The winter of 2024-2025 in Ukraine coincides with a number of complex and challenging factors that place a significant burden on the healthcare system and negatively affect the overall well-being of the population. The war, along with winter conditions, can increase the risk of cold-related morbidity and mortality due to ongoing attacks on civilian infrastructure, frontline movements, mass displacements and disruption of access to essential health services.
HMH is recounting the main points from the WHO report “Ukraine: Winter Risk Assessment 2024-2025”.
How the report was created
To assess the public health risk associated with severe cold in Ukraine, a risk model was developed based on 18 key indicators, grouped into three main groups: exposure, vulnerability and coping capacity. These indicators were drawn from a variety of medical and nonmedical data sources covering environmental hazards, demographics, socio-economic and health status, and factors affecting access to services, service delivery, safety, and security. A weighted sum of indicators was applied, with a focus on five key factors that have a significant impact on the outcomes of severe cold:
- Regional security situation and proximity to the frontline;
- Frequency and duration of power outages;
- Access to medical services and medicines;
- Number of internally displaced persons (IDPs);
- Average household income.
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Impact
In Ukraine, the cold season can last up to six months (from October to March). The coldest months are from December to March, when temperatures can drop to -20°C and rise to +13°C. All regions of Ukraine experience days with temperatures below -10°C between October and March. This means that the entire country is exposed to severe cold. Severe cold is a critical health risk factor, leading to weather-related deaths, increased risk of mortality, including through exacerbation of chronic diseases such as coronary heart disease, cerebral vascular accidents, chronic respiratory diseases, cold-related injuries and accidents, hypothermia and frostbite.
Vulnerability
The entire population of Ukraine is exposed to low temperatures in winter, and the health effects associated with cold can affect everyone. However, people with certain physiological and social characteristics are more susceptible to negative impacts than the average population. These vulnerable groups include the elderly, people with disabilities, people with heart or respiratory conditions, infants or young children, pregnant women, and workers who work outdoors. They also include people living in substandard housing or without access to adequate electricity and heating, and people who are poor, displaced or homeless.
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The ability to overcome
Ukraine’s basic infrastructure remains in a very critical situation. Targeted attacks have caused extensive damage, leading to disruptions in the supply of gas, heat, electricity, water and telecommunications, affecting large segments of the population. Ukraine’s energy capacity has been severely damaged, with about half of it lost to attacks on its energy infrastructure in 2024. To bridge the gap, Ukraine is importing electricity from neighbouring countries until repairs are completed.
Risk to public health
The aggregate winter health risk score for each oblast was determined based on the hazard exposure, population vulnerability, and public infrastructure coping capacity. The regions are classified into three risk groups: low, medium and high. High risk is assigned to areas where high vulnerability, frequent low temperatures and low coping capacity intersect. Chernihiv, Sumy, Kharkiv, Donetsk, Zaporizhzhia, Luhansk, Dnipro, Kherson, and Mykolaiv oblasts are classified as high risk for public health.
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Support
The cold temperatures in the 2024-2025 winter season are not expected to differ in severity from those of previous years. However, in the context of people’s needs and reduced coping capacity in the regions, vulnerable populations across the country need support to survive the third winter of war. The frontline areas face increased risks of adverse health outcomes during periods of severe cold due to ongoing uncertainty, which affects the functionality and accessibility of health services and infrastructure. Vulnerable populations living in areas affected by the hostilities are at particular risk.
Continued support and preparedness efforts, including increasing vaccination coverage, providing alternative sources of heat and electricity, and implementing strategies to respond to severe cold, are crucial to mitigate these risks and protect the well-being of the affected population.
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