Winter’s crisp air can be invigorating, but prolonged exposure to the cold poses serious health risks — chief among them, hypothermia. This life-threatening condition occurs when the body loses heat faster than it can generate it, causing one’s core temperature to drop below 95 degrees. Left untreated, hypothermia can lead to cardiac and respiratory failure.
When people are uncomfortably cold, they start shivering, their body’s attempt to generate heat — and a warning to get to a warm environment as soon as possible. If ignored, the symptoms can quickly progress to slurred speech, clumsiness, and confusion. Unconsciousness follows, and without intervention, death.
Hypothermia is commonly caused by wearing inadequate clothing; staying in garments wet from snow, rain or perspiration; or immersion in cold water — such as falling through ice. Hypothermia can occur indoors, too: Cool homes with thermostats set between 60 and 65 are considered unsafe for those over the age of 65.
Cold-related deaths in the United States have surged, doubling between 1999 and 2022. An estimated 2,245 Americans died from hypothermia in 2024 alone. Researchers attribute the increased mortality to rising rates of homelessness, substance abuse, and social isolation. Last year, more than 771,000 people— the most in U.S. history — were without shelter and exposed directly to the elements.
Consuming alcohol and drugs compounds the danger by accelerating heat loss and dulling awareness, making it harder for individuals to recognize life-threatening symptoms.
The elderly, particularly those living in rural areas, are also at an increased risk of hypothermia due to isolation.
More frequent extreme weather events have contributed to the rising death rate, too. Although U.S. winters average 4 degrees higher than 50 years ago, the warmer atmosphere has precipitated deep waves in the jet stream, bringing frigid Arctic air farther south to states unaccustomed to severe winter.
If you suspect someone has hypothermia, call 911 immediately. Gently move the person indoors: Jarring motions can trigger dangerous heart arrhythmias. Remove the victim’s wet clothes as quickly as possible and replace them with dry garments. If available, use a heating pad wrapped in a towel or an electric blanket. Offer warm, nonalcoholic beverages if the person is conscious, but avoid hot baths or showers, which can cause a dangerous drop in blood pressure.
To reduce the risk of hypothermia, follow these precautions:
- Dress appropriately: Wear loose-fitting, layered clothing, a hat, and mittens (which provide better insulation than gloves).
- Stay dry: Wet clothing accelerates heat loss, so change out of damp garments as soon as possible.
- Be prepared for winter driving: Keep your phone charged and inform someone of your travel plans.
- Exercise caution on ice: If walking or skating on a frozen lake or river, ensure the ice is at least four inches thick. Wear a life jacket and carry a whistle for emergencies.
Those at high risk for hypothermia — which also includes young children, people with chronic medical conditions, and those who take certain medications — should stay indoors as much as possible when it’s cold and set their home thermostat to 68 degrees. Checking in on elderly neighbors and relatives can be a simple but life-saving act. The New York State Department of Health has resources to help with home energy efficiency and heating bills.
Instructions can be found here if you fall through the ice or must rescue a victim who has done so.
Dr. Mary Jenkins, a contributor to the Herald and member of its board of directors, retired after nearly 40 years as a family practice physician in New York state.