Muhammad Mainuddin Patwary , Imran Chowdhury Sakib, Md Ismay Azam Badhon, Mondira Bardhan, Mohammad Javad Zare Sakhvidi, Dana Sikder, Payam Dadvand, Michelle L. Bell, Matthew Browning , Thomas Astell-Burt, Md Pervez Kabir, Peter James

Greenspace has been increasingly recognized for its role in mitigating heat-related mortality in the context of climate change. This systematic review and meta-analysis synthesized evidence from 43 studies covering over 160 million deaths. Using a random-effects meta-analysis, we found that high-greenness areas were associated with a lower risk of all-cause mortality during heat (≥90th percentile), with a pooled relative risk (RR) of 1.07 (95%CI: 1.00–1.15, n=11), compared to low greenness areas (pooled RR: 1.22, 95%CI: 1.09–1.36, n=11) with substantial heterogeneity (I²=88%). Sensitivity analyses showed consistent associations between high greenness and reduced mortality risk, though non-significant upon excluding 95th percentile heat-mortality studies. This quantitative evidence suggests that greenspace may play a role in reducing heat-related mortality risk. While the findings indicate the potential for urban greening as a mitigation strategy, the evidence is limited, warranting further investigation in the context of climate change.