Fuel Poverty and Health NHS Health Scotland NHS Lanarkshire

Fuel Poverty and Health The WHO estimate that 30% of excess winter deaths (EWD) are due to cold indoor temperatures: this would equate to 1,218 of the 4,060 EWD in 2014-15 in Scotland; For the youngest age groups cold homes have been linked to asthma, chest, breathing and mental health problems, slowed physical growth and cognitive development; In older people they are directly linked to an increased risk of circulatory and respiratory diseases, exacerbation of arthritis, increased risk of falls and injury. Indirect impacts may include social isolation. Cold homes are linked to poor mental health, with an increase in temperature associated with reduced risk of anxiety and depression.

Fuel Poverty and Health Adults who report they lack heating to keep home adequately warm 6.4 x as likely to report their health is bad 3.4 x as likely to report they have a long-term illness Source: Poverty and Social Exclusion Survey 2012 With implications for wellbeing and health services

Fuel Poverty and Health Health and Social Care Integration brings together some NHS and local authority care services under one statutory, unitary partnership. The aim is to keep people healthy and at home and prevent hospitalisation or residential care. This means the home needs to be suitable for healthy living - whether in relation to grab rails, ramps, or the ability to achieve a warm home. Fuel Poverty Strategic Working Group Report, 2016

“Household income is a major factor when it comes to affordable living standards.” Households in Scotland, 2014 Income poor Not income poor Fuel poor Highest risk 377,000 Vulnerable to changes in housing costs, fuel costs and incomes (earnings and benefits) Subsidising households not living with them? Fuel-efficient stock ? – future residents and climate change 468,000 Not fuel poor May be unable to heat home to achieve thermal comfort, vulnerable to changing costs and incomes 76,000 Lowest risk, though some groups more vulnerable than others 1,498,000

Fuel Poverty Maps (Changeworks, 2014) Guidance Addressing Fuel Poverty – Guidance for Directors of Public Health (Arnot, Burnett, Taulbut, Walton, Mackie, Oct 2016) Fuel Poverty Maps (Changeworks, 2014) Fuel Poverty and Income Poverty: A Commentary (Mackie, Taulbut, Oct 2016) Fuel Poverty: Literature Overview & Bibliography (Arnot, Oct 2016)

So how do we make sense of all that? Where do I start

Addressing Fuel Poverty - Local Action Maximise uptake of energy advice and assistance by those in need Establish an understanding of the HEEPS and ECO schemes currently in operation in the local area and support patients to access the support available Support local and national research and evaluation studies looking at effective approaches to behaviour change in relation to fuel use amongst those supported by the NHS

Addressing Fuel Poverty - Local Action Explore what opportunities there are for sharing intelligence on fuel poverty and its health consequences – why, what how who questions? Link fuel poverty with work that seeks to identify financial insecurity individuals and households: Supporting access to benefits and financial advice can be extended to include advice to address fuel poverty through a range of measures Improve our understanding of people living in fuel poor households and energy (in)efficient dwellings, and the impact on their health – data linkage

Fuel Poverty and Health Donna Burnett NHS Health Scotland donna.burnett@nhs.net Carol Chamberlain NHS Lanarkshire carol.chamberlain@lanarkshire.scot.nhs.uk

QUESTIONS?