The nights are drawing in, the temperature is dropping, there is less sunshine and immune systems are becoming more challenged: more people die in the winter than in the summer.

This excess winter mortality is associated with lower temperatures but conditions directly relating to cold, such as hypothermia, are not the main cause of excess winter mortality. The majority of additional winter deaths are caused by cerebrovascular diseases, ischaemic heart disease and respiratory diseases.

The cold can have various physiological effects, which may lead to death in vulnerable people. Woodhouse et al (1993) found that colder home temperature was associated with increased blood pressure in older people. The Eurowinter group (1997) noted that cold causes haemoconcentration, which leads to thrombosis, and that cold can also lower the immune system’s resistance to respiratory infections. Additionally, the level of influenza circulating in the population increases in winter and in vulnerable groups, such as the elderly or those with pre-existing health problems, influenza can lead to life-threatening complications, such as bronchitis or secondary bacterial pneumonia.
The relationship between temperature, influenza and winter mortality is complex but here's what we do know:

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