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Frostfall makes it so you can freeze to death, and with the Campfire mod, you can build a little temporary camp to survive. Eat, Sleep, Drink, Bathe is another mod that adds survival stuff to it. You get buffs and debuffs by managing thirst and hunger and sleep.
Then there's Alternate Death, which makes things more interesting. You don't automatically die, you go into your own NPC bleed out state, and if you survive long enough in that state, you get back up, just with low health.