Hypothermia in Missouri
Hypothermia Deaths and Associated Risk Factors 1980-2023
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Last updated: January 6, 2025
Hypothermia is defined as a drop in body temperature to less than 95° F as a result of exposure to cold weather or a cold natural environment. Hypothermia is usually caused by prolonged exposure to the cold but can also occur when a person becomes chilled by water or sweat in temperatures above freezing. Without immediate and aggressive efforts to restore the body’s core temperature, hypothermia can quickly lead to a dangerous loss of physical and mental abilities, unconsciousness and death.
The Missouri Department of Health and Senior Services (DHSS) conducts statewide surveillance of cold-weather illness and deaths. DHSS surveillance of confirmed hypothermia deaths involves investigation of trends and accompanying risk factors.
From 1980 to 2023, there were 1,008 confirmed hypothermia deaths in Missouri.
Total Hypothermia Deaths 1980-2023
The above map shows the total number of deaths from hypothermia during the years of 1980 to 2023. The majority of deaths occurred from 2000 to 2023 due to more records being available. As generally observed due to larger populations, higher numbers of deaths tended to occur in counties like Jackson County which includes most of Kansas City on the west side of the state and St. Louis City on the east side of the state. Most hypothermia deaths occur in Missouri's coldest months, from December to February.
Hypothermia Deaths vs Average Number of Freezing Days
The annual number of hypothermia deaths and the number of freezing days follow a similar pattern. The severity of winter temperatures varies from year to year in Missouri. For example, winter in year 2012 was fairly mild and had an average of less than 5 days when the maximum daily temperature was at freezing or below. As the graph above shows, that year also had lower numbers of cold-related deaths. Conversely, more deaths occurred in 2014 when the winter was notably harsher. The weather data shown is from the National Oceanic and Atmospheric Administration (NOAA). The number of freezing days is the total number of days each weather station recorded a maximum daily temperature 32°F or colder, averaged by the number of stations.
People at Higher Risk
Anyone exposed to cold weather or a cold environment for a sufficient period of time can be at a greater chance of hypothermia. Others with an increased risk are people living in poorly heated homes, those who are homeless or spend prolonged periods of time outside, including outdoor workers, hunters or hikers. Lastly, adults over 65, children and people with heart disease or other chronic health problems have a greater chance of hypothermia.
If you or someone else is showing possible signs of hypothermia, call 911 right away. Warning signs include shivering, memory loss, exhaustion or feeling very tired, slurred speech, confusion, drowsiness and fumbling hands in adults and cold red skin and lack of energy in infants.
77% of deaths were people at higher-risk.
Outdoor Workers, the Homeless and People Spending Time Outdoors
Anyone spending extended periods of time outdoors, including outdoor workers, the homeless, hunters and hikers, should wear multiple layers of clothing, a hat and waterproof boots in cold weather. Wearing layers of clothing is better than a single heavy layer because the space between the layers works as insulation to help keep you warmer. Take frequent breaks in a warm place. Minimize sitting or squatting in the cold for prolonged periods of time, as these activities can hinder circulation. Stay hydrated. Don’t wait until you feel thirsty to drink fluids. Avoid drinks containing caffeine and alcohol. Water, sports drinks, juice and warm drinks such as broth are good. Monitor yourself and others for signs of hypothermia. Before heading outdoors, let a coworker, friend or family member know where you are going.
5% of deaths were homeless individuals.
Older Adults
Approximately half of hypothermia deaths are people age 65 years or older. Debilitating medical conditions are often contributing causes. Some underlying health problems and medications, as well as age, affect the body's ability to regulate heat and respond to the cold. Individuals with insufficient clothing or indoor heat are at risk. Individuals who fall outside or suffer from dementia may be unable to reach help or shelter and succumb to hypothermia.
Older adults should stay indoors and in a warm area. Ask a friend or family member to shovel your walkways and check on you regularly. If you must go out, hold onto railings and don’t stay out for long. Dress warmly, both indoors and outdoors. Keep your home heat set to at least 68 degrees Fahrenheit. If your home is poorly heated, stay with a friend or family member or go to a warming center.
55% of deaths were people over the age of 65.
Infants and Children
Infants and small children lose body heat more easily than adults and should be dressed warmly, both indoors and outdoors, to prevent hypothermia. Infants sleeping in a cold bedroom are at risk. Young children who wander and become lost outdoors may succumb to hypothermia.
Dress infants and children in loose layers of clothing and ensure infants and children drink adequate amounts of liquids. If an infant has cold red skin and a lack of energy, or if their temperature is below 95 degrees Fahrenheit, get them emergency medical care.
Anyone with an Underlying Medical Condition
Underlying medical conditions are often contributing causes of hypothermia death. Individuals with cardiovascular disease, diabetes or other chronic health condition may be more susceptible to the cold or may be taking medications that increase their susceptibility to the cold. Talk with your doctor or pharmacist about whether you may be at higher risk and how to keep yourself safe.
22% of deaths occurred in individuals with a heart condition.
Individuals using Alcohol or Drugs
Substance abuse is frequently associated with hypothermia deaths. Rather than warming the body, drinking alcohol causes the body to lose heat more quickly. In addition, alcohol and illicit drug use can impair people's judgement about the cold weather or cause them to lose consciousness outdoors. Watch for signs of hypothermia in people who may be using alcohol or drugs.
33% of deaths occurred in individuals that used alcohol or illicit drugs.
Warming Centers in Missouri
Warming centers provide a warm, safe place for people to go during cold weather.
A warming center is a short-term emergency accommodation that operates when temperatures or a combination of precipitation, wind chill, wind and temperature become dangerously inclement. Their purpose is vital to the prevention of death and injury from exposure to the elements.
Additional Resources
Hypothermia (DHSS) - hypothermia signs and prevention tips; information on warming centers in Missouri; links to additional resources
Healthy Winter (DHSS) - resources on how to prepare yourself and your home for winter weather, along with carbon monoxide and radon testing information.
Winter Weather (CDC) - tips on preparing for and staying safe in a winter storm; tips on preventing hypothermia and frostbite
Cold Weather Safety for Older Adults (National Institute on Aging) - cold weather safety tips for older adults; links to assistance programs and other resources
Historical Weather Data - National Oceanic and Atmospheric Administration (NOAA) - maximum air temperatures from stations part of the NOAA's National Centers for Environmental Information.
Workplace Safety and Health Topics - Cold Stress (NIOSH) - cold stress recommendations for employers and workers; links to occupational safety resources
Missouri Environmental Public Health Tracking Program #MissouriTracking
If you have questions about the data presented here, please email the DHSS Environmental Public Health Tracking program at EPHTN@health.mo.gov. You may also contact the DHSS Bureau of Environmental Epidemiology at (866) 628-9891 or (573) 751-6102.