An unprecedented heatwave swept the globe in 2023, marking it one of the hottest years on record and raising concerns about its health impacts. However, a comprehensive assessment of the heatwave-related mortality and its attribution to human-induced climate change remains lacking. We aim to address this gap by analyzing high-resolution climate and mortality data from 2,013 locations across 67 countries/territories using a three-stage modeling approach. First, we estimated historical heatwave-mortality associations using a quasi-Poisson regression model with distributed lag structures, considering lag effects, seasonality, and within-week variations. Second, we pooled the estimates in meta-regression, accounting for spatial heterogeneity and potential changes in heatwave-mortality associations over time. Third, we predicted grid-specific (0.5 0.5) association in 2023 and calculated the heatwave-related excess deaths, death ratio, and death rate per million people. Attribution analysis was conducted by comparing heatwave-related mortality under factual and counterfactual climate scenarios. We estimated 178,486 excess deaths (95% empirical confidence interval [eCI], 159,892≥204,147) related to the 2023 heatwave, accounting for 0.73% of global deaths, corresponding to 23 deaths per million people. The highest mortality rates occurred in Southern (120, 95% eCI, 116≥126), Eastern (107, 95% eCI, 100≥114), and Western Europe (66, 95% eCI, 62≥70), where the excess death ratio was also higher. Notably, 54.29% (95% eCI, 45.71%≥61.36%) of the global heatwave-related deaths were attributable to human-induced climate change. These results underscore the urgent need for adaptive public health interventions and climate mitigation strategies to reduce future mortality burdens in the context of increasing global warming.

Biological Mision of Galicia Spain

Climate Air Quality Research Unit School of Public Health and Preventive Medicine Monash University Melbourne VIC Australia

Climate Research Foundation Madrid Spain

Department of Economics Ca' Foscari University of Venice Venice Italy

Department of Epidemiology Lazio Regional Health Service Rome Italy

Department of Epidemiology School of Public Health Cheeloo College of Medicine Shandong University Jinan China

Department of Pathology Faculty of Medicine University of São Paulo São Paulo Brazil

Department of Primary Care and Population Health University of Nicosia Medical School Nicosia Cyprus

Department of Public Health Environments and Society London School of Hygiene and Tropical Medicine London UK

Department of Public Health University of Otago Wellington New Zealand

Department of Statistics and Computational Research Universitat de València València Spain

Department of Statistics Computer Science and Applications G Parenti University of Florence Florence Italy

Doñana Biological Station Sevilla Spain

Environment and Health Modelling Lab Department of Public Health Environments and Society London School of Hygiene and Tropical Medicine London UK

Faculty of Environmental Sciences Czech University of Life Sciences Prague Czech Republic

Institute of Atmospheric Physics of the Czech Academy of Sciences Prague Czech Republic

Institute of Environmental Assessment and Water Research Barcelona Spain

Institute of Epidemiology Helmholtz Zentrum München German Research Center for Environmental Health Neuherberg Germany

National Institute of Environmental Health Chinese Center for Disease Control and Prevention Beijing China

RIVM National Institute for Public Health and the Environment Bilthoven Utrecht the Netherlands

School of Public Health and Social Work Queensland University of Technology Brisbane QLD Australia

School of the Environment Yale University New Haven CT USA

School of Tropical Medicine and Global Health Nagasaki University Japan

Spanish Consortium for Biomedical Research in Epidemiology and Public Health Madrid Spain

Swiss Tropical and Public Health Institute Allschwill Switzerland

University of Basel Basel Switzerland

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