Data-driven estimation of the onset of heat-related mortality in five Indian cities

Background: Extreme heat is an increasingly pressing public health threat, particularly in South Asia. Yet the temperatures at which mortality risk begins to increase in Indian cities remain poorly characterized. Operational heat wave definitions are based on meteorological criteria and may not reflect epidemiologically relevant temperature thresholds. Widely used distributed lag non-linear models are designed to flexibly estimate expected mortality as a function of temperature, but do not directly target the onset of excess risk from heat, a quantity central to early warning and planning. Met

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