title: 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.
authors: University of Michigan School of Public Health, Ann Arbor, MI 48109, USA.
authors: Kathryn C
authors: KC
authors: Conlon
authors: Nicholas B
authors: NB
authors: Rajkovich
authors: Jalonne L
authors: JL
authors: White-Newsome
authors: Larissa
authors: L
authors: Larsen
authors: Marie S
authors: MS
authors: O'Neill
references: Am J Epidemiol. 1993 Feb 1;137(3):331-41
references: 8452141
references: Environ Res. 2007 Jun;104(2):275-81
references: 17316603
references: Int J Cardiol. 2004 Apr;94(2-3):229-33
references: 15093986
references: J Epidemiol Community Health. 2003 Oct;57(10):784-9
references: 14573581
references: Am J Epidemiol. 2002 Jan 1;155(1):80-7
references: 11772788
references: Epidemiology. 2009 Mar;20(2):205-13
references: 19194300
references: Respir Med. 2009 Mar;103(3):456-62
references: 18977127
references: Stroke. 1992 Jan;23(1):24-7
references: 1731416
references: Stroke. 2011 Mar;42(3):593-600
references: 21273573
references: BMJ. 2004 Sep 18;329(7467):647
references: 15315961
references: Int J Cardiol. 2009 Jun 12;135(1):136-8
references: 18571257
references: Int J Cardiol. 2010 Sep 24;144(1):16-21
references: 19403184
references: Lancet. 1997 May 10;349(9062):1341-6
references: 9149695
references: Occup Environ Med. 2011 Jul;68(7):525-30
references: 21036791
references: J Epidemiol Community Health. 2005 Jul;59(7):551-7
references: 15965137
references: Lancet. 2009 Dec 5;374(9705):1917-29
references: 19942273
references: J Am Coll Cardiol. 2006 Jul 18;48(2):287-92
references: 16843177
references: Public Health. 1991 May;105(3):205-15
references: 2062993
references: J Am Med Dir Assoc. 2010 Jul;11(6):449-52
references: 20627187
references: Sci Total Environ. 2010 Apr 1;408(9):2042-9
references: 20138646
references: Am J Epidemiol. 2006 Jul 1;164(1):77-84
references: 16624968
references: Environ Res. 2001 Jul;86(3):209-16
references: 11453671
references: J Epidemiol Community Health. 2003 Oct;57(10):790-1
references: 14573582
references: Int J Cardiol. 1987 Jul;16(1):19-25
references: 3610394
references: Am J Public Health. 1982 Mar;72(3):261-5
references: 7058966
references: Am J Prev Med. 2008 Nov;35(5):501-7
references: 18929976
references: Science. 2005 Aug 12;309(5737):1040-4
references: 16099975
references: Environ Res. 2010 Aug;110(6):604-11
references: 20519131
references: Am Heart J. 1955 Jan;49(1):9-20
references: 13218000
references: Environ Res. 2006 Sep;102(1):52-60
references: 16460725
references: BMJ. 2007 Mar 3;334(7591):460
references: 17324975
references: Epidemiology. 2001 Nov;12(6):662-7
references: 11679794
references: Int J Trauma Nurs. 2001 Jan-Mar;7(1):26-30
references: 11174768
references: Sci Total Environ. 2009 Mar 15;407(7):2158-64
references: 19157521
references: Public Health. 2006 Feb;120(2):161-6
references: 16343566
references: Am J Epidemiol. 2008 Dec 15;168(12):1397-408
references: 18952849
references: Int J Biometeorol. 2005 Jan;49(3):179-83
references: 15290433
references: Sci Total Environ. 2010 Nov 1;408(23):5768-74
references: 20833411
references: Am Fam Physician. 2004 Dec 15;70(12):2325-32
references: 15617296
references: Soc Sci Med. 1998 Feb;46(3):331-44
references: 9460815
references: Environ Health Perspect. 2001 May;109 Suppl 2:185-9
references: 11359685
references: J Public Health (Oxf). 2005 Dec;27(4):353-8
references: 16155051
references: Int J Epidemiol. 2008 Oct;37(5):1121-31
references: 18522981
references: Public Health. 2010 Jul;124(7):398-403
references: 20541782
references: Int J Biometeorol. 1995 Mar;38(3):141-7
references: 7744529