Transcript Dr Simon Dean Clinical Director Horsham and Mid Sussex Clinical

Fuel poverty,
cold homes
and health
Dr Simon Dean
What is Fuel Poverty?
Warm Homes and Energy Conservation
Act 2000:
“a person is to be regarded as living “in
fuel poverty” if he is a member of a
household living on a lower income in a
home which cannot be kept warm at
reasonable cost”.
Whoever would study medicine … must
consider the effects of the seasons of the
year and the differences between
them...(and) must study the warm and the
cold winds common to every country...
Hippocrates 400BC
15°c
25°c
• Cardiovascular (heart, stroke) and
respiratory causes of death are those
most strongly associated with cold
temperatures
• Elderly and those with impaired health
most likely to suffer
How does a lower air temperature
change our bodies?
•
•
•
•
•
Mild cooling air for 6 hrs
No change in core temperature
Whole blood viscosity increased by 21%
Increased platelet count
Blood pressure rose on average from 126/69
to 138/87
• HDL and LDL Cholesterol increased
• ‘Could account for cardiovacular thrombosis
increase seen in cold weather”.
…in the real world – heart attacks
vs ambient temperature
• 2008 study; England & Wales
• 84,000 hospital admissions for heart
attacks in 15 conurbations
• Each 1°c fall associated with 2%
increased risk of heart attack
• This equates to 200 extra heart attacks for
every 1°c fall in ambient temperature
Effective home heating and
children with asthma
• 2007, New Zealand study
• Compared to the control group, children
had 1.8 fewer days off school, 0.4 fewer
visits to Doctor for asthma and
significantly less asthma symptoms.
Excess Winter Deaths (EWD)
• Measure of the excess deaths December to
March
• Countries with cold winters (eg Finland,
Germany) don’t have EWD
• Heart, stroke and respiratory disease have
higher winter death rates but cancer doesn’t
• No clear association with influenza or with
deprivation indices
• Housing standards and socioeconomic
conditions thought to be the most significant
factors influencing EWD
2014