Abstract
Background The Warm Front programme is a major energy efficiency initiative for England targeted at low income households. Its objective is to reduce fuel use and to improve indoor temperatures ‘to ensure that the most vulnerable households need no longer risk ill-health due to a cold home’. The health impacts of this programme have been the focus of a national evaluation over the winters of 2001–02 and 2002–03. Design Survey of dwellings in the scheme before and after energy efficiency improvements (new heating systems and/or other energy efficiency measures, including insulation and draught-proofing). It was focussed on households containing (a) family members over 60 years of age or (b) children < 16 years. Setting Dwellings in five geographical areas of England Methods Changes in physical conditions and health were measured in around 1100 pre-improvement and a similar number of post-improvement dwellings. Physical conditions, fuel use and energy ratings were assessed by trained surveyors. Indoor temperatures and relative humidity were recorded every 30 minutes over three week periods using data loggers. Thermal comfort, mental well being and health-related quality of life were assessed using standard instruments (Short Form, General Health Questionnaire, EQ5D) and contacts with the health service by questionnaire. In-depth interviews were also carried out in a sample of homes to gather information about changes in behaviours, and epidemiological modelling was used to estimate the impacts of the programme on mortality and hospital admissions. Cross-sectional comparisons were made between the pre- and post-improvement dwellings within each winter, and before-after comparisons were made of the pre-improvement dwellings from the winter of 2001–02 that were assessed again after improvement in 2002–03. Results Although the main results of the evaluation will not be available until autumn 2003, initial indications are that Warm Front improvements lead to appreciable improvement in energy efficiency, modest increases in indoor temperatures, substantial improvement in thermal comfort and significant benefits to quality of life. Epidemiological modelling also suggests modest but important reductions in cold-related mortality. The magnitude of these benefits is related to the type of improvement carried out and the type of households targeted. Conclusions The results to date suggest that energy efficiency improvement can be accompanied by appreciable benefits to health especially when targeted at vulnerable groups. We suggest that the evaluation of this scheme holds valuable lessons for improving population health through measures that also contribute to more sustainable lifestyles.
Published Version
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