Greater investment in home insulation and more help with heating costs for people living on low incomes could prevent thousands of unnecessary deaths each winter. This is the conclusion of a study carried out for the Joseph Rowntree Foundation by researchers from the London School of Hygiene and Tropical Medicine.
Britain has around 40,000 more deaths during December and March than expected from death rates in other months of the year, which is a larger ‘winter excess’ than in most other European countries, including Scandinavia. This is in spite of the fact that Britain has comparatively mild winters. The research team concludes that part of the explanation may lie with Britain’s ageing housing stock, which is less thermally efficient than in most other north European countries and may provide less protection against the cold.
The study matched mortality statistics for small, postcode neighbourhoods in England with data from a large national survey of housing conditions. It showed that:
There was a 23 per cent excess of deaths from heart attacks and strokes during the winter months compared with non-winter months. This seasonal increase in mortality was greatest among older people, but some rise was found for all ages.
The winter excess was especially marked among people living in homes that appeared to be poorly heated and with low energy-efficiency ratings.
There was a greater excess of winter deaths among people living in older properties (which are more difficult to heat) than recently built homes. The lowest risk was found among people in housing built since 1980 and the highest among those whose homes dated from before 1850.
Death rates in winter were around 20 per cent higher in the coldest 25 per cent of homes compared with the warmest 25 per cent.
Low indoor temperatures were, in turn, more likely if a property was old, had no, or inadequate, central heating, was costly to heat or the occupants had low incomes. People housed by local authorities or housing associations appeared especially likely to have low indoor temperatures during cold periods if their heating costs were high.
Dr Wilkinson, who led the research, said: "Taken as a whole, the results suggest a chain of causation that links older, poorly insulated, poorly heated housing and poverty to low indoor temperatures and cold-related deaths. Hence, it is likely that substantial health benefits could be achieved by measures aimed at improving the thermal efficiency of homes and the affordability of heating them."
He added: "Evaluations of the Government’s new Home Energy Efficiency Scheme should tell us more about ‘what works’ in preventing fatal illnesses in winter. But we need a wider debate about the ways that housing, energy and social policy can work together to reduce the level of excess winter deaths. In particular, we need to consider the types of energy efficiency programme and targeting methods that will deliver the greatest benefits to public health."
Richard Best, Director of the Joseph Rowntree Foundation, commented: "For years we have guessed that cold homes can kill: now, for the first time, we have strong, scientific evidence. National investment in insulation and better heating would not only improve the quality of life of older, poorer people – it would extend it."
