Winter conditions and impact on health Kas Hardy Public Health Specialist Lets Make Every Contact Count – All You Have To Do Is Ask Karen.hardy@kent.gov.uk (public health specialist)

Karen.hardy@kent.gov.uk (public health specialist) The effect of related winter conditions on health (Cold Weather Plan for England 2013, Public Health England) Temperature Effect 21°C (70°F) Minimum recommended daytime temperature for rooms occupied during the day 18°C (65°F) Minimum recommended night time bedroom temperature. No health risks, though occupants may feel cold Under 16° May diminish resistance to respiratory diseases 9-12° May increase blood pressure and risk of cardiovascular disease 5-8° Mean outdoor temperature threshold at which increased risk of death observed at population level 5° Poses a high risk of hypothermia Snow and ice Disruption to service provision, and reduction in access to essential services (including health and social care, transport and school closures. Increased risk of falls, injuries Lets Make Every Contact Count – All You Have To Do Is Ask Karen.hardy@kent.gov.uk (public health specialist)

Vulnerable people – who is at risk? People on a low income and/or in fuel poverty Pregnant women Households with young children (from new-born to school age) People with disabilities People with mental health conditions People with cardiovascular conditions People with respiratory conditions (in particular COPD and childhood asthma) People aged over 65 Lets Make Every Contact Count – All You Have To Do Is Ask Karen.hardy@kent.gov.uk (public health specialist)

Karen.hardy@kent.gov.uk (public health specialist) Excess Winter Deaths Definition: the winter period - December to March, and compares the number of deaths that occurred in this winter period with the average number of deaths occurring in the preceding August to November and the following April to July Usually calculated as a three year average to account for confounders, such as late or unusual weather conditions Often associated with winter flu viruses In common with other countries, in England and Wales more people die in the winter than in the summer Some association with cold homes Lets Make Every Contact Count – All You Have To Do Is Ask Karen.hardy@kent.gov.uk (public health specialist)

Karen.hardy@kent.gov.uk (public health specialist) National excess winter deaths Winter 2014-2015 Provisional ONS 25th November 2015 An estimated 43,900 excess winter deaths occurred in England and Wales in 2014/15; the highest number since 1999/2000, with 27% more people dying in the winter months compared with the non-winter months The majority of deaths occurred among people aged 75 and over; there were an estimated 36,300 excess winter deaths in this age group in 2014/15, compared with 7,700 in people aged under 75. There were more excess winter deaths in females than in males in 2014/15, as in previous years. Male excess winter deaths increased from 7,210 to 18,400, and female deaths from 10,250 to 25,500 between 2013/14 and 2014/15. Respiratory diseases were the underlying cause of death in more than a third of all excess winter deaths in 2014/15. Lets Make Every Contact Count – All You Have To Do Is Ask Karen.hardy@kent.gov.uk (public health specialist)

Karen.hardy@kent.gov.uk (public health specialist) Excess winter mortality index by underlying cause of death, England and Wales, 2012/13 to 2014/15 Lets Make Every Contact Count – All You Have To Do Is Ask Karen.hardy@kent.gov.uk (public health specialist)

Karen.hardy@kent.gov.uk (public health specialist) Small amount of Public Health Funding available to support vulnerable people (over 65 with health condition) for Sustainable solutions, through Warm Homes programme and district housing teams for 2015/16 Kent Fire and Rescue Service, offering home safety assessment, also have a small amount of winter warmth packs (Scarf, hat, gloves, hot water bottles, flask cup) Canterbury and Ashford CCG Pilot targeting 500 people with holistic approach For Further information, contact Kas (email below) Karen.hardy@kent.gov.uk (public health specialist)

Partnership Working NICE Guidance (March 2015) Recommendation 6: Non-health and social care workers, who visit people at home should: Refer anyone who needs help with the problems of living in a cold home to the local single-point-of-contact health and housing referral service, if they give their consent (see recommendations 2 and 3). Give people who may be vulnerable to the cold information on the effect that living in a cold home can have on their health and what can be done to remedy this. Lets Make Every Contact Count – All You Have To Do Is Ask Karen.hardy@kent.gov.uk (public health specialist)

Partnership Working NICE Guidance (March 2015) Recommendation 9: Train housing professionals and faith and voluntary sector workers to help people whose homes may be too cold for their health and wellbeing are aware of how cold housing can affect people's health and wellbeing can spot when and how someone is at risk of being too cold at home know of local services designed to address these problems understand how to refer someone for help Lets Make Every Contact Count – All You Have To Do Is Ask Karen.hardy@kent.gov.uk (public health specialist)

Kas Hardy Public Health Specialist Any Questions Kas Hardy Public Health Specialist Lets Make Every Contact Count – All You Have To Do Is Ask Karen.hardy@kent.gov.uk (public health specialist)