1. Fuel poverty, cold homes and health Dr Simon Dean

2. 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”.

4. 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

5. 15°c25°c

6. 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

7. 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”.

8. …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

9. 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.

10. 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

11. 2014