The Health Impacts of Cold Homes and Fuel Poverty
The Marmot Review Team was commissioned by Friends of the Earth to write this report which reviews the existing evidence of the direct and indirect health impacts suffered by those living in fuel poverty and cold housing. It makes the case for aligning the environmental and health benefits of reducing fuel poverty and improving the thermal efficiency of the existing housing stock.
To download the report, please click here.
Please click here for coverage of the report.
To read Michael Marmot's blog about the report, please click here.
To read about presentations and activities that have taken place since the publication of the report, (by the Marmot Review Team and others) please click here.
For our recent joint submission to the London Assembly on alleviating fuel poverty, please click here.
Fuel poverty is a long-standing health issue: the impact of cold housing on health and the stresses brought on by living in fuel poverty have been recognised for decades by researchers, medical professionals and policy makers alike. At the same time, it is an issue that often gets dismissed as the 'tough nature of things' because our housing stock is old and cold housing is so widespread that many have come to regard it as a normal state of affairs.
It should not be so. Cold housing and fuel poverty can be successfully tackled through policies and interventions if there is a will to do so. There is a social gradient in fuel poverty: the lower your income the more likely you are to be at risk of fuel poverty. Inequalities that are avoidable are fundamentally unfair - fuel poverty is avoidable and it contributes to social and health inequalities.
The Main Findings
The main findings on the direct health impacts of cold housing and fuel poverty are:
- Countries which have more energy efficient housing have lower Excess Winter Deaths (EWDs).
- There is a relationship between EWDs, low thermal efficiency of housing and low indoor temperature.
- EWDs are almost three times higher in the coldest quarter of housing than in the warmest quarter (21.5% of all EWDs are attributable to the coldest quarter of housing, because of it being colder than other housing).
- Around 40% of EWDs are attributable to cardio-vascular diseases.
- Around 33% of EWDs are attributable to respiratory diseases.
- There is a strong relationship between cold temperatures and cardio-vascular and respiratory diseases.
- Children living in cold homes are more than twice as likely to suffer from a variety of respiratory problems than children living in warm homes.
- Mental heath is negatively affected by fuel poverty and cold housing for any age group.
- More than 1 in 4 adolescents living in cold housing are at risk of multiple mental health problems compared to 1 in 20 adolescents who have always lived in warm housing.
- Cold housing increases the level of minor illnesses such as colds and flu and exacerbates existing conditions such as arthritis and rheumatism.
The main findings on the indirect health impacts of cold housing and fuel poverty and on other social benefits deriving from improved housing are:
- Cold housing negatively affects children's educational attainment, emotional well-being and resilience.
- Fuel poverty negatively affects dietary opportunities and choices.
- Cold housing negatively affects dexterity and increases the risk of accidents and injuries in the home.
- Investigating in the energy efficiency of housing can help stimulate the labour market and economy, as well as creating opportunities for skilling up the construction workforce.
Many different population groups are affected by fuel poverty and cold housing, with various levels of health impacts relating to different groups:
Children: significant negative effects of cold housing are evident in terms of infants' weight gain, hospital admission rates, developmental status, and the severity and frequency of asthmatic symptoms.
Adolescents: there are clear negative effects of cold housing and fuel poverty on the mental health of adolescents.
Adults: there are measurable effects of cold housing on adults' physical health, well-being and self-assessed general health, in particular for vulnerable adults and those with existing health conditions.
Older people: effects of cold housing were evident in terms of higher mortality risk, physical health and mental health.
Improving the energy efficiency of the existing stock is a long-term, sustainable way of ensuring multiple gains, including environmental, health and social gains.