The Heat Warning Assumes Someone Is Coming

In August 2003, France experienced one of the defining public-health failures of modern Europe. Around 14,800 excess deaths were reported in less than three weeks. Older people were disproportionately affected, particularly women over 75. The lethal nature of extreme heat was exposed as were the consequences of social isolation, unsuitable housing and systems that did not know who was in danger.

France responded. A national warning system and heat action plans followed. Surveillance improved. Municipalities began identifying people at particular risk.

Twenty-three years later, those measures matter, but the question has changed.

Between June 17 and July 2 this year, France recorded a preliminary estimate of at least 5,764 excess deaths, during an exceptionally severe heatwave. Two-thirds were among people aged 75 and over. Germany estimated around 9,800 heat-related deaths so far this year, with the largest proportion again among people aged 75 and over. Britain has estimated 2,877 heat-associated deaths, approaching its 2022 record.

WHO reports that heat-related mortality among people over 65 increased by approximately 85 per cent between 2000–2004 and 2017–2021.

Extreme heat is becoming one of the conditions in which we are growing old.

It would be wrong to argue that older people have simply been ignored.

Paris now has REFLEX, a voluntary register through which people aged 60 and over and people with disabilities can be contacted during exceptional events. Cologne developed a heat action plan specifically for older people, mapping heat exposure and working directly with older residents. Barcelona has built a network of climate shelters in public buildings and community spaces. England’s Adverse Weather and Health Plan explicitly identifies populations at increased risk.

These are important responses. They also reveal their own limits.

A register protects the person who is registered. A telephone call reaches the person who can answer. A climate shelter helps the person who can get there. Advice to stay indoors assumes that this is safer.

And somewhere inside many of these plans is the family member who calls, the neighbour who knocks, the home-care worker who notices, the volunteer who checks.

The heat warning assumes someone is coming.

Age can increase physiological risk from extreme heat. And the WHO is explicit that vulnerability is also shaped by socioeconomic circumstances and by the environments in which people live.

An 82-year-old living in a well-insulated home with effective cooling, reliable income and family nearby faces a very different risk from an 82-year-old living alone on the top floor of an older building, worried about electricity costs and unable to reach a cooling centre.

I grew up as one of five children in Perth, Australia. We did not have air conditioning. It was just not common. I’m not sure we could have afforded it. On very hot days, Mum used small fans and sometimes placed a bowl of water beneath them to make the rooms a little cooler.

I do not remember that as a charming story about another time. I remember it because cooling has always been connected to income, housing and circumstance. What has changed is the intensity of the heat and the consequences when improvisation is no longer enough.

The more I looked at this, the more the problem appeared to be fragmentation rather than complete inaction.

Climate policy increasingly recognises older people as a population at increased risk. Ageing policy focuses on autonomy, housing, care, social connection and functional ability. Yet the two still too often travel on parallel tracks. France’s 2024 law on building a society for “well-ageing and autonomy”, for example, addresses autonomy, prevention, isolation, services and living at home, but contains no reference to climate, heat or heatwaves.

There is movement. WHO has explicitly connected healthy ageing and climate change in work supporting the UN Decade of Healthy Ageing. Its new 2026 guidance on heat-health action plans identifies population ageing as one of the forces making extreme heat more dangerous and calls for coordinated action that extends well beyond issuing warnings.

The beginnings of the conversation exist. What we do not yet have is a global conversation equal to the scale of what is happening.

By 2050, the global population aged 60 and over will reach 2.1 billion. At the same time, heatwaves are becoming more frequent, intense and prolonged.

We should already be comparing what cities are learning, examining how homes and care facilities must change, asking who pays for cooling and retrofitting, and deciding who is responsible for the older person known to no system at all. This should bring together climate experts and ageing experts, but also housing, energy, transport, long-term care, public health, cities and older people themselves.

Not simply to identify older people once again as a vulnerable population, but to ask a more consequential question.

What does it mean to build a climate-resilient ageing society?

France in 2003 taught us to build the warning. The challenge now is larger: to build societies capable of acting on it.

In a hotter, older world, resilience cannot depend on who can afford to keep cool, who happens to be on a register, or whether somebody remembers to come through the door.