Cutting the Cost of Cold: Affordable Warmth for Healthier Homes

Book Cover......Page 1
Half-Title......Page 2
Title......Page 3
Copyright......Page 4
Editors’ note and acknowledgements......Page 5
Contents......Page 7
Abbreviations......Page 9
About the authors......Page 10
Cutting the cost of cold......Page 16
Introduction......Page 18
Part One: Current research......Page 30
1 Cold weather, cold homes and winter mortality......Page 32
2.1 Introduction......Page 40
2.2 Seasonal variation in mortality......Page 41
2.3 Relationship with housing......Page 42
2.4 Affordable warmth......Page 44
2.6 Conclusions......Page 48
3.1 Introduction......Page 50
3.2 Cold environment and the respiratory system......Page 51
3.3 Cold housing and respiratory health......Page 52
3.5 Hygrothermal conditions, mould growth and allergies......Page 53
3.6 Transmission of infections......Page 55
3.7 The elderly and vulnerable groups......Page 56
3.8 Seasonal respiratory mortality......Page 57
3.9 Conclusion......Page 59
4.1 Introduction......Page 62
EXCESS WINTER DEATHS AND AGE......Page 63
CAUSES OF WINTER DEATH......Page 64
LABORATORY STUDIES......Page 65
FIELD AND CLINICAL STUDIES......Page 66
4.4 Cold stress and behavioural risk......Page 68
SEASONAL DIFFERENCES IN ACTIVITY......Page 70
PHYSICAL ACTIVITY AND BLOOD PRESSURE......Page 71
IMPLICATIONS FOR HEALTH......Page 73
4.6 Conclusions......Page 74
5.1 The rising incidence in asthma......Page 76
5.2 Housing and health......Page 77
5.4 The house dust mite......Page 78
HOUSE DUST MITE ALLERGENS......Page 79
5.5 Asthma—pathology, sensitizers and triggers of asthma......Page 80
5.6 Prevention measures......Page 81
5.7 Meta-analysis......Page 82
5.8 An interventionist double-blind placebo controlled trial......Page 83
GENERATING THE SAMPLE......Page 84
HOUSE PERFORMANCE......Page 85
DUST MITE LEVELS......Page 86
ASTHMA MONITORING......Page 87
FANS......Page 88
SAMPLE SPLIT......Page 89
6.1 The sample......Page 92
6.3 The results......Page 93
PAYMENT OF BILLS......Page 94
HEALTH PROBLEMS......Page 95
6.4 Correlations between illnesses and housing problems (relating to aspects of fuel poverty)......Page 97
6.5 Children’s health......Page 98
6.6 Conclusions......Page 99
7.1 Introduction......Page 102
7.2 Aim of the Sheffield study......Page 103
7.3 Research design......Page 105
7.4 Results: Energy consumption and temperature......Page 109
7.5  Results: Moisture production, damp and mould......Page 112
7.6 Results: Health status......Page 113
7.7 Conclusion......Page 116
Part Two: Tools for research and practice......Page 118
8.1 Introduction......Page 120
8.2 The development of the AWI......Page 122
INCOME......Page 123
FUEL RUNNING COST......Page 124
AFFORDABLE WARMTH INDEX SCALE......Page 127
PENSIONERS’ ENERGY PLAN......Page 130
NATIONAL ENERGY ACTION (NEA)......Page 132
ABERDEEN CITY COUNCIL......Page 133
FIRST REPORT......Page 134
9 Mould Index......Page 136
9.2 Conditions for mould growth and dust mites......Page 137
9.3 Micro environmental conditions......Page 139
MOISTURE PRODUCTION......Page 140
MOISTURE TRANSPORT......Page 141
9.5 Internal temperature......Page 142
9.6 Relative humidity modelling......Page 143
9.8 Mould Index......Page 144
9.8 Conclusions......Page 147
10.1 Changing priorities......Page 148
10.3 Development of the methodology......Page 150
10.4 An indicator for ill health related to cold......Page 151
10.5 Low income indicator......Page 152
10.6 Housing energy performance......Page 153
10.8 Conclusions......Page 154
11.1 Prevalence of cold or damp housing......Page 158
11.2 Health, use of health services and cold, damp housing......Page 159
11.3 Modelling the costs......Page 160
11.4 General assumptions and limitations within the model......Page 161
11.6 Mental health problems associated with damp housing......Page 162
11.8 Estimated cost savings......Page 163
11.9 Limitations of this modelling approach......Page 164
11.10 Comparisons with other published estimated costs......Page 165
11.11 Recommended methodologies to guide policy......Page 166
Part Three: Inter-agency partnership in practice......Page 168
12.1 Introduction......Page 170
CHOOSING THE TARGET GROUP......Page 171
CHOOSING THE STUDY DESIGN......Page 172
CHOOSING THE OUTCOME MEASURES......Page 173
IDENTIFYING THE CHILDREN......Page 174
12.3 Effects on housing, symptoms and school attendance......Page 175
12.5 Interpretation of findings......Page 176
12.7 Policy considerations......Page 178
12.8 The future......Page 179
Acknowledgements......Page 180
13.1 Background......Page 182
13.2 The Study......Page 183
13.4 Results......Page 185
13.5 A partnership—real or imagined?......Page 186
13.6 The relationship in the partnerships......Page 187
13.7 Funding partners......Page 189
13.8 Operational partnership......Page 190
14.1 Health in your environment’ strategy......Page 192
14.3 Outcomes from the Energy Efficiency, Health and Environment Seminar......Page 193
14.5 Potential barriers to progress......Page 195
14.7 Building on success......Page 196
15.1 Urban decline......Page 198
15.2 An alternative approach......Page 199
15.3 Consultation......Page 200
15.5 Partnership......Page 202
15.6 Information, advice and practical assistance......Page 203
15.7 Health......Page 204
15.8 Community training......Page 206
15.10 Community builders’ list......Page 207
15.11 Resourcing work......Page 208
15.13 Communication......Page 209
15.14 Achievements......Page 210
15.15 Conclusion......Page 211
16.1 Introduction......Page 212
16.3 Case studies......Page 213
C. ENERGY ACTION FOR HEALTH......Page 214
F. BEAT THE COLD......Page 215
I. CORNWALL AND ISLES OF SCILLY......Page 216
BARRIERS TO MULTI-AGENCY WORKING......Page 217
HOW BARRIERS COULD BE OVERCOME......Page 218
16.5 Recommendations......Page 219
16.6 Conclusions......Page 220
Part Four: Ways forward......Page 222
17.1 The origins of the research......Page 224
17.2 The CEHI research programme......Page 225
17.3 Poor quality housing and ‘exported costs’......Page 226
17.4 A matrix of ‘exported costs’......Page 227
IN CENTRAL STEPNEY......Page 228
WORK IN HOLLY STREET HACKNEY......Page 230
PROGRESSIVELY REDUCE ‘SPATIAL FRACTURING’......Page 232
SENSITIVE NEIGHBOURHOOD AND HOUSING MANAGEMENT......Page 233
‘DESIGN OUT’ CRIME......Page 234
17.7 Conclusions......Page 235
18.1 Introduction......Page 236
18.2 Cold damp housing and health......Page 237
18.3 Use of NHS resources......Page 238
18.4 Understanding the evidence......Page 239
18.5 Using local health information......Page 240
18.6 Health service organisation and policy......Page 244
18.8 Assessing health and housing needs......Page 247
HEALTH PROMOTION......Page 250
JOINT INVESTMENTS IN HOME ADAPTATIONS OR IMPROVEMENT......Page 251
REGENERATION INITIATIVES......Page 252
18.8 Making the strategic links......Page 253
19 The unavoidable imperative cutting the cost of cold......Page 256
A funding model......Page 258
Private rented accommodation......Page 259
References......Page 266
Keyword index......Page 286