A Social Housing Guide to Eliminating Fuel Poverty

Fuel poverty can have a detrimental and profound impact on both residents and landlords. Not only are there health implications for residents living in fuel poverty, but it also increases the rates of property condensation, damp and mould issues as well as a host of other unintended side effects.

Social housing bears the brunt of this problem (likely due to its role in housing the country’s most vulnerable people) – and so it is up to social housing providers to take a proactive and innovative approach to the issue. Generally speaking, fuel poverty rates have remained stable over the last few decades – so the housing sector needs to take an honest look at what they are doing, how effective it actually is and if there are any other approaches that might help to combat the issue.

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What is an underheated home?

2.53 million households in the United Kingdom are currently facing fuel poverty. This is a growing, and deadly, problem that is facing both social and private residents. The NEA notes that last winter, there were a further 28,300 excess winter deaths as a result of living in cold homes – many of which will take place in social housing. Residents living in a cold home are exposed to a range of health risks, including high blood pressure, pneumonia and even hypothermia. Those with pre-existing conditions such as asthma, diabetes, arthritis, depression and anxiety are at risk of their conditions worsening. These risks are even greater for the most vulnerable in society.

Alongside this, an under-heated property can also facilitate an increase in condensation. With a reduced home temperature, moist air comes into contact with a cold surface more often, condensing to become liquid. The resulting damp conditions encourage mould growth that can have damaging effects on a resident’s health, the properties fabric, as well as the contents within it. Mould is known to cause a range of respiratory problems and allergic reactions to residents exposed to it. This leaves residents who are already struggling, vulnerable not just to the effects of the cold house but also to the negative effects of mould.

The widely accepted definition of an underheated home is a household at a temperature below 16°C. Households consistently heated below this temperature are considered at risk of fuel poverty. The World Health Organisation has even stricter guidelines, recommending keeping indoor temperatures above 18°C. If infants, elderly or sick people are present, this temperature should rise to above 21°C. Studies have proved that temperatures between 12-16°C raise a resident’s risk of respiratory disease. When temperatures are below 9°C residents have even more severe hazards, with an increased risk of hypothermia.

Over the past 40 years, there have been major improvements to the number of underheated properties in the UK – primarily thanks to the dispersion of central heating and improved insulation standards. As a result, the average UK indoor temperature has risen from 12°C in 1970 to 18°C today. Even more positively, the UK norm for thermostat settings is 20°C for eight hours per day during the winter months.

Despite all of these improvements, the UK is still facing a major fuel poverty crisis. It has one of the highest excess winter mortality rates in northern Europe and the rising cost of fuel bills are disproportionately impacting the most vulnerable demographics. The elderly are especially vulnerable to fuel poverty – as they spend more time at home so they need to be able to afford to heat their homes for longer. Poor families are also affected, facing the choice to ‘heat or eat’ – sacrificing a warm home for a healthy diet or vice versa.

The Human Cost of Fuel Poverty

The human cost of Fuel Poverty is enormous, both in terms of deaths and in terms of suffering. In the UK, 9,700 excess winter deaths (EWD) every year are attributed to people living in a cold home. That is the same number of people that die from breast or prostate cancer. Of these, approximately 3,200 deaths are directly linked to people experiencing fuel poverty. The graph below shows where cold homes and fuel poverty rank in causes of death in the UK.

Given the magnitude of the problem, it should come as no surprise that The National Institute for Health and Care Excellence (NICE) recognises health risks associated with cold homes as a priority. They note that deaths related to cold homes can cost the NHS £1.36bn a year, an estimate that excludes costs related to social care services. Further than that, a recent Chief Medical Officer report states that for every £1 invested in keeping homes warm the NHS saves 42 pence in health costs. The social value gained from helping vulnerable people efficiently heat their homes, therefore, is enormous.

To highlight the scale of the problem the UK faces, it has the sixth-highest excess winter mortality (EWM) index in Europe. Worse yet, four of the five countries ranking worse than the UK are ‘warm’ southern European Countries. Of the European countries most consistently exposed to cold weather, the UK and Ireland are the worst performers.

EWM index for 30 European countries, 1980-2013(Liddell et al., 2016)

The UK’s high EWM position is due primarily to the poor thermal condition of our ageing property stock. A Friends of the Earth report found a significant increase in EWM rates in older properties. Properties built before 1850 had a 28.8% EWM rate, compared to 15% in properties built after 1980. The report goes on to highlight the strong link between EWD and lower indoor temperatures. Residents in the coldest 25% of properties had a 20% higher risk of death than those in the warmest properties. The report concluded “that winter mortality and cold-related mortality are linked to sub-optimal home heating.’’ These findings highlight building construction as the primary factor in our underheating crisis – with colder countries, which have had higher building standards than the UK for many years, having much lower rates of excess winter deaths.

The Health impacts

There are numerous areas in which fuel poverty has an impact on vulnerable people’s health. Some of these are direct health impacts, such as circulatory and respiratory problems, and some of them are indirect. All of them, however, have negative effects on resident’s lives.

Circulatory problems 

Cold conditions are associated with an increased risk of circulatory problems. Cold temperatures, especially those below 12°C, can result in significantly raised blood pressure. Blood vessels narrow, increasing the thickness of the blood as more fluid is lost from circulation. Increases in blood pressure and blood viscosity like these increase the risk of strokes and heart attacks.

A study of people aged 35-64 in 21 countries found a considerable increase in the number of fatal heart attacks in cold periods. The study also found that cold temperatures affect both high and low-risk groups equally. In housing, research shows the correlation between the improved thermal efficiency of a property and improvements in circulatory health. One such study showed significant falls in blood pressure, use of medication as well as hospital admissions amongst individuals living in properties with improved thermal efficiency. Conversely, no changes in blood pressure were detected for those living in properties that had not been upgraded.

Respiratory problems

Respiratory problems such as coughs and colds are common in cold conditions. Multiple studies have concluded that cold air impedes respiratory performance. This is because when exposed to cold air the bronchi in the lungs constrict thereby increasing mucus production and decreasing mucus clearance. A recent study proved that amongst adults, increased respiratory-related hospital admissions caused by cold temperatures can be attributed to fuel poverty. When a similar study was conducted focused on the effects that this has on children, these conditions were explicitly linked with the cold condition of the children’s housing.

To make matters worse, condensation and damp, also caused by cold housing conditions, compounds respiratory problems. Mould growth can trigger allergic reactions such as asthma in both adults and children. Children living in damp, mouldy homes are 1.5-3x times more prone to coughing and wheezing than those in dry homes and twice as likely to suffer from asthma and bronchitis. Children that develop asthma at a young age can have long-term or even lifelong symptoms. This comes with a significant social cost to the greater society, with the NHS spending £847 million in 2008  (approximately 1% of its annual budget) on treating and preventing asthma.

Mental health problems

Until recent years, the link between mental health and an adequately heated home was weak. However, the proliferation of mental health research since the turn of the century has highlighted the impact on mental health for residents living in under-heated homes.

A study by the Warm Front and Scottish CHP found that as average bedroom temperature rose, the chances of the occupant avoiding depression increased as well. Those with bedroom temperatures of 21°C were found to be 50% less likely to suffer depression and anxiety than those with bedroom temperatures of 15°C. Similarly, another study found that young people living in cold homes had a 28% chance of having mental health symptoms compared to 4% among those living in warm homes.

Indirect health problems

An under-heated home can have more far-reaching impacts than the immediately recognisable circulatory, respiratory and mental health problems. It can impact low-income residents more severely by reducing their disposable income and affecting their life choices. They face the impossible choice to ‘eat or heat’ – either having to spend less money on a sufficient, healthy diet (and thus negatively impacting their physical health), or less on heating their properties to a healthy temperature.

A 2003 report on cold weather and nutrition on poor American families found that during periods of cold, spending on food decreased by a similar amount to the extra spent on heating. The report also noted that during these cold spells, both adults and children consumed 200 calories less per day.

Unsurprisingly, the indirect health problems of underheating impact the young and the elderly the most. The elderly are more prone to domestic accidents and have an increased risk of falls. Furthermore, they can feel socially isolated – high heating bills prevent them from going out, they don’t wish to return and are shown to have a reluctance to invite friends around.

For young people, living in an under-heated home is associated with reduced academic performance. With a cold home, young people find themselves having no place to do academic work comfortably. This negatively impacts a child’s academic development, and subsequently, work opportunities in later life.

The Property Impacts

There are a few major issues that arise in property condition from underheating. The first is the damage done by the cold itself. This includes burst pipes and damage to building fabric caused by rapid temperature swings. These repairs are often expensive, and unnecessarily regular if the behaviour of a resident doesn’t change.

The greatest effect on a property’s condition, however, is from the facilitation of condensation, damp and mould (CDM) growth. Mould grows well on paper, cardboard and wood, as well as damaging paint and insulation. Remedial fixes for these smaller issues can be high, with estimated damage of around £700 per property to the properties paint and plaster.

Further improvements that are often needed to combat the condensation, damp and mould problem are also expensive. Implementing building fabric upgrades such as external wall insulation and ventilation can cost an average of £1,500 per property. These actions are often needed to tackle the root causes of the condensation, damp and mould, as well as to reduce the impact it is having on the residents. Unfortunately, if the installation of insulation isn’t carried out alongside increased ventilation it can cause condensation, damp and mould as housing providers have been finding out over the last few years.

However, the costliest impact of condensation, damp and mould can be disrepair claims – whereby a resident claims their property has fallen into disrepair due to neglect from their landlord, and consequently, it has deteriorated their quality of life. The average cost of disrepair claims is just under £11,000 per case. If you would like to know more about condensation, damp and mould as well as techniques that can be deployed to combat it – you might find more from our whitepaper.

Preventing under heating

Over the past few decades, the UK has invested heavily into building properties to the highest energy efficiency standards. Likewise, there has been substantial investment into improving the efficiency of existing housing stock. However, 11.1% of households in England still live in fuel poverty. Preventative measures like those listed below can help to prevent a home from being under-heated and becoming cold:

Traditional Methods:

Insulation

Insulation is usually the first thing that housing providers turn to when addressing a fuel poverty issue (apart from financial advice). Insulation helps to improve the energy efficiency of a property by preventing warm air from escaping from the property. Before adequate insulation, warm air can escape from a property in all directions – from the roof, floor, walls, windows and doors. Insulation can be one of the most effective ways to warm a resident’s home and reduce their energy bills.

This has two big caveats though. The first is that insulation can be significantly more expensive to install depending on the property construction. If a property has solid construction walls, it will not be possible to install cavity wall insulation and so relies on more expensive external wall insulation. If a property has solid floors – the same is true and it might not be possible to further insulate a roof. The second issue is that without careful implementation, insulation might improve the energy efficiency of a property but massively increase the properties condensation, damp and mould problems. This is because, before the insulation installation, the property was venting high humidity air regularly to the outside. With the new insulation, that air is now trapped inside – increasing the internal relative humidity and causing condensation. Insulation as a solution to fuel poverty, therefore, needs to be considered and monitored to ensure no unexpected side effects occur.

Windows

Another seemingly obvious solution to fuel poverty is to simply upgrade the windows and doors of the property. Windows and doors can be a massive source of ‘natural ventilation’ – as over time the seals can weaken. The property can also shift, creating new gaps around windows and doors and allowing cold external air into the property in an unregulated way. Installation of double glazed windows and doors is a good solution to this problem – as it can significantly reduce the resident’s perception of a draught. It will also improve the efficiency of the heating system – allowing the house to retain more heat.

Additionally, cheaper draught-proof strips can be installed along windows and doors to further reduce air transfer. This is a very good option for many housing providers, but with several green-focused grants over the last couple of decades, a huge number of properties have been given new windows and doors already. This limits how effective this tactic is over an entire property portfolio.

Timed or smart ventilation fans

The breadth of options available with ventilation systems nowadays can be daunting but the basic principle is as follows. An appropriate installation of a smart ventilation system will reduce the overall amount of air transferred between the inside of the property and the outside. This is because it is only active when it is needed (for example when relative internal humidity reaches a certain level). This ensures that additional heat is not lost through a ventilation system running unnecessarily.

This has a very positive secondary effect of reducing the occurrences of ventilation deactivation. When residents feel as if their heat is being wasted through a ventilation system, they are likely to turn it off. This results in a build-up of moisture and an increased rate of mould. When a fan is not noticeably impacting a resident’s heating bill – they are far less likely to deactivate it. Add into this a heat-recovery ventilation system (which will reduce the wasted heat through ventilation), and housing providers can reduce the occurrences of mould, without the penalty to heat. Unfortunately, the more advanced the system, the more likely the cost is going to increase – and installation of a full ventilation system can be extremely expensive depending on the construction of the property.

Curtains

The final, but surprisingly effective, option when combatting fuel poverty is simply to install good quality curtains. As surprising as it might seem, a good pair of curtains can reduce the heat lost by as much as 60% for single-glazed windows and 40-50% for double glazed. This is not an approach that will work in most places as properties are likely to already have curtains (and likely they are owned by the resident). But it is nonetheless an option in the arsenal when looking to keep people warm.

Technological Solutions

Smart thermostats

Smart thermostats, especially those like Switchee, have an obvious effect on fuel poverty as well as another slightly less well-known effect. A smart thermostat helps a resident more effectively heat their home. It does this in a couple of ways. The first is that it can learn and understand a heating pattern in a property and then apply more optimal heating settings to improve the efficiency of heating a property in the way the resident wants. The thermostat also gives residents much quicker and easier access to the heating settings. A traditional thermostat is not particularly user friendly and does not often have a lot of customisation in the way it works. Smart thermostats have apps that let residents remotely control the heating as well as much more user-friendly interfaces. All of this improves the heating efficiency – in Switchee’s case, it increases the efficiency by upwards of 15%.

The second, and slightly less well known, way that smart thermostats can help reduce fuel poverty is through data-based alerts. The same data that is helping residents heat their properties better can also be used to understand the risks of a host of issues – including fuel poverty and mould. With this information, and a remote notification sent straight to a housing provider, resident liaison officers can intervene quicker in cases of fuel poverty. This data can also help housing providers to understand what about the property might be improved to lessen the issues. Research has shown that the earlier an intervention is made in fuel poverty cases, the better the outcome for the resident.

Smart meters

Smart meters can counteract fuel poverty in a similar way to smart thermostats. Their data can help housing providers remotely understand a property and address an individual property or resident’s issue. This prevents the ‘everyone gets new windows’ approach of previous decades – which has wasted a lot of resources on those that were not struggling to begin with and hasn’t addressed the problem for many struggling households that need other changes made to their property.

Summary

Fuel poverty in social housing is obviously a big and growing problem. Unfortunately for most housing providers, the drivers for fuel poverty are very often external to them. Poor economic conditions, increasing fuel prices and a particularly cold winter are all factors in fuel poverty that housing providers cannot control. The health side effects of fuel poverty also cannot be understated. With 9,700 deaths a year due to fuel poverty and many more thousands suffering mental health issues, pneumonia and heart attacks – this is not a problem that can simply be ignored. By the very nature of social housing, the most vulnerable to these effects are housed by the UK’s councils and housing associations. 

Unfortunately tackling the problem is not simply the case of installing new insulation in every property. Solutions need to be thought out and individual. What works for one property and one family will likely not work for another. Therefore, data is king when it comes to creating a sustainable solution to fuel poverty. Pinpointing properties requiring attention allows landlords to act and repair quickly. Proactive intervention enables better targeting of resources, resolving damp and insulation deficiencies more quickly, saving money and improving living conditions for residents. Understanding an entire stock, looking to intervene early and finding direct solutions to each problem is the only way that housing providers are going to be able to rid themselves and their residents of fuel poverty in the next 20 years.

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