Extreme temperatures are killing thousands across India

Heat and cold are claiming more lives across India as extreme temperatures become an increasingly deadly threat.

A 19-year analysis has found that nearly 20,000 people have died from heatstroke and over 15,000 from cold exposure since the early 2000s. These numbers tell only part of the story – many deaths go unreported, and the risks are growing each year.

The findings come from scientists at O.P. Jindal Global University (JGU) in Sonipat, India. The research focuses on the intersection of climate change, public health, and social systems, revealing a concerning upward trend in deaths from both heatstroke and hypothermia.

Extreme temperatures in developing nations

Unlike many previous studies that focused on developed countries or isolated weather events, this work takes a long-term view of the dangers facing people in low- and middle-income nations like India, where climate extremes are becoming more frequent and intense.

Using official data from 2001 to 2019, the researchers identified 19,693 deaths caused by heatstroke and 15,197 from cold exposure.

These figures likely underestimate the true scale of the crisis, as not all temperature-related deaths are formally recorded.

Heatstroke and cold exposure

The worst year was 2015, when 1,907 people died from heatstroke and 1,147 from the cold. “Deaths due to heatstroke is more significant, compared to deaths due to cold exposure, albeit recording an upward trend,” said Professor Pradeep Guin, the study’s lead author.

While it may be surprising that cold remains such a threat in a country known for scorching summers, cold-related deaths continue to occur – even as average winter temperatures rise. Some areas are experiencing record lows, and many are unprepared.

“While the average winter temperature is increasing, some parts of India are experiencing new lows,” said Professor Guin. “These states are not used to cold temperatures and so likely don’t have measures in place to deal with them, which could explain why the number of deaths from the cold is rising.”

Extreme temperature risk among men

The data revealed that adult men are most likely to die from temperature extremes. In fact, men were three to five times more likely to die from heatstroke and four to seven times more likely to die from cold exposure compared to women.

The most affected age group was 45–60 years, followed by the elderly and people aged 30–45. Why are men more vulnerable?

“The higher death toll from heatstroke in working-age men may reflect the fact that men are more likely to work outdoors than women,” said Professor Guin.

“Even with improvements in the female labour force participation rate in India in the recent years, there are more men working outside in the open environment to meet their household needs.”

Outdoor work and poverty

This increased vulnerability isn’t just biological – it’s deeply tied to the nature of outdoor work and the economic pressures many men face.

“Physically demanding outdoor work, such as construction work, should be halted during heatwaves, and those with other outdoor jobs, such as auto-rickshaw drivers and gig economy workers, should be provided with adequate relief measures such as shaded parking areas with provisions for drinking water and toilets,” noted Professor Guin.

“Essentially, those who are working outside are more exposed to extreme heat, thereby the more vulnerable gender to death.”

There’s also an economic dimension to the risk. Many outdoor workers live hand to mouth.

“We believe that the government should consider offering some form of social support to outdoor workers, particularly low-income workers and those on a daily wage, who may feel they have no option but to turn up to work, whatever the temperature.”

Deadliest temperature extremes

The team also analyzed data at the state level. For heat-related deaths, Andhra Pradesh, Uttar Pradesh, and Punjab top the list. For cold-related deaths, the worst-affected states were Uttar Pradesh, Punjab, and Bihar.

Interestingly, the deadliest temperature extremes aren’t happening in India’s hottest or coldest states.

“Should it be surprising that most deaths due to extreme temperatures are not being reported from traditionally either the hottest or coldest regions in India? This is likely due to higher adaptative mechanisms that help residents survive the harshest of temperature,” said Professor Guin.

“On the other hand, states which recorded more extreme temperature-related deaths are likely to have lower adaptive mechanisms and need greater infrastructural and social safety-net support.”

The research shows that where there is more investment in healthcare and social programs – particularly in large urban areas – there tend to be fewer deaths from extreme temperatures.

Preparing for India’s extreme temperatures

India has already taken some steps to address these risks. Some states have created heat action plans, and others are expanding efforts to prepare for cold waves. But more is needed.

“Several states in India are developing heat action plans that can provide relief through innovative built environment initiatives, and these need study as well as scale-up, including expanding cold action plans across more vulnerable states,” said Professor Nandita Bhan of the Jindal School of Public Health and Human Development at JGU.

Solutions don’t have to be complex. Bus stops and walkways can be shaded. Public awareness campaigns can use simple, local language.

More night shelters and better living conditions for homeless people can save lives. Health systems also need to be trained to respond to temperature-related emergencies.

“With an intense heatwave forecast to hit most of the country this summer and extreme weather events becoming more frequent around the globe as the world warms, there is no time to be lost in raising awareness about the dangers of extreme temperatures and putting in place measures to reduce their impact. Support systems exist, but more needs to be done,” said Professor Guin.

Using data to save lives

The study also shows how important local data is for planning effective interventions. The team hopes their work can lead to more local-level planning in the future.

“In the future, further research and analytics at sub-national levels, including districts will be able to guide district authorities to make localized intervention plans, including improved early warning systems and enhanced welfare programs,” said co-author Keshav Sethi, a doctoral candidate at the Jindal School of Government and Public Policy.

The researchers acknowledge the challenges in gathering accurate temperature and mortality data across a country as vast as India, but also the value that such data holds.

“Collecting and collating data on temperature and mortality for a country the size and scale of India is challenging, and initiatives of state agencies to maintain these data archives is commendable. It allowed researchers like us to test our hypotheses and can lead to evidence-informed policy,” concluded Professor Bhan.

“We are hopeful that our work will lead to a further momentum of collaborations to understand the global and national impacts of climate change on human health.”

The full study was published in the journal Temperature.

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