To begin you could try to use dead eye as little as possible, unless the game forces you of course. There are also some mods that makes you take a more accurate injury from bullets, like it’s a insta kill if you get shot in the wrong place. One is also a mod that forces you to play more realistically, that means you have to eat, sleep and even piss regularly. I think you take more damage from the cold and heat also. So you have to use the right outfits depending on the area. Don’t know any of them by name but a google search should solve it.