Variation in Cold-Related Mortality in England Since the Introduction of the Cold Weather Plan: Which Areas Have the Greatest Unmet Needs?

Peninah Murage,Shakoor Hajat,Angie Bone

doi:10.3390/ijerph15112588

Abstract

The Cold Weather Plan (CWP) in England was introduced to prevent the adverse health effects of cold weather; however, its impact is currently unknown. This study characterizes cold-related mortality and fuel poverty at STP (Sustainability and Transformation Partnership) level, and assesses changes in cold risk since the introduction of the CWP. Time series regression was used to estimate mortality risk for up to 28 days following exposure. Area level fuel poverty was used to indicate mitigation against cold exposure and mapped alongside area level risk. We found STP variations in mortality risk, ranging from 1.74, 1.44–2.09 (relative risk (RR), 95% CI) in Somerset, to 1.19, 1.01–1.40 in Cambridge and Peterborough. Following the introduction of the CWP, national-level mortality risk declined significantly in those aged 0–64 (1.34, 1.23–1.45, to 1.09, 1.00–1.19), but increased significantly among those aged 75+ (1.36, 1.28–1.44, to 1.58, 1.47–1.70) and for respiratory conditions (1.78, 1.56–2.02, to 2.4, 2.10–2.79). We show how spatial variation in cold mortality risk has increased since the introduction of the CWP, which may reflect differences in implementation of the plan. Combining risk with fuel poverty information identifies 14 STPs with the greatest need to address the cold effect, and that would gain most from enhanced CWP activity or additional intervention measures.

Highlights

Significant gains were made in reducing cold-related health burdens throughout much of the last century [1], there is evidence that risk reductions have plateaued in more recent periods [2].As such, cold-related health remains an important public health issue, especially in the UK. where burdens remain higher than many of its European neighbors [3]
We show how spatial variation in cold mortality risk has increased since the introduction of the Cold Weather Plan (CWP), which may reflect differences in implementation of the plan
We examined area variations in mortality risk and levels of fuel poverty, and used these two indicators to highlight areas where risk is worse than the national median, and where the proportion of fuel poor households is higher than average

Summary

Introduction

Significant gains were made in reducing cold-related health burdens throughout much of the last century [1], there is evidence that risk reductions have plateaued in more recent periods [2].As such, cold-related health remains an important public health issue, especially in the UK. where burdens remain higher than many of its European neighbors [3]. Significant gains were made in reducing cold-related health burdens throughout much of the last century [1], there is evidence that risk reductions have plateaued in more recent periods [2]. Cold-related health remains an important public health issue, especially in the UK. Where burdens remain higher than many of its European neighbors [3]. Whilst mortality is the most extreme outcome of cold exposure, other associated outcomes, such as increase in GP (general practitioner) consultations and hospital admissions, result in considerable burden on the health services. The cost that is associated with inadequately-heated private housing is estimated to be £848 million [4]. The full cost to society, including spending by social services, loss of productivity, and workplace absenteeism is not known

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