the health risks of not turning on the heating in winter

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<p>People in the UK may be tempted to keep their heating off to offset steep increases in energy bills this winter.  A recent <a href=YouGov poll, revealed that 21% of respondents would not turn on their heating until at least November. Could the health of these people be in danger?

Before COVID, an average of 25,000 more deaths occurred between December and March than any other four month period of the year. Even if COVID didn’t exist, the cost of living crisis could mean the toll for next winter is worse than usual.

The groundhog review (a report investigating the effects of cold houses and fuel poverty) estimated that 21.5% of all excess winter deaths could be attributed to the coldest 25% of houses in the UK population.

This would suggest that 5,000 extra deaths occur in winter because people live in cold houses. But that doesn’t mean that cold houses cause the deaths. People who live in cold houses may have other disadvantages, which make them less able to survive the winter.

Would it make a difference whether they left their heating on or off? Studies suggest that temperatures should be maintained at minus 18℃ to minimize health risks, but is it easy to maintain if houses are poorly insulated?

Research into what is best for people’s health ideally relies on randomized controlled trials to tell us about cause and effect. But it would be unethical to conduct a trial where some people had to turn off their heating and others had to keep it on to see if it had any effect on mortality. Instead, we have to rely on what are called “longitudinal studies” where people are followed for many years and regularly answer questionnaires.

In one such study in the 1970s, the British Regional Heart Study recruited thousands of then middle-aged men from across Britain. In 2014, about 1,400 of these men, then aged 74 to 96, answered a questionnaire including home heating questions.

One question asked if, during the previous winter, the respondent had: “Turn off the heating, even when you were cold because you were worried about the cost? One hundred and thirty men (9.4%) said yes. These men did not seem more likely to die within two years than the men who answered no.

A larger study would have given a stronger answer. And in the absence of other direct evidence, we must draw conclusions from circumstantial evidence, such as this.

The most vulnerable

Recently, Swedish researchers attempted to assess a series of questions about the effects of energy consumption, energy poverty and improvements in energy efficiency on people’s health. They systematically reviewed all relevant studies on the subject. One of their findings consistently showed across four studies the link between fuel poverty and premature death.

The British Regional Heart Study showed that energy poverty was more likely to be found among single, poor and working-class people. This suggests that the most financially vulnerable people will be the most likely to leave the heating off. As with climate change, the poorest are the hardest hit.

So far I have only discussed the health effects in terms of death, which in the UK mainly affects older people. The winter deaths that do occur are usually the result of heart disease, stroke, and respiratory disease. Yet increasing attention has also been paid to the significant effects of cold weather on mental health.

The journal Marmot cited studies that drew attention to the depressive effect of living in a cold house. Children in adolescence may seek respite and privacy away from home, which puts them at mental health risk. The misery caused by financial pressures only adds to this burden.

Given that the most financially vulnerable people are also the most vulnerable health-wise, it should follow that government-level interventions are urgently needed to offset the likely health crisis looming from the COVID-19 pandemic. increase in energy costs.

The most vulnerable will need the most help. Yet a common paradox observed in public health is that interventions that apply to the whole population will save more lives than those that target only most at risk.

Indeed, there are many more people in the population at moderate risk than at high risk. Only a modest proportion of people at moderate risk will benefit. Yet, since this group is much larger than the high-risk group, more lives could be saved among those at moderate risk.

Buildings in the UK clearly need better insulation, but that sort of thing will come too late for this winter. Mitigating rising energy costs must be the only way forward to allow homes to be heated to a comfortable level and avoid a tidal wave of excessive winter deaths.

This article is republished from The conversation under Creative Commons license. Read it original article.

The conversation

Richard Morris conducted research on this topic while employed by UCL (until 2014) and the University of Bristol (2014-2020): these jobs were both funded by HEFCE.