Association between the education level and heatwaves mortality in Slovenia, 2015-2022

Abstract Background So far only a few studies have addressed the heat related mortality risks associated with socioeconomic factors. The study aimed to determine whether low education is associated with more deaths during heat waves, which in turn leads to health inequalities linked to climate change. Methods In this time series study, we assessed the association between the level of education in three Slovenian climate regions and mortality during the heatwaves from 2015 to 2022. We estimated the relative risks (RR) with 95 % confidence interval for the number of deaths due to all causes among persons with three different levels of education associated with heatwaves in three Slovenian climate regions independently, comparing the number of deaths during heat waves with the reference days. Results Continental and Littoral Climate: We found no statistically significant association in the number of deaths due to all causes during heatwaves according to the three levels of education. When comparing these three levels to each other (Relative Risk Ratio), we found no statistically significant differences between them. Transitional Climate: For the second education level (middle education) we found statistically significant increase in number of deaths due to all causes (12%; 95% CI: 2%, 23%). When comparing the three education levels to each other, we found statistically significant decreased number of deaths in the first education level (low education) compared to second (-13%; 95% CI: -24%, -1%). Conclusions When assessing the effects of climate change on health and planning preventive measures, it is necessary to consider both socioeconomic factors and the characteristics of different climate regions in Slovenia. Further studies are needed. Key messages • Heatwaves will contiue to be more intense, longer and more frequent also in Europe. • Not many studies assessed association between social status and mortality durin heatwaves. WE found statistically significant more deaths in middle class education group. Further studies are needed.