A groundbreaking study published in The Lancet Public Health has revealed that while most European cities have implemented measures to combat rising temperatures, the pace of adaptation remains insufficient to protect millions of residents from the accelerating impacts of climate change.
The first Lancet Countdown report on health and climate change in European cities analyzed 850 urban areas across the continent, where three out of four Europeans live. The findings paint a concerning picture for Southern Europe, particularly Spain, where several cities are experiencing dramatic increases in heat-related mortality and economic disruption.
Alarming Mortality Increases in Spanish Cities
Heat-related deaths have surged by 161% across Southern Europe over the past decade compared to the 1991-2000 reference period, representing a sharper increase than any other European region. The situation is especially critical in Castellon de la Plana, a city of 184,000 residents located approximately 50 kilometers north of Valencia.
Mortality rates in Castellon have skyrocketed by 553%, rising from 25.7 deaths per million inhabitants during the reference period to 168.1 during the 2015-2024 decade. The heat’s impact extends beyond health to economic productivity, with Seville and Cordoba ranking among the cities experiencing the most significant reductions in annual working hours per employee due to temperature anomalies.
Disparate Progress on Urban Greening
Southern European cities lag considerably behind their northern counterparts in providing public transportation, pedestrian zones, and shaded areas. As of 2020, only 12% of southern cities met the United Nations recommendation that 30% of urban territory be covered by trees. Not only has no progress been made, but this coverage has actually decreased by 0.9%, while it has increased in other European regions such as Eastern and Northern Europe.
Cuenca stands out as the Spanish city with the highest tree-covered area, with 48,500 hectares representing more than 50% of its municipal territory. At the opposite end of the spectrum is Cadiz, with 0%. However, it should be noted that the Castilla-La Mancha city possesses one of Spain’s largest municipal territories, while Cadiz’s is considerably smaller.
Regarding recent progress, the Madrid municipality of Torrejon de Ardoz recorded the largest increase in forested area since the beginning of the century, growing from 4.9 hectares to 17.4 hectares—a 257% increase, albeit from a very low baseline. While the data presented covers only the period through 2020, José Chen, a researcher at ISGlobal in Barcelona and lead author of the study, emphasizes that since then, “Barcelona and other cities have made encouraging progress through measures such as ‘superblocks’ [clusters of city blocks where through-traffic is drastically limited].”
Granada: A Permanent Heat Island
The creation of green spaces is an essential measure to combat the urban heat island effect, which occurs when asphalt and concrete retain heat during the day instead of reflecting it. Southern European cities are experiencing a disproportionate increase in days when urban temperatures exceed those of surrounding non-urbanized areas by more than 1.5°C.
Granada leads this troubling ranking. Between 2003 and 2020, this Andalusian city recorded more than 300 days when urban temperatures exceeded surrounding rural areas by more than 1.5°C.
Pamplona Leads in Sustainable Mobility
Beyond heat adaptation measures, cities can also reduce greenhouse gas emissions and pollutants. Europe has made considerable progress in reducing pollutants from energy production, industry, and transportation, resulting in a 40% decrease in premature deaths attributable to fine particulate matter (PM2.5) exposure since 2002. In the transportation sector, mortality has dropped dramatically by 63% thanks to electrification and stricter engine regulations.
However, significant work remains. Southern Europe shows the worst figures for pedestrian and cycling infrastructure, as well as public transportation provision. In Spain, for example, bike lanes cover only 11% of roads, though conditions vary between cities.
José Chen cites Girona and Lugo as positive examples of two-wheel mobility, though Cadiz has the best cycling figures (19% of all roads have bike lanes), while Alcala de Guadaira, near Seville, ranks last with only 1%.
Salamanca is classified as the most pedestrian-accessible city, with 68% of all roads suitable for pedestrians, while Lorca in the Murcia region is the least accessible (20.3%). For public transportation, Santa Coloma de Gramenet near Barcelona tops the ranking, with 82% of its territory located within 250 meters of a public transit stop. Sanlucar de Barrameda near Cadiz reaches only 0.3%.
Analyzing all these indicators together, Pamplona achieved the best score for sustainable mobility in 2022. The Navarre capital also recorded the largest decrease in premature deaths attributable to fine particles, with a 78% reduction—156.2 fewer deaths per 100,000 inhabitants. Additionally, Vitoria-Gasteiz, which implemented an ambitious sustainable mobility plan, recorded the largest reduction in per-capita emissions between 2000 and 2024, at 87%.
Torrelavega: Highest Mortality from Polluting Fuels
At the opposite end of the ranking is Torrelavega in Cantabria. In 2023, this city recorded Spain’s highest rate of premature mortality attributable to particles from polluting fuels—144.4 deaths per 100,000 inhabitants—with transportation being the primary culprit.
“We have the means to reduce this mortality rate, and we are already doing so,” Chen emphasizes. “Much remains to be done; we already know what measures to take, but we need the necessary technical and financial resources.”
The study’s findings underscore the urgent need for accelerated climate adaptation across European cities, particularly in Southern Europe, where the combination of rising temperatures, inadequate green infrastructure, and limited sustainable mobility options poses growing risks to public health and economic productivity.
