UK Health Security Agency reports sharp rise in cold-related deaths among older adults across England last winter

England faced a harsh reality last winter as cold weather claimed thousands of lives, according to the first Cold Mortality Monitoring Report published by the UK Health Security Agency (UKHSA).

Covering the period from November 2024 to January 2025, the report sheds light on the hidden toll of cold weather, revealing patterns that could help protect the most vulnerable in future winters.

Thousands of Deaths Linked to Cold Weather

UKHSA estimates that 2,544 deaths across England were associated with three distinct cold episodes during the winter.

The deadliest stretch was a six-day cold snap in early January 2025, which alone accounted for 1,630 deaths.

Two shorter periods—one in November and another in early January—were linked to 421 and 493 deaths, respectively.

Older adults were the hardest hit. The risk of death increased sharply with age, particularly for those aged 85 and above.

Men also experienced higher mortality than women, with 1,439 male deaths compared to 1,117 female deaths.

Heart-related conditions led the pack, with 834 deaths attributed to circulatory diseases such as heart attacks.

Where and How People Died

Most cold-related deaths occurred in hospitals (975), yet the report highlights that the relative risk was higher for residents of care homes and for those who died at home.

Interestingly, mortality did not spike immediately; the study found that deaths peaked around five days after cold exposure and remained elevated for up to nine days.

Heart-related deaths appeared within a few days, while respiratory and infection-related deaths tended to show a delayed pattern, sometimes appearing weeks later.

How UKHSA Tracks Cold-Related Deaths

The agency combines daily death registrations with Met Office temperature records to create a statistical model that estimates the number of deaths linked to cold spells.

Unlike death certificates, which rarely cite cold weather as a cause, this method captures the broader impact of low temperatures on public health.

These findings are part of a wider winter health surveillance program that monitors not only cold weather, but also seasonal pressures like flu, COVID-19, RSV, and norovirus.

The Cold Mortality Monitoring Report offers up-to-date insights into specific winter episodes, complementing long-term analyses by the Office for National Statistics (ONS), which examine trends over decades.

While the numbers aren’t directly comparable, together they provide a more complete picture of how cold weather affects health in England.

Who Is Most Vulnerable

Dr. Agostinho Sousa, Head of Extreme Events and Health Protection at UKHSA, emphasized that cold weather remains a serious, preventable public health risk.

The report identifies key groups at greatest risk:

• People aged 65 and over
• Those with cardiovascular or respiratory conditions
• Individuals with dementia
• Residents of poorly insulated homes or those experiencing fuel poverty

The analysis also suggests that vulnerability may be increasing.

Compared to the previous five years, deaths rose more sharply as temperatures dropped, likely due to an ageing population and the growing burden of chronic diseases.

Factors such as home insulation, access to healthcare, vaccination rates, and public awareness of cold weather risks can all influence outcomes.

What’s Next?

UKHSA’s findings are already informing winter preparedness plans and Cold Weather Alerts, ensuring that responses are based on evidence rather than just temperature forecasts.

Future research over longer periods will be essential to understand whether the trend of increasing vulnerability continues.

Meanwhile, targeted interventions—like better home heating, flu and COVID-19 vaccinations, and focused support for older adults—could save lives during future cold snaps.

Summary

The first Cold Mortality Monitoring Report from UKHSA paints a sobering picture of winter 2024–2025 in England.

Over 2,500 deaths were linked to cold spells, with older adults, men, and people with heart or respiratory conditions most affected.

Mortality peaks days after exposure and remains elevated, underscoring the delayed impact of cold weather on public health.

By tracking daily deaths alongside temperature data, UKHSA provides a vital tool for understanding, preparing for, and preventing the toll of cold weather in vulnerable communities.