# Exploring 130 years of temperature-related mortality in the city of Madrid

## TL;DR

This study examines how temperature-related deaths in Madrid changed from 1890 to 2019, finding that cold-related deaths decreased while extreme heat risks remained.

## Contribution

The study provides a long-term analysis of temperature-related mortality in Madrid, revealing adaptation patterns and the dual impact of climate change on health.

## Key findings

- Cold-related mortality risks decreased across all population groups over time.
- Extreme heat effects remained stable, with a slight increase in recent years.
- Climate change is shown to reduce cold-related deaths while stabilizing heat-related risks.

## Abstract

The relationship between ambient temperatures and health outcomes has been extensively studied, yet long-term analyses of mortality responses to extreme temperatures, particularly in the Mediterranean region, remain scarce. This study leverages daily all-cause mortality and air temperature data in the city of Madrid from 1890 to 2019 to examine adaptation patterns to extreme and moderate heat and cold. Using a distributed lag non-linear modeling framework, we explored temperature-mortality relationships and estimated decade-specific adaptation metrics. Results indicate a general reduction in temperature-attributable mortality, primarily due to decreased cold-related risks across all population groups. While moderate heat impact declined over time, extreme heat effects remained stable, with a slight increase towards the study’s end. Our findings highlight the dual impact of climate change, i.e. reducing cold-related mortality while stabilizing heat-related risks, which emphasizes the complex interplay of climate change and health outcomes and offers new insights into adaptation dynamics using long-term temperature-mortality time series.

The online version contains supplementary material available at 10.1038/s41598-026-38595-4.