How are non-optimal air temperatures related to health care use among older populations in Europe?: A systematic scoping review 2000–2024

Abstract

Aims: The climate in Europe is warming, and the population is ageing faster than on other continents. These concurrent trends present significant challenges for social, economic and ecological sustainability of health care systems. This systematic scoping review examines how non-optimal air temperatures are associated with health care utilization among older populations in Europe. Methods: We screened peer-reviewed articles from six databases (MEDLINE, Science Direct, Web of Science, Scopus, ProQuest and GreenFILE) published in English during 2000–2024. The key search terms were air temperature, older people, health care services and Europe. We screened 1794 articles, reviewed 144 full-texts and extracted data from 52 articles. Of the included articles, 29 (56%) focused on heat exposure, 10 (19%) on cold exposure and 13 (25%) on both. Results: A positive association between non-optimal air temperature and health care use was found in 43 (38%) of heat-related and 30 (48%) of cold-related analyses. Emergency hospital admissions were the most frequently examined type of health care service, with cardiovascular and respiratory conditions being the primary causes. The strongest evidence of positive associations was observed for respiratory conditions in emergency hospitalisations and for cardiovascular hospitalisations associated with cold exposure. The evidence regarding modifying effects of social vulnerabilities remains limited. Conclusions: Our findings highlight the need for future research using large datasets to explore a wider range of health conditions, to identify individual and area-based risk factors and to explore different types of health care services, transitions between them, and mortality as a competing event.