Cold Comfort: The Social and Environmental Determinants of Excess Winter Deaths in England, 1986-96

Cold Comfort: The Social and Environmental Determinants of Excess Winter Deaths in England, 1986-96

Cold Comfort: The Social and Environmental Determinants of Excess Winter Deaths in England, 1986-96

Cold Comfort: The Social and Environmental Determinants of Excess Winter Deaths in England, 1986-96

Synopsis

The UK government has recently introduced a new home energy efficiency scheme (known as Warm Front) to improve the energy efficiency of dwellings of those on low income. The aim of this scheme is partly to tackle the adverse health consequences (including winter death) of inadequate home heating. This is the first study to make a direct connection between the risk of winter mortality and housing quality in England. It demonstrates that people living in homes that are difficult or costly to heat are at increased risk of winter/cold-related death.

Excerpt

Britain has a large winter excess of mortality, which is greater than in many other European countries. Although the reasons for our poor position are not clearly understood, much of the winter increase in mortality is attributable to the direct or indirect effects of cold, and there are strong theoretical reasons to think that inadequate home heating may be an important risk factor.

This research aimed to investigate this, using both seasonal and daily time-series analyses. the results provide evidence that the substantial winter–summer difference in mortality is indeed related to indoor temperature and to dwelling characteristics that are determinants of indoor temperature. Moreover, indoor temperatures predicted from household and dwelling characteristics appear to influence the seasonal pattern of mortality and, more specifically, the strength of association between low outdoor temperatures and cardiovascular death. People living in dwellings that are intrinsically cold had a substantially larger seasonal swing in death rates and a greater percentage rise in mortality for each degree Celsius fall in outdoor temperature.

Although not conclusive, these findings suggest that indoor temperature and markers of the thermal efficiency of dwellings, including property age, are determinants of vulnerability to winter death from cardiovascular disease. This suggests that substantial public health benefits can be expected from measures that improve the thermal efficiency of homes and the affordability of heating them. Evaluations now underway of the government’s hees should provide evidence on this. However, wider debate is also needed to consider the forms of housing, energy and social policy that are likely to deliver the greatest public health benefits in relation to winter death.

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