality impacts at urban scale under climate scenarios: A methodological review

Liu, K., Wang, R., Tukker, A., K.C., S., & Hoekstra, R. (2026). Projecting temperature-related mortality impacts at urban scale under climate scenarios: A methodological review. Sustainable Cities and Society 145 e107476. 10.1016/j.scs.2026.107476.

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Abstract

Global warming and resulting extreme weather patterns are expected to substantially increase temperaturerelated mortality, with urban populations especially at risk due to high density, rapid urbanization, and the urban heat island effect. While projections of the climate-health impacts in urban contexts have proliferated in the literature, systematic evaluation of methodological approaches underpinning the studies remains limited. Understanding of the methods is crucial for interpreting the projected outcomes, uncertainties, and policy relevance. Here, we conducted a PRISMA-guided review of 110 studies published between 2015 and 2025 and synthesized a six-domain urban scale methodological framework spanning climate scenarios, environmental epidemiology, demographic and socioeconomic projections, urban characteristics and processes, health impact assessment, and uncertainty and sensitivity analysis. Our review shows how divergent methodological choices, such as climate data inputs, static versus dynamic demographics, or adaptation considerations, drive large differences in projected health outcomes. We also highlight coverage gaps in existing literature that most studies focus on high-income areas, leaving low- and middle-income countries (LMICs) underrepresented despite their greater vulnerability and limited adaptive capacity. Building on these findings, we propose a roadmap for nextgeneration urban-scale projections that integrate high-resolution climate data, scenario-consistent demographic and socioeconomic projections, intra-urban vulnerability, urban heat island and land-use dynamics, and multifaceted adaptation modeling. This approach enables more credible, equitable, and policy-relevant assessments of climate-related health risks, strengthening the evidence base for urban resilience planning and climate-health governance.

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