# Disease burden attributable to high temperature between 1990 and 2021 in South Asia and Southeast Asia, with projections to 2045

## TL;DR

This study examines how high temperatures have contributed to disease burden and deaths in South and Southeast Asia from 1990 to 2021, projecting a significant rise in deaths by 2045.

## Contribution

The study provides new projections of high temperature-related disease burden in South and Southeast Asia using advanced statistical models and demographic forecasts.

## Key findings

- South Asia and Southeast Asia accounted for over half of global deaths attributed to high temperatures in 2021.
- Pakistan had the highest number and rate of high temperature-related deaths in the region.
- Deaths attributed to high temperatures are projected to exceed 400,000 in South Asia and 100,000 in Southeast Asia by 2045.

## Abstract

Disease burden attributable to extreme high temperature requires more attention amid dramatic climate change, especially in South Asia and Southeast Asia.

We analyzed comprehensive estimates from the GBD 2021 Study, examining mortality and disability-adjusted life years (DALYs) across 369 diseases and 88 risk factors. This study employed joinpoint regression analysis and Age-Period-Cohort modeling to examine time trends from 1990 to 2021 and projected disease burden up to 2045 by incorporating demographic forecasts and a Bayesian Age-Period-Cohort model.

South Asia and Southeast Asia contributed more than half of the global death number attributed to high temperature. In 2021, South Asia recorded 209,537 deaths and Southeast Asia recorded 32,230 deaths attributed to high temperatures. In South Asia and Southeast Asia, Pakistan bore the highest number and rate of deaths attributed to high temperature. The population above 55 and below 5 years in South Asia and Southeast Asia experienced higher disease burden attributed to high temperature. The leading cause of ASMR attributed to high temperature in South Asia and Southeast Asia was non-communicable diseases. Population growth and aging were the main drivers of ASMR increases in South Asia and Southeast Asia, while epidemiological changes contributed to a reduction in ASMR. Deaths attributed to high temperatures in South and Southeast Asia are projected to rise until 2045, with South Asia exceeding 400,000 and Southeast Asia approaching 100,000 deaths in 2045.

This study highlights the urgent need for region-specific, gender-specific and age-specific interventions to reduce high temperature-related disease burden in South Asia and Southeast Asia.

The online version contains supplementary material available at 10.1186/s41182-025-00823-4.