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Vulnerability to winter mortality in elderly people in Britain: population based study
Paul Wilkinson1, Sam Pattenden, Ben Armstrong
1London School of Hygiene and Tropical Medicine, London WC1E 7HT. paul.wilkinson@lshtm.ac.uk
BMJ (Clinical Research Ed.)
|August 19, 2004
Summary
Excess winter mortality in the elderly is higher in women and those with respiratory illness. Socioeconomic factors did not predict winter death, indicating a need for broader strategies beyond fuel poverty relief.
Area of Science:
- Gerontology
- Public Health
- Epidemiology
Background:
- Elderly populations are vulnerable to seasonal variations in mortality.
- Understanding the determinants of winter mortality is crucial for public health interventions.
Purpose of the Study:
- To investigate factors contributing to increased mortality risk during winter in older adults.
- To identify specific vulnerabilities associated with age, sex, socioeconomic status, and clinical conditions.
Main Methods:
- A population-based cohort study involving 106 general practices in Britain.
- Follow-up of 119,389 person-years, recording 10,123 deaths through the Office for National Statistics.
- Analysis of mortality rates comparing winter and non-winter periods, adjusted for covariates.
Main Results:
- A 31% higher mortality rate was observed during winter compared to non-winter months (rate ratio 1.31).
- This excess winter mortality was primarily associated with female sex and a history of respiratory illness.
- No significant association was found between winter mortality and socioeconomic deprivation or financial worries.
Conclusions:
- Female sex and pre-existing respiratory conditions are key vulnerabilities for excess winter deaths in the elderly.
- The absence of a socioeconomic gradient suggests that current policies addressing fuel poverty may be insufficient.
- Additional measures are required to effectively reduce the burden of excess winter deaths in the elderly population.