Preventing cold-related morbidity and mortality in a changing climate

Abstract

Winter weather patterns are anticipated to become more variable with increasing average global temperatures. Research shows that excess morbidity and mortality occurs during cold weather periods. We critically reviewed evidence relating temperature variability, health outcomes, and adaptation strategies to cold weather. Health outcomes included cardiovascular-, respiratory-, cerebrovascular-, and all-cause morbidity and mortality. Individual and contextual risk factors were assessed to highlight associations between individual- and neighborhood- level characteristics that contribute to a person’s vulnerability to variability in cold weather events. Epidemiologic studies indicate that the populations most vulnerable to variations in cold winter weather are the elderly, rural and, generally, populations living in moderate winter climates. Fortunately, cold-related morbidity and mortality are preventable and strategies exist for protecting populations from these adverse health outcomes. We present a range of adaptation strategies that can be implemented at the individual, building, and neighborhood level to protect vulnerable populations from cold-related morbidity and mortality. The existing research justifies the need for increased outreach to individuals and communities for education on protective adaptations in cold weather. We propose that future climate change adaptation research couple building energy and thermal comfort models with epidemiological data to evaluate and quantify the impacts of adaptation strategies.

Effects of temperature on mortality in Hong Kong: a time series analysis

“…Multi-city studies reported the cold effects were most significant in warm regions (Langford and Bentham 1995;Wang et al 2012) or areas with moderate winter climates (Conlon et al 2011). …”

Temperature deviation index and elderly mortality in Japan

“…Fourth, caution should be exercised in interpreting these results because the study included only prefectures in Japan. Populations residing in different geographic regions may also be exposed to various extreme temperatures, and their adaptation may depend on individual-or neighborhood-level protection factors (Conlon et al 2011) as well as on cultural variables (Hancock et al 2008). Furthermore, exposure measurements were based on a capital city of a prefecture or the closest city if data were not available.…”

Summer temperature variability and long-term survival among elderly people with chronic disease

“…These time series can be analyzed to yield information on how environmental conditions may contribute to increases in deaths and illness on a short-term time scale (days to weeks after the environmental exposure). In the last decade, numerous multicity time series analyses have demonstrated that cold and hot temperatures, as well as extremes of cold and hot temperature, are associated with increased death rates in the days after these weather conditions (1)(2)(3)(4)(5)(6)(7)(8)(9)(10). These findings have important implications for understanding the health effects of climate change, given that climate change is increasing both the variability of temperatures and the frequency, duration, and intensity of heat waves (11)(12)(13).…”