Objectives The aims of this study are to identify the patterns of excess winter mortality (due to diseases of the circulatory system) and to analyse the association between the excess winter deaths (EWD) and socio-economic deprivation in Portugal. Methods The number of EWD in 2002–2011 was estimated by comparing the number of deaths in winter months with the average number in non-winter months. The EWD ratio of each municipality was calculated by following the indirect standardization method and then compared with two deprivation indexes (socio-material and housing deprivation index) through ecological regression models. Results This study found that: (1) the EWD ratio showed considerable asymmetry in its geography; (2) there are significant positive associations between the EWD ratio and both deprivation indexes; and (3) at the higher level of deprivation, housing conditions have a stronger association with EWD than socio-material conditions. Conclusions The significant association between two deprivation dimensions (socio-material and housing deprivation) and EWDs suggests that EWD geographical pattern is influenced by deprivation.

On summer and winter months, cardiovascular morbidity and mortality rates vary throughout Europe. For example, areas with mild winters seem to be the ones with higher number of seasonal mortality. In fact, Portugal is one of the southern countries together with Ireland that have higher mortality in winter. However, the number of studies relating cold weather with morbidity/mortality is still very rare. These occurrences are suspected to be associated with housing quality especially thermal insulation. In order to assess the relation between the incidence of coronary events and housing conditions in Portugal, a survey on inpatients with any form of acute coronary syndromes was undertaken during winter months, in order to get some data about houseability and residents behavior attitudes against cold exposure. It remained clear that poor housing conditions and/or lack of protective measures against cold exposure are common in Portugal. A better knowledge about the impact of weather and climate on health may be applied to built up a set of regulations for housing design (for new but also for old dwellings restoration); but also it is essential for the establishment of adaptation and mitigation policies and strategies, as well as on health planning and on the development of early warning systems

In this initial study of a research project, this paper seeks to understand the thermal conditions in the cities of Lisbon and Munich, specifically focusing on Urban Heat Island intensity and on thermal comfort using the Universal Thermal Climate Index modeling data at the Local Climate Zone scale. Based on these datasets, Munich has exhibited more unfavourable thermal conditions than Lisbon. In terms of UHII, both cities have shown that low, medium, and high rise compact urban areas and bare rock or paved areas have the highest values, while sparsely built areas have the lowest. These results differ from the UTCI, which indicates that in Lisbon and Munich, these sparsely built areas as well as areas with low plants and vegetation are the most uncomfortable. In Munich, the population was exposed to very strong heat stress, while Lisbon experienced strong heat stress conditions. Conversely, low, medium, and high rise compact urban areas and densely wooded areas in Munich, and scattered trees areas and large low-rise urban areas in Lisbon, have demonstrated the lowest monthly mean and average maximum values. These results will be further explored in future studies in the city of Lisbon and cross-checked with data obtained from roving missions. This will enable a more detailed temporal and local analysis.