Abstract Recent research has found robust evidence that climate change is often negatively impacting on human health. These impacts are distributed spatially unequal both across the countries of the world and within the countries. While research has clearly outlined this unequal distribution on the country level, for instance with the recently added non-optimal temperature risk factor of the Global Burden of Disease 2019 dataset, thereby acknowledging the impact of unfavorable average temperatures on health, the spatial differences in climate change impacts on health on the subnational level is hardly researched. By operationalizing climate data for a climate change trend analysis of various climate change parameters in GIS, and by applying mortality data for different high-, low-, and middle-income countries on administrative area level 2 for both an Ordinary Least Squared (OLS) and Geographically Weighted (GWR) regression analysis, the proposed article is analyzing the unequal impact of climate change on health inequalities within different countries. Under the assumption that climate change-induced changes of local climate-related conditions affect those areas that already are in a disadvantaged position when it comes to health inequality, the paper is expected to show that inequality gaps are further widening due to climate change, not only but especially in low- and middle-income countries that are more affected by climate change than most of the high-income countries. Therefore, it will have to be discussed, how these increasing health inequalities can be dealt with in a just way and under consideration of already existing vulnerabilities in the most affected areas of climate change. Key messages • Climate change directly influences mortality in all analyzed countries with a bigger impact on low- and middle-income countries. • Climate change contributes to widening health inequalities on a subnational level and especially in low- and middle-income countries.
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