In short, it is very easy to die from passive game-state injury (especially Starvation, Thirst, and Bleeding) for players with a maxed-out Toughness skill investment, because it is extremely easy to miss all the visual cues that death is imminent. A fix would be to add better/more visual cues, and additional sound cues.
Suggestions for fix:
Add pulsing/flashing/passive (maybe settings-based) icons for when any stat bar is sub-25% (maybe 20, 10)
Add audio cues for passive damage (stomach growling for hunger, cartoon drying up sound for thirst, geiger counter for low radiation)
(Maybe override Toughness resistances when taking damage from Hunger, Thirst, and Radiation?)
Description of issue
While yes, you still visually take damage, the way the current skill system works means that these damage indicators can become extremely hard to see (which makes sense for a combat scenario for awareness), but also means that you may not receive visual (or even audible) indication until it’s far too late. This can be exacerbated by players with a small UI (especially on 1440p and similar), where active damage states may be missed.
In honesty, this post is somewhat of a mald, because this is the only way I’ve consistently died in PvE gameplay (PvP, obviously players are involved), despite having supplies to prevent it. Yes, this is a “skill issue” that I acknowledge I should have solved even after nearly 2000 hours of gameplay… But this is something that I realize could also be an accessibility issue, especially for newer players or those struggling to notice game-state details like this.