Abstract
Extreme temperature events, particularly heatwaves, are intensifying due to climate change and urbanization, posing major public health challenges in Central Asia (CA), where research is limited. Despite the rising frequency and severity of heat extremes, long-term assessments of their health impacts are scarce. This study addresses this gap by analyzing historical and future heatwave trends and associated health risks using multi-ensemble climate models across 700 locations from 1959 to 2100. Bias correction improved GCMs, reducing bias and RMSE by 24% and 14%, respectively. Under SSP2–4.5, projected heatwave magnitudes (HWM) shift from 26 to 31 °C, consistent with historical moderate to severe events. Under SSP5–8.5, HWM increases to 29–36 °C. Turkmenistan is expected to experience ultra-extreme heatwaves in the far future, a pattern not seen in other CA countries. Under SSP2–4.5, Kazakhstan and Uzbekistan show the highest rises in heatwave-related mortality rates, with slopes of 5.432 and 3.021 in the near future, declining to 1.377 and 1.102 in the far future. SSP5–8.5 shows similar but higher estimates, highlighting escalating public health risks. Findings emphasize the urgent need for region-specific climate policies and public health strategies to mitigate the growing burden of extreme heat in CA.