Improvements in life expectancy mask rising trends in heat-related excess mortality attributable to climate change.

While the subperiod-average percentage of the population >65 years only appeared as a marginally significant predictor (likelihood ratio test, p = 0.081) in the second-stage meta-regression (Supplementary Table 3 ), it is still conceivable that our estimates of the climate-change attributable death burden in Germany are biased by ignoring age-group-specific temperature-mortality associations.

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Subperiod-specific, pooled RRs at the 99th percentile of daily warm-season temperatures showed a negative trend over the study period (Fig. 2c ), suggesting a decreasing vulnerability of the German population to heat over time.

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