England and Wales suffered a 29% increase in excess winter deaths in the 2012-13 winter compared to the previous year, according to a report from the Office of National Statistics, released in November 2013. The main reasons are thought to be the winter outbreaks of flu and respiratory virus infections plus the prolonged cold spell in late winter and early spring. The majority of these deaths affected people aged over 75, who accounted for some 25,600 of the estimated 31,100 total excess deaths.
Every year more people die in the period December to March than in the rest of the year, but the 2012-13 winter saw a spike in mortality. Historically since the 1950s, the trend has been falling, but over the last decade it has flattened out on average, although yearly totals rise and fall depending on the severity of the winter weather. In 2013 we experienced the coldest March since 1962, which coupled with influenza caused higher than average mortality for early spring. The West Midlands had an Excess Winter Mortality Index of 21.0, which was second highest of the English regions, surpassed only by the North West on 21.4.
Professor John Ashton, president of the UK's Faculty of Public Health, said 'It's time we took this whole issue seriously, about how we look after our old people'. And Caroline Abrahams, Charity Director of Age UK, described the statistics as 'shameful' and called for the government to cut energy bills for the frail and elderly, who are most at risk of excess winter deaths.
The main causes of increased winter mortality are:
- respiratory diseases
- circulatory diseases
- dementia and Alzheimer's disease
- injury, including accidental falls
Studies have shown that it is not the cold itself - i.e. hypothermia - that is the main killer, but rather the physiological effects of prolonged exposure to cold conditions. These include raised blood pressure, thickening of the blood leading to an increased risk of thrombosis, and lowered immune resistance. This means that the body is less able to fight infections, which then cause secondary and potentially fatal complications such as bronchitis and pneumonia.
How do we compare with other countries?
Paradoxically, European countries with very cold winters, such as Norway, Sweden and Finland, generally have the lowest rates of excess winter deaths, whereas ones with mild winters such as Portugal and Spain have the highest rates in Europe as a whole. A 2003 report put England and Wales amongst the worst-performing countries in this regard. The reasoning is that people who consider severe winters to be the norm prepare accordingly, by ensuring that both they and their homes are well insulated and properly equipped to cope with wintry conditions.
What action should we take?
See 'How to combat the cold this winter', which summarizes what to do and where to turn for help in fighting the cold weather this winter.