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A deadly harvest: the effects of cold on older people in the UK.

Excess winter mortality of some thousands of deaths of older people has occurred in the UK for the past 150 years and shows only moderate abatement. Government policies in both health and social care have had little apparent effect, other than a slow decline in seasonality due largely to secular trends. There are a number of apparent misconceptions, commonly held in the public mind and subsumed in public policy, which need to be corrected in order to reduce the toll of winter cold on older people. The evidence shows that winter deaths are to a large extent avoidable. They are not due to hypothermia as is widely believed, may not be necessarily reduced by climate change in the foreseeable future and may only be partially reduced by improving indoor warmth alone. The key is an integrated policy which reduces all risks equally. Community nursing is well placed to play a pivotal role in such policies.