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ENERGY POVERTY HANDBOOK

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• Research on the

• Research on the health impact of cold homes and energy poverty has also tended to focus upon discrete disciplines such as epidemiology, housing, energy efficiency and energy provision. Research often adopts a single discipline approach rather than examining the interrelationship between these factors. There has also been a tendency to ignore the role of human behaviour in keeping warm at home. Fundamental to understanding the health impact of cold homes and fuel poverty is a need to understand how various factors influence householders’ behaviour and choices in terms of risks, experiences and responses, especially those from vulnerable groups. • The lack of in-depth behavioural insight of all at risk groups. There is a lack of granularity and a tendency towards generalisations e.g. policy references to disability without breaking down and understanding different types and severity of disability. Future research needs to acknowledge that variation and examine energy poverty experience and behaviour across different groups, across the life course. • Excessive heat impacts on health are very under-researched and poorly understood. There is a corresponding gap in knowledge about summertime energy poverty issues, relating to access and affordability of air conditioning, everyday practices and coping strategies, and the flexibility of the built environment. • More generally, there is an overall lack of evidence, which in part can be attributed to the complexity of the topic, as well as the absence of appropriate data. on individual circumstances, and will vary in intensity depending on pre-existing conditions and levels of social support. Via the two case studies for Katie and Nigel we have provided some insight into the everyday lived experience for people in energy poverty and highlighted the cumulative effect of stress and anxiety. Beyond this, we have also considered some of the key challenges for understanding and addressing the impact of energy poverty on human health. On the basis of evidence and information presented, a number of policy recommendations can be made: 1. There is a need for long-term strategic planning for winter preparedness via national and regional Cold Weather Plans. See for example Public Health England (2015a; 2015b). 2. Investment in energy efficiency and housing improvements should be prioritised for energy poor households, in order to potentially realise significant reductions to public expenditure on health care, and decrease the number of preventable deaths and illnesses. 3. Greater funding should be allocated for multi-disciplinary scientific research to establish the precise interaction of cold housing and energy poverty with health and well-being, the extent to which EWM can be attributed to energy poverty, and to assess which interventions are most effective. conclusions and policy recommendations Over the course of this chapter we have identified population vulnerability to both high and low outdoor temperatures, and the existence of seasonal mortality rate increases. We have discussed the widely used EWM metric, and considered a new method for quantifying cold-related mortality. From the existing scientific literature, we have established that living in a cold home and experiencing energy poverty is associated with a broad range of physical, psychological, and social health morbidity impacts, although the precise nature of these relationships is dependent 52 HEALTH IMPACTS OF COLD HOUSING AND ENERGY POVERTY HEALTH IMPACTS OF COLD HOUSING AND ENERGY POVERTY 53

notes 1 Acknowledgments: This chapter was supported with funding from the European Research Council under the European Union’s Seventh Framework Programme (FP7/2007–2013)/ERC grant agreement number 313478. 2 http://kwillt.org/ 3 http://www.winterwarmthengland.co.uk/ references braubach, m., jacobs, d.e. and ormandy, d. (2011) Environmental burden of disease associated with inadequate housing. Denmark: WHO Regional Office for Europe. ekamper, p., van poppel, f., van duin, c. and garssen, j. (2009) 150 Years of temperature-related excess mortality in the Netherlands. Demographic Research, 21(14): 385-426. emerson e., hatton c., robertson j. and baines s. (2014). Perceptions of neighbourhood quality, social and civic participation and the self-rated health of British adults with intellectual disability: cross-sectional study. BMC Public Health, 14:1252. gilbertson j., bashir n., cronin de chavez a., tod a., sanderson e. and wilson, i. (2013) An evaluation of the FILT Warm Homes Service. Retrieved from: http://www4.shu.ac.uk/research/cresr/sites/shu.ac.uk/ files/eval-filt-warm-homes-summary.pdf Accessed: 07-10-2016. gilbertson j., grimsley m., green g., warm front study group (2012) Psychosocial routes from housing investment to health: Evidence from Englands home energy efficiency scheme. Energy Policy, 49: 122-133 healy, j. d. (2003) Excess winter mortality in Europe: a cross country analysis identifying key risk factors. Journal of Epidemiology and Community Health, 57: 784-789. international energy agency (2014) Capturing the multiple benefits of energy efficiency. Retrieved from: http://www.iea.org/publications/free publications/publication/Captur_the_MultiplBenef_ofEnergyEficiency.pdf Accessed: 07-10-2016. liddell, c. and guiney, c. (2015) Improvements in household heating and insulation and their associations with adult mental health and wellbeing. Public Health, 129(3): 191-199. liddell, c., morris, c., thomson, h. and guiney, c. (2015) Excess winter deaths in 32 European countries: a critical review of methods. Journal of Public Health, doi: 10.1093/pubmed/fdv184 liddell, c. and morris, c. (2010) Fuel poverty and human health: A review of recent evidence. Energy Policy, 38(6): 2987–2997. macinnes t., tinson a., gaffney d., horgan g. and baumberg, b. (2014) Disability, long term conditions and poverty. New Policy Institute. Retrieved from: http://npi.org.uk/files/7814/0490/1005/Disability_long_ term_conditions_and_poverty.pdf Accessed: 07-10-2016. marmot review team (2011) The health impacts of cold homes and fuel poverty. London: Friends of the Earth. middlemiss, l. and gillard, r. (2015) Fuel poverty from the bottom-up: characterising household energy vulnerability through the lived experience of the fuel poor. Energy Research and Social Science, 6: 146-154. doi: 10.1016/j.erss.2015.02.001 mzavanadze, n. (2016) Draft methodology for quantifying social welfare impacts. Manchester: COMBI project. national institute for health and care excellence (nice) (2015) Excess Winter Deaths and Morbidity and the Health Risks Associated With Cold Homes. Retrieved from: http://www.nice.org.uk/guidance/ng6 Accessed: 01-08-2016. nelson, p., tod, a. m., powell-hoyland, v., cronin de chavez, a. and stocks, a. (2014) Warm Well Families Executive report. Available at: https://www.shu.ac.uk/?sc_itemid=0C5D5C57-1F6B-4D9B- 90FA-9EE41A116DB4 Accessed: 10-2016. public health england (phe) (2015a) Cold Weather Plan for England. Making the case: why long-term strategic planning for cold weather is essential to health and wellbeing. Retrieved from: https://www.gov.uk/ government/uploads/system/uploads/attachment_data/file/365269/CWP_ Making_the_Case_2014_FINAL.pdf Accessed: 07-10-2016. public health england (2015b) The Cold Weather Plan. Protecting health and reducing harm from cold weather. Retrieved from: https://www. gov.uk/government/uploads/system/uploads/attachment_data/file/365756/ CWP_2014.pdf. Accessed: 07-10-2016. rudnick, a., montgomery, p., coatsworth-puspoky, r., cohen, b., forchuk, c., lahey, p., perry, s. and schofield, r. (2014) Perspectives of social justice among people living with mental illness and poverty: a qualitative study. Journal of Poverty and Social Justice, 22(2): 147-157. 54 HEALTH IMPACTS OF COLD HOUSING AND ENERGY POVERTY HEALTH IMPACTS OF COLD HOUSING AND ENERGY POVERTY 55

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