108,500 Deaths in the US in 2008; 36,700 in England and Wales Last Winter; 5,600 in Canada (2006); 7,000 in Australia (1997-2006 Average); Thousands in Other Developed Countries
Indur M. Goklany
Since extreme cold has gripped much of the Northern Hemisphere, some newspapers have been keeping a tally of the number of deaths obviously caused by extreme cold (e.g., freezing). But the BBC’s Health Correspondent, Clare Murphy, in a very timely and, in my opinion, excellent article, How cold turns up the heat on health, reminds us that many more deaths occur from chronic conditions that are exacerbated by cold weather. She also notes that, “For every degree the temperature drops below 18C, deaths in the UK go up by nearly 1.5%.”
Following is a compilation of excess deaths during the winter months (compared to what occurs on average during the rest of the year) in a number of developed countries in both the Northern and Southern Hemispheres. Unfortunately, our politicians complain about the warmth and would like to make the climate cooler if they could, even as they bemoan the costs of health care.
United States. 2001-2008
Figure 1: Average daily deaths for each month, United States, 2001-2008. Sources: 2001-2004 data from National Center for Health Statistics, DataWarehouse at http://www.cdc.gov/nchs/datawh/statab/unpubd/mortabs/gmwkIV_10.htm, and National Vital Statistics System available at http://www.cdc.gov/nchs/deaths.htm; 2005 data from Births, Marriages, Divorces, and Deaths: Provisional Data for 2006, Volume 55, Number 20, 6 pp (PHS 2007-1120); 2006 data from Births, Marriages, Divorces, and Deaths: Provisional Data for 2007. NVSR Volume 56, Number 21, 6 pp (PHS) 2008-1120; 2007-08 data from Births, Marriages, Divorces, and Deaths: Provisional Data for 2008. NVSR Volume 57, Number 19, 6 pp.
The figure above, based on data from the US National Center for Health Statistics for 2001-2008, shows that on average 7,200 Americans died each day during the months of December, January, February and March, compared to the average 6,400 who died daily during the rest of the year. In 2008, there were 108,500 “excess” deaths during the 122 days in the cold months (January to March and December; it was a leap year).
Canada, 1991-2006
Figure 2, based on data from CANSIM for 1991-20068, shows that on average 656 Canadians died daily in January compared to 546 per day in August. In 2006, there were 5,640 excess deaths during the winter months in Canada.
Figure 2: Average daily deaths for each month, Canada, 1991-2006. Source: CANSIM (2009).
England & Wales, 1950/51-2008/09
Figure 3: Excess winter mortality, England and Wales, 1950/51–2008/09. Source: UK ONS (2009).
Figure 3 shows that despite an increase in the population of England and Wales, excess winter deaths have generally declined since the 1950s due, probably, to increased affluence, better heating and insulation, clothing and any warming (whether due to UHI or global warming). [Also, some readers may know more about this, but I believe rationing was still in force in the UK in the early 1950s. Poor nutrition would have exacerbated mortality.]
However, last winter (Dec 2008-Mar 2009), there was a remarkably large jump in the excess number of winter deaths, perhaps due to colder/damper weather and increased fuel prices. The UK’s Office of National Statistics states:
“In the winter period of December to March 2008/09 there were an estimated 36,700 more deaths in England and Wales, compared with the average for the non-winter period (see definition below). This was an increase of 49 per cent compared with the number in the previous winter 2007/08. This is the highest number of excess winter deaths since the winter of 1999/2000, when excess winter mortality was nearly a third higher than in 2008/09.”
It will be interesting to see the figures when data are available for this year.
Other Developed Countries
Figure 4: Monthly percentage variation in mortality compared to yearly average over the last years in European Mediterranean countries and other selected countries worldwide. Countries in the legend are listed according the absolute number of average deaths per day observed, in descending order. Source: Fagalas et al. (2009).
Finally, Figure 4 shows the percent variation in monthly mortality relative to annual averages for recent years in various developed countries. Notably, even Greece and Cyprus (!) have greater mortality in the winter months, even though one would not classify either of them as particularly cold places. See the Table above.
References:
Falagas ME, Karageorgopoulos DE, Moraitis LI, Vouloumanou EK, Roussos N, Peppas G, Rafailidis PI (2009). Seasonality of mortality: the September phenomenon in Mediterranean countries. CMAJ 181(8): 484-6.
See: Ch 9 Human Health Effects of Climate Change Reconsidered
For further details see:
Chapter 9.1 Diseases
Interesting that the worst effects are in countries where winters are not so harsh as to make proper planning for them economically sensible.
UK, France, Italy, Spain, Japan.
I wonder whether the construction industries will be told to take note of that in those countries, eh?
Benjamin (01:26:40) :
> The U.S. has 108,500 to Canada’s 5,640 excess deaths. That’s quite a difference.
> Insights, anyone?
Here’s a different take on this anomaly:
In Canada so many retires are snowbirds that travel to the southern US for the winter. Any deaths (from this older demographic) would be recorded with a US death certificate not a Canadian one. Thus skewing the US winter count slightly up, but more significantly skewing the Canadian winter count down.
It’s just a thought.
http://www.ncbi.nlm.nih.gov/pubmed/12843774CONCLUSIONS: These results suggest that stroke occurrence rises with decreasing temperature, and that even a moderate decrease in temperature can increase the risk of ischemic stroke. Susceptible people should take steps to protect themselves from cold, especially in the winter.
? (07:46:21) :
kadaka: You should read more carefully
True, and I should avoid doing too much late night math. Granted back in college I was doing advanced calculus for my physics degree, but then local economic conditions lead to a career where simple trigonometry was an advanced concept. Programming a VMC from scratch for 4140 or even 6061-T6 is more my current forte. Knowledge withers when not in use, guess I better dig out my old books.
TerryS (01:10:25) :
David S (07:04:09) :
Of course a time element would be introduced into the relationship. As it stays at the extreme cold longer, more of the vulnerable would die, especially as supply shortages advance. Then it should plateau when it gets down to the hardiest survivors, with a death rate that will likely be greater than the “warm” amount but not so drastically severe as the 1.5% figure.
Of course if the UK were cut off from outside sources and had to endure those temperatures continually, after five years, maybe ten, there may only be a handful left. Let us hope the globe has not entered into some catastrophic cooling event; I for one am in no hurry to collect the data to figure out the real relationship.
Benjamin (01:26:40) :
The U.S. has 108,500 to Canada’s 5,640 excess deaths. That’s quite a difference.
Insights, anyone?
Reply:
All of Canada is used to winter. The difference of an additional 5C colder when you are used to dealing with the temp dipping below freezing regularly is irritating but not life threatening.
However much of the cold weather and snow this winter in the USA was in areas that rarely see snow and rarely see freezing weather for more than overnight. A couple of weeks of temperatures below freezing in the south can mean frozen pipes and the house temperature dipping well below the comfortable. People do not have the cold weather clothing or cold tolerance either. I am in mid North Carolina, usually I never run the heat in the winter, I just open the windows in the late afternoon. I can’t do that when the temp has barely made it above 32F/0C for a couple of weeks.
A view of frozen Britain: http://news.bbc.co.uk/2/hi/in_depth/8447023.stm
Who was that blighter who complained he couldnt ice-skate in Holland anymore? There has been silence from him. I wonder if he is busy ice-skating.
The UK MET OFFICE just realeased the December 2009 UK temperature data
as follows and I quote them in part only:
“The month was mostly changeable, the first 10 days being mild but it then turned colder with snowfalls after mid-month. Overall, it was a very cold month with mean temperatures 1.5 to 2.0 °C below the 1971-2000 normal over England and Wales, 2.0 to 2.5 °C below over Northern Ireland and 2.5 to 3.5 °C below over Scotland. Provisionally, it was the coldest December over the UK since 1995.”
polistra (07:53:58) :
Thanks for the compilation of rates. However, it would probably be more relevant to calculate death rates based on the population > 65 yrs (or some other criterion for the elderly), since they seem to be most at risk. Also, one should be calculating the average of death rates for each year. Also, the data for each country are for different periods. A longer/older period means that death rates could be higher because people used to be less affluent and had fewer technological options than they are today.
Chip Knappenberger (10:04:07) :
Thanks for dropping by. I’ll read your paper more carefully, but the question remains: why do more people die in winter than at other times? What is it that distinguishes winter from other seasons? Offhand, one would say shorter days, less sunshine, lower radiation intensity, less Vitamin D, colder temperature. All these depend on each other either directly or indirectly. Shorter days and less sunshine lead to cooler temperatures which means people spend less time outdoors, and when they do they are more heavily bundled up, all of which leads to less Vitamin D etc. All these possibilities ought to be explored, but may not be separable. There are also good physiological reasons why one might expect higher mortality from cardiovascular and respiratory disease in wintertime. See, e.g., http://ijch.fi/issues/614/614_keatinge.pdf. Clearly, mnuch more work needs to be done to elucidate the precise mechanism(s) for the increased mortality in winter months.
Tom in Co. (13:02:20) :
Interesting idea regarding why Canada’s crude “death rates”(based on population) are so much lower. Other reasons could be: the Canadian data are for 2006, while the US’s is for 2008. Then there is is the acclimation factor, which is why the temperatures at which mortality hits a minimum (for both winter and summer), varies from place to place. I think in general Canadians are better prepared for the cold than their southern neighbors. Conversely , I would not be surprised if they don’t fare worse under an excessive heat situation than people in the US.
Healy (2003) speculating on why southern European countries have higher excess winter mortality rates compared to Scandinavia, suggest that the latter necessarily have better housing with better insulation. Perhaps, something similar explains he difference between Canada and the US. See: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1732295/pdf/v057p00784.pdf.
Ric Werme (06:08:26) : “Speculation: The winter storm track is consistently south of Canada, so Canadians expect it to be cold and prepare for it.”
Many have commented on this. It probably has little to do with better insulated houses .. perhaps slightly. Might be lots of sunshine in winter–generally. But it is simple I think. Be prepared or die.
1) We have shelters in all major cities. (There are virtually NO homeless in small towns. Move or die.) Generally, no one is turned away. Yes, people sleep outside on hot-air vents … and a few die in cold weather.
2) The climate simply makes it difficult to survive unless you are prepared, whether you are rich or poor or homeless or housed. Even if you need more cardboard for your crude shelter. ☺
In generally warmer climes, poor folks are not prepared and vulnerable. It gets cold and they get whacked hard. It was -35°C last night. There are homeless in our community. None died. There are one million people in Calgary and hundreds of homeless. No one died last night. If it went to -35°C in (say) Chicago, how many would die?
There are almost certainly other factors, such as social services and health care for all including poor elderly. But I think it is “Be prepared or die.” And it is ingrained in our society.
A correlation between two variables does not imply causation, as any climate sceptic should know. For example, an increase in death rates during winter may be caused by a reduction in sunlight and reduced seratonin levels. Reduced seratonin results in reduced feelings of well being.
Thanks to all for their replies to my question. I’ve come to conlcude that for the most part, it probably is a matter of preparation/expectation.
But strictly in terms of the countries examined in the chart, Sweden tells the story. Less populated than Canada, but more cold deaths percentage-wise. And that’s probably because Sweden isn’t as cold as one might expect it to be, given it’s location.
So, Canada gets the gold medal on this one. They deal with the cold better than the rest of us!
I see they’re still waffling out their, “the weather is not climate” snip. How about:
Street crime is not the game Grand Theft Auto; the former happens in the real world to real people, whilst the latter happens in a computer.
The weather is not ‘climate’; the former happens…
[lets try to keep the site clean ok? – MikeLorrey]
David Hall (10:42:21) :
Watts going on ?
When there is an exceptional waether event in the UK (heavy prolonged rainfall with floods, or a cold snap), there is almost always an accepted reason for why it happens, which is a change in the position of the jet stream – coming lower over the UK rather than just over the top of Scotland.
But now? Exceptional cold over Europe (including the UK), Russia, China, most of the USA ?? Has anybody a sensible reason for the whole Northern hemisphere suddenly suffering great cold?
…The weather we are now experiencing is caused by the Arctic Oscillation going into a negative high-pressure phase which forces cold air and arctic-like conditions up to 1,000 miles further south than normal.
See http://nsidc.org/arcticmet/patterns/arctic_oscillation.html
The only thing staying warm these days are the temp stations placed close to the heat exchangers and behind jet exhaust at the airports…
here’s Britain taken by Nasa’s Terra satellite on 7 January
http://news.bbc.co.uk/1/hi/in_depth/8447023.stm
and here’s the feature
http://news.bbc.co.uk/1/hi/uk/8448399.stm
Indur,
Definitely, the seasonal cycle in mortality and its causes is a complex issue.
In major cities across the U.S., the amplitude and timing of the seasonal mortality cycle is very similar. In Phoenix, for example, where you could argue that more people spend more time outside during the winter than the summer, the cycle is the same as Minneapolis, where people get very bundled up and stay inside more in the winter. In Miami, the seasonal cycle is also similar to Minneapolis, even though the winter temperatures in Miami aren’t that much different than the summer temperatures in Minneapolis. Given the wide variety of climates across the U.S., and the similarity of the mortality cycle, it is *very* hard to identify a climatic cause.
I think influenza plays a huge role—but its link to climate is also difficult to unravel. How deadly the flu is from year to year may depend more on the type of influenza than the climate variability from year to year.
There is still a lot of work to be done here.
-Chip
David Hall (10:42:21) :
Watts going on ?
has it to do with the quiet Sun? No doubt the IPPC will just laugh that out of court…..
There is a direct connection between the jet stream position and solar activity. With a quiet sun, the jet stream position is more equatorward and opposite. That has to do with the amount of UV light (10% higher with an active sun), which is absorbed mainly by ozone in the stratosphere, warming the equatorial stratosphere with 1 K, which increases the poleward flow of the stratosphere.
At low solar activity, this results in a lot more rain and bad weather in Southern Europe, precipitation in the Mississippi basin, and may be at the base of the AO change.
See: http://www.sciencedaily.com/releases/1999/04/990412075538.htm
but forget their take on global warming…
and a direct connection with the Arctic Oscillation:
http://www.agu.org/pubs/crossref/2005/2005GL024393.shtml
and more…
http://www.nwra.com/resumes/dunkerton/pubs/jastp.xx.xx.xx.pdf
There was a large investigation in Europe by Keatinge e.a. which shows that the minimum mortality range of about 3 K is lower in Northern Europe than in warmer parts. Above this band, mortality increases, below that band, mortality increases much more. In general there are 10 times more cold related deaths than heat related. See:
http://www.bmj.com/cgi/content/full/321/7262/670
Why the difference in minimum moratlity range is not fully understood. Maybe it is just direct adaptation, or some genetic predisposition/adaptation of Nordic people to colder climates. Something similar can be seen in UV/skin cancer resistance between descendants of the pale UK migrants to Australia and the aboriginals…
Another factor with Canada might be that the weak already died waiting to get in to see a doctor. But that wouldn’t explain the UK and Sweden.
We notice that the elderly tend to die in the winter, this in the upper midwest as far north as the Canadian capital. They have heat. They have food. They might not have as many visitors, as people don’t get outside as much, and if you are snowed in, you can’t visit, either. They certianly don’t have as much sun. That can certainly lead to depression. Add in the dry air effect on repiratory ailments and lack of vitamin D? Would that do it? Do Canadians habitually eat more fish? (But then why the high number for Japan?)
Steve Schaper (11:35:44) :Another factor with Canada might be that the weak already died waiting to get in to see a doctor.
That makes no sense whatsoever. Old folks are not dying because they can’t see a doctor. (Maybe there have been too many false accounts of our medical system in the news recently. Maybe it is not the best but it is good.)
Any Canadian can see a doctor within one or two hours (or a few hours at most) unless they live in a remote place … their choice. I might have to wait to see my own GP until tomorrow if I insist on seeing him specifically, but if I needed to see a doctor I could see one in a couple of hours. On New Years Eve 2008, I had a medical event … turned out fine. ☺ I walked into the emerg in our small town hospital and saw a doctor within one minute. I was taken by ambulance to emergency in the city and saw a doctor there within 30 minutes. Tests started within a couple of minutes of arriving.
Waiting lists for non critical care (hip replacements) can be too long … a few months in some cases. My buddy had to wait about five months for his new hip. And people die waiting for transplants like in any country…not a function of the medical system .. lack of donors.
Travel (or getting out in winter) indeed may be a small factor, but restricted travel here is most uncommon. Closed roads get full media coverage when it happens, but is not a significant factor in this discussion. From what I’ve seen on the news this past two weeks it would seem that a lot more roads were closed in the UK and USA than we see here.
Clive
Alberta Canada
Just in from England…
http://www.express.co.uk/posts/view/150858/Freeze-may-kill-60-000
Morer People in the world, Numbers Go Up you MOONCALF’s