Climatic Change

, Volume 102, Issue 3–4, pp 539–553 | Cite as

Causes for the recent changes in cold- and heat-related mortality in England and Wales

  • Nikolaos ChristidisEmail author
  • Gavin C. Donaldson
  • Peter A. Stott


Cold related mortality among people aged over 50 in England and Wales has decreased at a rate of 85 deaths per million population per year over the period 1976–2005. This trend is two orders of magnitude higher than the increase in heat-related mortality observed after 1976. Long term changes in temperature-related mortality may be linked to human activity, natural climatic forcings, or to adaptation of the population to a wider range of temperatures. Here we employ optimal detection, a formal statistical methodology, to carry out an end to end attribution analysis. We find that adaptation is a major influence on changing mortality rates. We also find that adaptation has prevented a significant increase in heat-related mortality and considerably enhanced a significant decrease in cold-related mortality. Our analysis suggests that in the absence of adaptation, the human influence on climate would have been the main contributor to increases in heat-related mortality and decreases in cold-related mortality.


Comfort Zone Internal Climate Variability General Circulation Model Output Central England Temperature Canadian Forest Fire 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Allen MR, Tett SFB (1999) Checking for model consistency in optimal fingerprinting. Clim Dyn 15:419–434CrossRefGoogle Scholar
  2. Allen MR, Stott PA (2003) Estimating signal amplitudes in optimal fingerprinting, part I: theory. Clim Dyn 21:477–491CrossRefGoogle Scholar
  3. Basu R, Samet JM (2002) Relation between elevated ambient temperature and mortality: a review of the epidemiologic evidence. Epidemiol Rev 24:190–202CrossRefGoogle Scholar
  4. Christidis N, Stott PA, Brown S, Hegerl GC, Caesar J (2005) Detection of changes in temperature extremes during the second half of the 20th century. Geophys Res Lett 32:L20716. doi: 10.1029/2005GL023885 CrossRefGoogle Scholar
  5. Confalonieri U, Menne B, Akhtar R, Ebi KL, Hauengue M, Kovats RS, Revich B, Woodward A (2007) Human health. In: Parry ML et al (eds) Climate change 2007: impacts, adaptation and vulnerability. Cambridge University Press, CambridgeGoogle Scholar
  6. Conti S, Meli P, Minelli G, Solimini R, Toccaceli V, Vichi M, Beltrano C, Perini L (2005) Epidemiologic study of mortality during the Summer 2003 heat wave in Italy. Environ Res 98:390–399CrossRefGoogle Scholar
  7. Curriero F, Patz JA, Rose JB, Lele S (2001) The association between extreme precipitation and waterborne disease outbreaks in the United States, 1948–1994. Am J Publ Health 91:1194–1199CrossRefGoogle Scholar
  8. Davis RE, Knappenberger PC, Michaels PJ, Novicoff WM (2003) Changing heat-related mortality in the United States. Environ Health Perspect 111:1712–1718CrossRefGoogle Scholar
  9. Davis RE, Knappenberger PC, Michaels PJ, Novicoff WM (2004) Seasonality of climate–human mortality relationships in US cities and impacts of climate change. Clim Res 26:61–76CrossRefGoogle Scholar
  10. Dessai S (2002) Heat stress and mortality in Lisbon part I. Model construction and validation. Int J Biometeorol 47:6–12CrossRefGoogle Scholar
  11. Diaz J, Jordan A, Garcia R, Lopez C, Alberdi JC, Hernández E, Otero A (2002) Heat waves in Madrid 1986–1997: effects on the health of the elderly. Int Arch Occup Environ Health 75:163–170CrossRefGoogle Scholar
  12. Donaldson GC, Keatinge WR (1997) Mortality related to cold weather in elderly people in southeast England, 1979–94. BMJ 315:1055–1056Google Scholar
  13. Donaldson GC, Keatinge WR, Näyha S (2003) Changes in summer temperature and heat-related mortality since 1971 in North Carolina, South Finland, and Southeast England. Environ Res 91:1–7CrossRefGoogle Scholar
  14. Frumkin H (2002) Urban sprawl and public health. Public Health Rep 117:201–217Google Scholar
  15. Gillett NP, Weaver AJ, Zwiers FW, Flannigan MD (2004) Detecting the effect of climate change on Canadian forest fires. Geophys Res Lett 31:L18211. doi: 10.1029/2004GL020876 CrossRefGoogle Scholar
  16. Gosling SN, McGregor GR, Páldy A (2007) Climate change and heat-related mortality in six cities part 1: model construction and validation. Int J Biometeorol 51:52–540CrossRefGoogle Scholar
  17. Guest CS, Willson K, Woodward AJ, Hennessy K, Kalkstein LS, Skinner C, McMichael AJ (1999) Climate and mortality in Australia: retrospective study, 1979–1990, and predicted impacts in five major cities in 2030. Clim Res 13:1–15CrossRefGoogle Scholar
  18. Guha-Sapir P, Hargitt D, Hoyois H (2004) Thirty years of natural disasters 1974-2003: the numbers. UCL, Presses Universitaires de Louvrain, Louvrain la NeuveGoogle Scholar
  19. Hajat S, Bird W, Haines A (2004) Cold weather and GP consultations for respiratory conditions by elderly people in 16 locations in the UK. Eur J Epidemiol 19:959–968CrossRefGoogle Scholar
  20. Hales S, Weinstein P, Woodward A (1996) Dengue fever epidemics in the South Pacific: driven by El Niño Southern Oscillation? Lancet 348:1664–1665CrossRefGoogle Scholar
  21. Hari Kumar R, Venkaiah K, Arlappa N, Kumar S, Brahman G, Vijayaraghavan K (2005) Diet and nutritional status of the population in the severely drought affected areas of Gujarat. J Hum Ecol 18:319–326Google Scholar
  22. Health Statistics (2006) Report: estimated daily mortality during July 2006 in England and Wales. Health Stat Q 32:107–111Google Scholar
  23. Hegerl GC, Zwiers FW, Braconnot P, Gillett NP, Luo Y, Marengo Orsini JA, Nicholls N, Penner JE, Stott PA (2007) Understanding and attributing climate change. In: Solomon S et al (eds) Climate change 2007: the physical science basis. Cambridge University Press, CambridgeGoogle Scholar
  24. Huynen MM, Martens P, Schram D, Weijenberg MP, Kunst AE (2001) The impact of heat waves and cold spells on mortality rtes in the Dutch population. Environ Health Perspect 109:463–470CrossRefGoogle Scholar
  25. Ito K, De Leon SF, Lippmann M (2005) Associations between ozone and daily mortality: analysis and meta-analysis. Epidemiol 16:446–457CrossRefGoogle Scholar
  26. Johns TC, Durman CF, Banks HT, Roberts MJ, McLaren AJ, Ridley JK, Senior CA, Williams KD, Jones A, Rickard GJ, Cusack S, Ingram WJ, Crucifix M, Sexton DMH, Joshi MM, Dong B-W, Spencer H, Hill RSR, Gregory JM, Keen AB, Pardaens AK, Lowe JA, Bodas-Salcedo A, Stark S, Searl Y (2006) The new Hadley Centre climate model HadGEM1: evaluation of coupled simulations. J Clim 19:1327–1353CrossRefGoogle Scholar
  27. Jones GS, Stott PA, Christidis N (2008) Human contribution to rapidly increasing frequency of vary warm Northern Hemisphere summers. J Geophys Res 113:D02109. doi: 10.1029/2007JD008914 CrossRefGoogle Scholar
  28. Kalkstein LS (1993) Health and climate change. Direct impacts in cities. Lancet 264:1397–1399CrossRefGoogle Scholar
  29. Karoly DJ, Stott PA (2006) Anthropogenic warming of central England temperature. Atmos Sci Lett 7:81–85CrossRefGoogle Scholar
  30. Keatinge WR, Donaldson GC, Bucher K, Jendritzky G, Cordioli E, Martinelli M, Katsouyanni K, Kunst AE, McDonald C, Nayha S, Vuori I (2000a) Winter mortality in relation to climate. Int J Circumpolar Health 59:154–159Google Scholar
  31. Keatinge WR, Donaldson GC, Cordioli E, Martinelli M, Kunst AE, Mackenbach JP, Nayha S, Vuori I (2000b) Heat related mortality in warm and cold regions of Europe: observational study. BMJ 321:670–673CrossRefGoogle Scholar
  32. Kovats S (ed) (2008) Health effects of climate change in the UK 2008. Department of Health, Health Protection Agency, DH Publications, LondonGoogle Scholar
  33. Malezer D, Hales S, Weinstein P, Zalucki M, Woodward A (1999) El Niño and arboviral disease prediction. Environ Health Perspect 107:817–918CrossRefGoogle Scholar
  34. Manley G (1974) Central England temperatures: monthly means 1659 to 1973. Q J R Meteorol Soc 100:389–405CrossRefGoogle Scholar
  35. McGeehin MA, Mirabelli M (2001) The potential impacts of climate variability and change on temperature-related morbidity and mortality in the United States. Environ Health Perspect 109:185–189CrossRefGoogle Scholar
  36. McMichael AJ (2001) Impact of climatic and other environmental changes on food production and population health in the coming decades. Proc Nutr Soc 60:195–201Google Scholar
  37. McMichael AJ, Campbell-Lendrum D, Kovats RS, Edwards S, Wilkinson P, Edmonds N, Nicholls N, Hales S, Tanser FC, Le Sueur D, Schlesinger M, Andronova N (2004) Climate change. In: Ezzati M, Lopez AD, Rodgers A, Mathers C (eds) Comparative quantification of health risks: global and regional burden of disease due to selected major risk factors, vol 2. WHO, GenevaGoogle Scholar
  38. McMichael AJ, Woodruff RE, Hales S (2006) Climate change and human health: present and future risks. Lancet 367:859–869CrossRefGoogle Scholar
  39. Medina-Ramón M, Schwartz J (2007) Temperature, temperature extremes, and mortality: a study of acclimatisation and effect modification in 50 US cities. Occup Environ Med 64:827–833Google Scholar
  40. Nicholls RJ, Tol RSJ (2006) Impacts and responses to sea-level rise: a global analysis of the SRES scenarios over the 21st century. Philos T R Soc A 364:1073–1095CrossRefGoogle Scholar
  41. Parker DE, Horton B (2005) Uncertainties in Central England temperature 1878–2003 and some improvements to the maximum and minimum series. Int J Climatol 25:1173–1188CrossRefGoogle Scholar
  42. Patz JA, Campbell-Lendrum D, Holloway T, Foley JA (2005) Impact of regional climate change on human health. Nature 438:310–317CrossRefGoogle Scholar
  43. Rose JB, Epstein PR, Lipp EK, Sherman BH, Bernard SM, Patz JA (2001) Climate variability and change in the United States: potential impacts on water and foodborne diseases caused by microbiologic agents. Environ Health Perspect 109:211–221CrossRefGoogle Scholar
  44. Schwartz J, Levin R (1999) Drinking water turbidity and health. Epidemiology 10:86–89CrossRefGoogle Scholar
  45. Singh R, Hales S, de Wet N, Raj R, Hearnden M, Weinstein P (2001) The influence of climate variation and change on diarrhoeal disease in the pacific islands. Environ Health Perspect 109:155–159CrossRefGoogle Scholar
  46. Stott PA, Tett SFB, Jones GS, Allen MR, Mitchell JFB, Jenkins GJ (2000) External control of twentieth century temperature variations by natural and anthropogenic forcings. Science 290:2133–2137CrossRefGoogle Scholar
  47. Stott PA, Stone DA, Allen MR (2004) Human contribution to the European heatwave of 2003. Nature 432:610–613CrossRefGoogle Scholar
  48. Stott PA, Jones GS, Lowe JA, Thorne P, Durman CF, Johns TC, Thelen J-C (2006) Transient climate simulations with the HadGEM1 climate model: causes of past warming and future climate change. J Climate 19:2763–2782CrossRefGoogle Scholar
  49. Sur D, Dutta P, Nair GB, Bhattacharya SK (2000) Severe cholera outbreak following floods in a northern district of West Bengal. Indian J Med Res 112:178–182Google Scholar
  50. Tett SFB, Jones GS, Stott PA, Hill DC, Mitchell JFB, Allen MR, Ingram WJ, Johns TC, Johnson CE, Jones A, Roberts DL, Sexton DMH, Woodage MJ (2002) Estimation of natural and anthropogenic contributions to twentieth century temperature change. J Geophys Res 107. doi: 10.1029/2000JD000028
  51. Vandentorren S, Empereur-Bissonnet P (2005) Health impact of the 2003 heat-wave in France. In: Kirch W, Menne B, Bertollini R (eds) Extreme weather events and public health responses. Springer, Berlin, pp 81–88CrossRefGoogle Scholar
  52. World Health Organisation (2002) The World Health Report. WHO, GenevaGoogle Scholar

Copyright information

© Crown Copyright 2009

Authors and Affiliations

  • Nikolaos Christidis
    • 1
    Email author
  • Gavin C. Donaldson
    • 2
  • Peter A. Stott
    • 1
  1. 1.Met Office Hadley CentreExeterUK
  2. 2.Academic Unit of Respiratory MedicineUniversity College London, Royal Free and University College Medical SchoolLondonUK

Personalised recommendations