Who Survives Extreme Winter Storms?

Winter kills.  Extreme cold weather affects the elderly and very young children who can’t keep themselves warm, the homeless living on the street, and the poor who have to choose between food or heat.  Also, people who get trapped in their cars, or end up in an auto accident due to slippery roads, are also paying the price of extreme winter weather.

The homeless are especially at risk.  When I was in medical school during my vascular surgery rotation at the Veteran’s Administration Hospital, one night we amputated both feet of a homeless veteran due to massive frostbite and gangrene.  This happened in a big western city, during a winter storm with temps well below zero.  This is the sort of thing will happen more often in a world of extreme winters.


Let’s find out who is at risk…

A very interesting report written by the Centers for Disease Control and Prevention (CDC) called “Deaths Attributed to Heat, Cold, and Other Weather Events in the United States, 2006–2010″, in National Health Statistics Reports, provides us with some insight. The CDC researchers looked at death certificate data across the country to see what they could find out about weather-related deaths.

Here’s a key quote from this report that sums it up:

“Subpopulations at risk for cold-related mortality (death) are … older adults, infants, males, black persons, and persons with preexisting chronic medical conditions.  Alcoholics, persons taking recreational drugs (especially alcohol), homeless persons, those with inadequate winter clothing or home heating, those who go on wilderness excursions, and those who participate in winter sports also are at increased risk of cold-related mortality.”

The figure below from the CDC report shows that more people die from cold than from heat or other weather events.  Some other interesting things that stand out are that young infants and the elderly are at greatest risk.  This chart does not tease out the effects of poverty or homelessness, but it is discussed in the text of that report.  Also, the report states that cold-related deaths for men were 2.5 times higher than for women.

cold related deaths by age

The second interesting chart from the CDC report shows deaths by region and community size.

cold related deaths by region

From this graph it looks like the western U.S. far outpaces the Midwest and Northeast for cold-related deaths in small cities, towns and rural areas.  “Large central metro” are areas with more than 1,000,000 people, the “small metro” are small cities with less than 250,000 people, and the “noncore” represents strictly rural areas.  So it seems that the further out in the country-side you go, the greater the risk, maybe due to isolation or lack of timely care.

It’s important to note that the data for this study was taken from death certificates, which means that the number of deaths related to cold and other weather events are probably a lot higher than reported .  This happens because the person filling out the death certificate often only knows the direct cause of death and not what happened to the person before they were brought to the hospital.

“Winter storms kill more people than heat waves”, the deniers of climate change are fond of saying.  The implication being that if global warming were real, then it’s no big deal, and might even save a few lives.

However, little do they realize that climate change will make winter storms much worse, as we learned in another post

  • The Arctic is warming at twice the rate of the rest of the world
  • A warming Arctic affects atmospheric circulation that leads to extreme winter storms
  • And, it’s going to get worse

It would be really interesting to see how the rate of cold-related deaths has changed over the past 50 years, before the likely impacts of climate change on winter weather.  Although, just based on my own personal recollection, it seems like these bad winters have only been common over the past decade or so.  So I guess time will tell.

I also wonder how cold deaths by region will change over time, because the Midwest and Northeast, and even the South, are projected to suffer the most from the increase in severe winter weather, while the western winters may become more warm and dry, which is not a good thing either.


Well let’s add this all up

Carbon dioxide emissions are heating up the atmosphere.  The average global temperature is rising.  The Arctic is warming at twice the rate of the rest of the planet.

Arctic warming is linked to severe winter weather in the mid-latitudes by any of several mechanisms.  The incidence of severe winter weather in the Midwest, Northeast, and South is increasing.  Cold weather kills more people than hot weather, so it is likely that more people will be at risk of dying in the future from extreme winter storms.

A disturbing thought from all this is that people are dying today from the effects of climate change due to worsening winter storms.  I have read in the public health literature about recent big heat waves associated with climate change, that are potentially linked to thousands of deaths; however, I haven’t seen any studies about the effects of winter yet.  Maybe that’s because winter weather picks off people here and there, while heat waves kill a bunch of people all at once, but much less often.  So it might be a bit harder to figure out.  I’m sure we will know soon enough.

If winter is getting worse, what can we do to prepare?

winter storm ready with the CDC

Don’t forget your cell phone charger!

I used to live in a big snowy western city a few years ago, and had a “winter bag” that I kept in my truck.  In the bag I kept a down jacket, a wool blanket, two quarts of water, protein bars, a folding snow shovel, and some other odds and ends.  Just enough to see me through if I got stuck in the snow for a while.

At home, I’m better prepared.  I keep a case of bottled water, dehydrated food to last a week, and, being that I’m a doctor you should see my med kit — anything short of major surgery, I got you covered.  And, of course, I always have my bug out bag ready to go.

Click for a list of stuff to make a winter kit for your car.

The general recommendation by FEMA for emergency supplies is three days, I was going to say a week, but maybe it’s better to have even more.

Fortunately, there’s plenty of good information out there about how to prepare.  Here are three great websites…

  1. http://www.redcross.org/prepare/disaster/winter-storm – great info on how to prepare in advance, and what to do during a snow emergency
  2. http://emergency.cdc.gov/disasters/winter/beforestorm/supplylists.asp – the CDC always has great info.  They have detailed articles, but the best part is the page of checklists for communications, food, water, heating and so on; all on one page.
  3. http://readywisconsin.wi.gov/winter/HowToMakeAKit.asp — make a winter emergency kit for your car.  Great tips, a video, and a checklist!


What are the important items these sites have in common?

For your home

  • A gallon of water per person, per day for three days (a week is better!)
  • At least three days of non-perishable food (or more!)
  • Alternate source of heat, such as electric space heaters, kerosene heaters, wood stove, etc.
    • Make sure you have a carbon monoxide detector if you plan to use kerosene or wood
    • and never leave these alternate sources of heat unattended (100’s die, and 1,000’s are injured every year due to fire, smoke and carbon monoxide, especially during extreme weather!  This is a category of death/injury that will also likely increase with more extreme weather due to climate change.)
  • Extra cell phone batteries or way to charge up your devices
  • Enough of your important prescription medications to see you through
  • And, maybe most important, a family communications plan

For your car

  • Water, a couple of bottles or a gallon (in plastic in case they freeze)
  • Snacks, like energy bars or dried fruit
  • Snow shovel
  • Flashlights
  • Blankets
  • Maybe a spare winter coat
  • And it’s probably a good idea to keep your gas tank at least 3/4 full at all times during storm season (which of course also goes for any other type of extreme weather you might be at risk for)


  • Don’t forget about your pets and other animals
  • And don’t forget to check on isolated friends and family because they are at greater risk.


Lastly, how about we keep it from getting worse??

Reduce your carbon footprint, by consuming less, driving less, spending less and saving more.  Vote for politicians who recognize the issue.  I’m no partisan, but it seems that one party has many more deniers in it than the other.  I bet they will change their tune in the near future; at least if they want a chance at getting elected.  And, last but not least, divest from fossil fuels.

If you’ve got some additional suggestions for surviving winter, please tweet me or send an email from the contact page.

I’ll leave you with this interesting video from the Winter of 2014.

The new normal??


This post last updated 08 January 2017.