While the majority of assessments of future heat-related health risk are based on projections of heat hazards superimposed on current socioeconomic conditions only, the Shared Socioeconomic Pathways (SSPs) appear to have the potential to enhance the integration of future socioeconomic conditions in assessments of future heat-related health risk. That is, to account for the influence that changes in socioeconomic vulnerability and exposure have on future heat-related health challenges. In this presentation, we report the findings of two studies in which we combined extended SSPs with RCPs to provide spatially explicit projections of heat-related health risk and mortality that account for multiple changes in both socioeconomic and climatic conditions. In this study, we paid a particular attention to the quantification of the diversity of drivers of vulnerability – such as pre-existing medical conditions, social isolation, age, education, income, and land use – under different SSPs. The case-studies employed are the European Union and Houston, Texas. We emphasize here that socioeconomic development pathways should not be viewed solely as potential means to reach a given level of radiative forcing, but also as key determinants of future climate risks, particularly when considering their impact on future populations' vulnerability at the local scale. This sheds light on the undeniable necessity to consider the future state of vulnerability – and its uncertainties under a number of locally relevant extended SSPs – when assessing future heat-related health challenges and designing health adaptation strategies.