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.
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 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.