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The best New Year’s Resolution is to resolve to survive – new evidence that Christmas and New Year elevate your chances of dying.

Raj Persaud and Peter Bruggen

View of London at dawn - picture by Raj PersaudA study published by academics at the University of California has established that Christmas and New Year are significant risk factors for death. Using all official  U.S. death certificates, from 1979-2004 (57,451,944 deaths), David Phillips, Gwendolyn Barker and Kimberly Brewer have established that in the two weeks starting with Christmas, there is an excess of 42,325 deaths from natural causes, above and beyond the increase usually put down to winter.

Christmas and New Year appear to be risk factors for deaths from many diseases, with holiday spikes for each of the top five (circulatory; neoplasms; respiratory; endocrine/nutritional/metabolic; digestive), conclude the authors in their study published in the academic journal ‘Social Science and Medicine’. It’s not just the general time of the year either, that can be blamed, as on Christmas and New Year mortality from natural causes spikes on those specific days, in dead-on-arrival cases arriving at the emergency department, plus those who die in emergency departments themselves.

Indeed the authors found there are more Dead-On-Arrival and Emergency Department deaths on Christmas, the day after Christmas, and New Year than on any other day of the year. They argue mere cold or adverse weather by itself couldn’t produce such distinct spikes found in their death data.

The authors also reject the famous ‘death postponement’ theory, which is that very ill people may ‘hang on’ until a significant date for various powerful psychological reasons (maybe they want to make it to that day perhaps to celebrate one last time with the family), therefore ‘postponing’ death.  But the authors argue, such a  “postponement hypothesis” would mean Christmas and New Year death spikes should be preceded by a compensatory decline in mortality. No such decreases are evident from their data.

The investigation examined death certificates where substance abuse was mentioned as a factor in the death, but could see no pattern incriminating such abuse in the increased death rate at this time.

The authors of the study – entitled ‘Christmas and New Year as risk factors for death’, speculate  medical care may worsen at this time, because health care professionals are more likely to be on holiday, while the number of patients coming through the emergency department might increase at this precise time.

Phillips and colleagues suggest evidence for this theory comes from the fact Emergency Department overcrowding has apparently worsened over time in the USA, and these death spikes were found to also increase in recent years, just as would be expected if they were associated with ever more overcrowded Emergency Departments. entering tunnel in Austria - picture by Raj Persaud

Another possibility is that during the holiday season many may postpone medical treatment which they otherwise would seek during a more normal time, so unknowingly dicing more with death.

There has recently also been a relatively new syndrome described as “holiday heart” which it seems could be more likely at this time, even in those with no previous cardiac problems. ‘Holiday heart’ is developing a temporary heart rhythm disturbance due to unusual circumstances more likely found during a break. The irregular heartbeat usually corrects itself shortly but can be ignited by dehydration, strain and excessive alcohol intake. Getting older, alcohol tolerance might lessen with even moderate quantities producing episodes of ‘holiday heart’.

Perhaps a clue as to another possible cause comes from the finding of death peaks for all age groups except children. Is it possible psychological stress could be a factor; Christmas and this season are not meant to be as demanding for children, as possibly for adults?

The authors of the study accept that psychological stress levels may indeed fluctuate around Christmas and New Year, but complain there is no adequate measurement of stress to allow a proper testing of this theory. It is also notable that although data is conflicting, many studies find a general decline in suicide rates during the holiday season, yet a sharp rise afterwards. The authors wonder, however, about how heightened psychological stresses could cause abrupt, sharp increases in mortality across such a wide range of different diseases and across practically the whole population.

Whatever the cause – the study is enough to suggest you should be careful and look after yourself at this time of the year.

Maybe the best New Year’s resolution is to resolve to survive. We wish you well and may you live as long as you want.


Christmas and New Year as risk factors for death. David Phillips, Gwendolyn E. Barker and Kimberly M. Brewer. Social Science & Medicine 71 (2010) 1463-1471.

sunset in Austria - picture by Raj Persaud taken with phone!

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