Dying of cold

The snow falls, public transport grinds to a halt, schools are closed, and the Met Office issues “severe weather” warnings.

And death rates go up: as the temperatures drop, so-called “excess winter mortality” kicks in. This phenomenon has been noted in many other countries, too, but why does it happen? A reasonable suggestion is that fuel poverty and cold living conditions cause people to become unwell and a proportion to die. A large study published in the BMJ a few years ago, found that for people aged over 75, being female or having respiratory illness were risk factors for increased mortality. But there was no relationship found between increased mortality and either having trouble heating the house or suffering financial difficulties. In other words, providing winter fuel allowances – which the UK does - was not, according to this study, going to be enough to protect people from excess winter mortality. Interestingly, a study trying to find risk factors for excess winter mortality in New Zealand concluded that there was a ‘surprising’ lack of relationship to commonly supposed risk factors – making it difficult, of course, to know what to do to protect people from it.

In Siberia, there is only excess winter mortality when the temperature dips below 0 degrees C, unlike in Europe where the excess mortality starts above this. So what do they do differently in Siberia? In an interview study of 1,000 Russians, published in the BMJ in 1998, the researchers noted their ability to keep their homes cosy even when outside temperatures dipped below -25 degrees C,  and the admirable amount of clothing they wore. The average number of items of clothing was 16, with the average layers of clothing worn being 3.7. This reflects another study published by the Lancet in 1997 which concluded that fewer clothes, less activity and colder homes across Europe were all related to higher mortality.

It is therefore quite nice to not only feel justified in my rather large collection of assorted hats, gloves, scarves, coats, boots and various other apparel which I  can now not only consider essential, but can also heartily recommend to others.

Margaret McCartney’s Blog

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A forum on healthcare policy and professional issues, by Glasgow-based GP and FT Weekend columnist Margaret McCartney.

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