1. Energy Efficiency is good for your health Pamela Akerman 20 October 2009

2. Energy efficiency is good for your health Excess winter deaths Fuel poverty Uptake of Warm Front grants Housing factors Benefits uptake Actions

3. Excess winter deaths 4 winter months (Dec – Mar) Relation to a cold snap – Heart attack 2 days – Stroke5 days – Respiratory disease12 days

5. Number of excess winter deaths in England & Wales from 1950 to present

6. Excess winter deaths – Tip of an iceberg of misery Approx 1 in 20 of all deaths are excess winter deaths For each excess winter death, there is an estimated 8 emergency admissions each winter and over 100 households living in fuel poverty.

7. Indoor v outdoor cold Indoor temperature – 20% difference in EWDs between coldest and warmest homes 1 o fall in outdoor temperature – 2.8% mortality rise in coldest 10% homes – 0.9% mortality rise in warmest 10% homes (Wilkinson 2001) 1 o fall in average outdoor temperature – 8000 extra winter deaths in E&W

9. Fuel Poverty A household in fuel poverty spends more than 10% of its income to provide an adequate standard of warmth (21 o C living room, 18 o C other rooms) UK Fuel Poverty strategy to end fuel poverty in vulnerable households by 2010 and in all households by 2016

10. Cold Homes A home that is too cold can increase the risk of – Respiratory illness (secondary infections to colds or “flu” including bronchitis and pneumonia) – Heart attacks and strokes – Hypothermia (in vulnerable people if exposed to temp less than 9C for 2 hours or more) – Deteriorating mental health

11. % Households in Fuel Poverty in South West 2003 Source: CSE

12. Fuel Poor Households in England by type of occupant, 2004 Source: DTI, DEFRA

13. Domestic fuel prices and South West fuel poverty, 2004-2008 Source: BERR, DEFRA

14. ‘Causes’ of Fuel Poverty High Fuel Bills – Tariff advice Energy inefficiency – Energy efficient central heating – Improved insulation Low income – Benefit entitlement Under occupation

15. Uptake of Warm Front Grants Government funded Energy conservation – Loft and cavity wall insulation – Central heating Vulnerable households – eligibility criteria includes: – Over 60 + qualifying benefits – Under 16 + qualifying benefits – Pregnant + qualifying benefits

19. Warm Front referrals as % of private sector housing – South West 2008/09

20. Uptake of Warm Front Grants Rural/Urban South West population – 17.7% population in rural areas Fuel poverty 2006 – 18% of fuel poor in rural areas Warm Front grants – 10% in rural areas Source: SWPHO, BERR, CRC

21. Health benefits of energy efficient measures - Warm Front Post intervention - 50% reduction in depression – warmth and debt related Improves self rated health by approximately 50%, results in fewer visits to a general practitioner by 27% and fewer days off work by 38% Improves children’s educational achievements, school attendance (50% reduction in self reported days off school following insulation measures) Reduces the incidence of childhood asthma

22. Housing Factors

23. Energy inefficient homes in England 2005 Source: English Housing Condition Survey 2005

24. Housing factors - Rural/Urban Solid walls – Rural 33%, Urban 26% – older property, hard to treat Off gas mains - Rural 42%, Urban 9% – Higher costs – Fewer tariff discounts – Warm Front grant top up costs Under occupation – 41.5% properties in South West Source: CRC, BERR

25. % persons aged 65+ living in housing with no central heating by Local Authority 2001 Source: ONS 2001 census

26. ‘Good housing leads to good health’ Toolkit for environmental health practitioners – CIEH Evidence private sector housing condition on public health HHSRS – the Home Health and Safety Rating System Procedure for homes covering 29 hazards A risk assessment HHSRS Costs calculator for PCTs Impact of housing intervention measures on wider health benefits

27. Example from Bristol

28. Benefits Uptake

29. Pensioner Benefits Take up 1997-2007

30. Benefits uptake – Rural/Urban Pension credit non-uptake by eligible – Rural areas 42% – Villages, hamlets, isolated dwellings 54% – Urban areas 35% Source - CRC 2007

31. Increasing Benefits Uptake Around two fifths of pensioner households entitled to council tax benefit and pension credit are not claiming them Between £6 billion and £10 billion of entitled benefits and credits go unclaimed each year. Warm Front Benefit Entitlement Check Average increase household income – £31 per week – £1,615 per year

32. Locality Actions Joint strategic needs assessment Targeting grant advice and uptake to elderly and vulnerable people Improving housing condition & energy efficiency Tackling fuel poverty (NI 187)

33. Locality Actions (2) Seasonal flu/swineflu immunisation Pneumoccocal immunisation Long term conditions care Met office forecast alert scheme Cold weather health warnings

34. South West Regional actions Excess winter deaths summit Regional organisations work together Regional priority Monitoring LAA delivery