Cold-related deaths in the United States have more than doubled from 1999 to 2022, according to a research letter published in the Journal of the American Medical Association.

The study, led by Michael Liu of Beth Israel Deaconess Medical Center in Boston, analyzed mortality trends using data from the U.S. Centers for Disease Control and Prevention. Researchers examined death certificates where cold exposure was listed as an underlying or contributing cause of death.

Over the 23-year period, 63,550,429 deaths were recorded, of which 0.06 percent were attributed to cold-related causes. The age-adjusted mortality rate (AAMR) for cold-related deaths increased by 109 percent, from 0.44 per 100,000 persons in 1999 to 0.92 in 2022.

The study observed a 3.4 percent annual rise in cold-related AAMRs overall, with a relatively stable period between 1999 and 2017 (annual percent change [APC]: 1.0 percent) followed by a sharp uptick from 2017 to 2022 (APC: 12.1 percent).

Older adults were particularly vulnerable, with individuals aged 75 years or older experiencing the highest cold-related AAMR of 4.23 per 100,000 persons in 2022. Meanwhile, adults aged 45 to 74 years had the steepest annual increase in cold-related deaths over the study period (APC: 4.8 percent). Males consistently had higher cold-related mortality rates than females, although significant increases were observed across both genders.

“Cold-related mortality rates more than doubled in the United States between 1999 and 2022,” the authors noted, emphasizing that prior research indicates cold temperatures are the primary contributor to temperature-related deaths.

The findings underscore the growing public health challenge posed by cold exposure and highlight the need for targeted interventions, especially for vulnerable populations like older adults. Notably, one author disclosed ties to the pharmaceutical industry, but the study’s implications remain critical for addressing temperature-related mortality trends.