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NLM Director’s Comments Transcript

Higher Cold Weather Deaths in the Rural West: 04/13/2015

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I'm Rob Logan, Ph.D. senior staff U.S. National Library of Medicine.

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Deaths attributable to cold weather occurred more often in the rural west — and cold weather related deaths occurred more frequently in rural than urban areas across the nation, finds a recent summary in BMJ of a report released by the Centers for Disease Control and Prevention (CDC).

The CDC’s analysis of 5,809 deaths across the nation (reported from 2010-2013) found the proportion of age adjusted, cold weather related deaths in the rural, western part of the U.S. was 20.5 deaths per million persons. By comparison, the proportion of age adjusted, cold weather related deaths in other rural areas of the U.S. ranged from just 4.5 to 7.8 deaths per million persons.

In addition, the CDC found cold weather related deaths clustered in rural compared to urban areas in western states. Comparatively, only about three persons per million died from cold weather related causes in metropolitan areas within western states from 2010-2013. Similarly, the CDC found death rates in metropolitan areas were significantly lower than rural areas across the U.S.  

The BMJ article notes the CDC did not explain why cold related deaths in rural areas of western states are higher than the rest of the country as well as the urban-rural differences nationwide. However, the BMJ article explains a prior CDC report found adults have an increased risk of cold weather related deaths if they live in areas with rapid temperature shifts, with large variation in night-to-day temperatures, and at higher elevations.

Many of the U.S. states with large mountain ranges, including Alaska, California, Oregon, Washington, Nevada, Montana, Wyoming, Arizona, New Mexico, and Utah were assessed as part of the western region in the CDC study.

BMJ notes the urban-rural difference might be partially addressed by prior CDC findings that suggested rates of deaths from cold and heat were more likely to occur in low income compared to higher income counties. The BMJ report notes rural counties in western and other regions of the U.S. often have overall lower incomes compared to metropolitan areas. 

While the CDC did not compare its current with previous cold weather related death findings, the BMJ article notes prior reports suggested demographic rather than regional differences were associated with intra and inter-regional differences. For example, in one previous CDC report cold weather deaths per million were significantly higher among seniors than younger adults. Specifically, the CDC found cold weather related deaths were more likely to occur in adults ages 75-84, and after age 85, compared to middle aged and younger men and women.

Incidentally, the CDC’s findings were published in an article within the agency’s weekly morbidity and mortality reports. The CDC’s morbidity and mortality weekly reports (MMWR) are accessible for free by typing ‘CDC mortality reports’ in any Internet search engine and clicking on the link to “MMWR reports.’

Meanwhile, MedlinePlus.gov’s winter weather emergencies health topic page provides a number of helpful resources about staying well in cold weather. For example, the U.S. Department of Homeland Security provides a guide to preparing and coping with winter storms in the ‘start here’ section of MedlinePlus.gov’s winter weather emergencies health topic page.

A prevention guide to promote personal health and safety in extreme cold (from the CDC) is available in the ‘related issues’ section of MedlinePlus.gov’s winter weather emergencies health topic page. More specific guides from the CDC (also available in the ‘related issues’ section of MedlinePlus.gov’s winter weather emergencies health topic page) provide tips for indoor and outdoor health and safety in cold weather.

Tips to help teens and seniors also are available in the ‘teenagers’ and ‘seniors’ section of MedlinePlus.gov’s winter weather emergencies health topic page.

MedlinePlus.gov’s winter weather emergencies health topic page additionally provides links to the latest pertinent journal research articles, which are available in the ‘journal articles’ section. You can sign up to receive updates about the health implications of winter weather as they become available on MedlinePlus.gov.

To find MedlinePlus.gov’s winter weather emergencies health topic page type ‘winter weather’ in the search box on MedlinePlus.gov’s home page, then, click on ‘winter weather emergencies (National Library of Medicine).’ MedlinePlus.gov also has health topic pages devoted to heat illness and heat emergencies.

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