State-of-Art in Studying the Public Health Effects of Heat: A Literature Review.

The impact of heat and heatwaves on human health constitutes a significant hazard, disproportionately affecting various regions worldwide and continuously exacerbating due to climate change. While human pathophysiology is well understood, addressing this challenge from a public-health perspective is essential to generate population-level insights and provide policymakers with evidence-based guidance. This calls for an interdisciplinary "environmental epidemiology" approach, which embraces multiple areas including (but not limited to) health sciences, geomatics, data-science, environmental analyses, and social sciences. Since the early 2000s, scientific production on this topic is increasing exponentially. This review aims to provide a narrative synthesis of the most relevant public-health studies, offering a comprehensive overview of prevailing perspectives within the scientific community. A key challenge highlighted is the lack of standardized thresholds, measures, and confounders, further complicated by variations in measurement methods, the urban heat island effect, and local disparities. The Distributed Lag Non-linear Model (DLNM) has emerged over the past decade as the gold-An standard for modeling heat-attributable health burdens. This approach enables risk stratification based on socio-demographic factors, evaluation of confounding variables, and scenario simulations. Numerous adaptation strategies are proposed, and with the support of emerging technologies, scientific research is increasingly shifting toward data-driven methodologies, unlocking new possibilities.