Illustration: Rosie Carmichael
Coronavirus’ uneven ravages are finally drawing our attention towards a vulnerable group of the population, whose plight has remained unaddressed for too long. In the UK, on average 32,000 more people die in winter compared with death rates across a similar period during the rest of the year – a figure often blandly referred to as ‘excess winter deaths’.
“Basically it means older and vulnerable people are dying younger than they otherwise would” explains David Gordon, a professor of social justice at the University of Bristol.
When accounting for the relative length of the season when we heat our homes, the UK has the second-highest long-term rate of excess winter mortality, surpassed only by Ireland, out of 30 European countries. Of these deaths, 9,700 are directly attributable to living in a cold home.
Vulnerable residents, such as elderly people with underlying health conditions, become prone to cardiovascular and respiratory diseases. Now, of course, this demographic is also more at risk from COVID-19. Living in a cold home can suppress the immune system, decrease resistance to infection, and increase levels of damp and mould, contributing to respiratory problems.
Cold homes death figures ‘underestimated’
Shocking as the above figures are, they may in fact underestimate winter deaths that are due to cold homes. “They underestimate the attribution to cold homes, really that’s what the excess winter death statistic is for,” says Gordon. He adds that the Office for National Statistics (ONS) has a routine press release explaining that some of the excess winter deaths are related to flu.
But, according to Gordon, that explanation is insufficient, because the number of influenza cases have been going down. Additionally, while some winter deaths can be attributed to flu, this should also apply to other countries like Finland, Norway and Sweden, which nonetheless have lower excess winter death rates. “Flu doesn’t discriminate,” Gordon says, “whereas cold homes are different”.
Further, even the non-flu related causes of death will not necessarily be linked back to cold homes. “It depends on what’s written on the death certificate,” Gordon adds. “No one dies of being cold, they die of hypothermia, and they die in hospital generally, so unless someone’s found frozen in their home, it won’t necessarily be recorded, it will be recorded as a heart attack.”
In Bristol, between 2012 and 2015, there were on average 16.2% more deaths in winter compared with a similar period during the rest of the year – lower than the national rate of 20.9%, but still clearly a cause for concern. Excess winter death figures also do not reveal the extent of cold homes-related physical and mental health issues. According to National Energy Action, fuel poverty contributes to poor mental health, including anxiety, chronic depression and – tragically – even suicide.
Healthcare partnerships and other solutions
It is worth emphasising that excess winter deaths arise from entirely preventable circumstances. When I speak to William Baker, from the European Commission-funded Solutions to Tackle Energy Poverty (STEP) project, he suggests it would be useful to have a direct measure of cold homes-related illnesses and not just the excess winter death figures.
Baker also proposes building more partnerships between health staff and energy advice services, including around training frontline staff to recognise clients’ health symptoms related to living in cold homes.
This taps into the idea that addressing cold homes can prevent illnesses and save the healthcare system money. “In some areas the health sector is even putting money into capital expenditure on housing – there is perhaps a feeling [that], wouldn’t it be better for the health sector to be paying for this rather than treating the symptoms?” Baker says.
However, he acknowledges that with “huge demand on the health service already”, direct funding of warm homes by health services is not necessarily the solution, but more an illustration of how addressing causes, rather than symptoms, is more likely to offer useful ways forward.
Fears for next winter
Bristol has been pioneering the collaboration between energy advice and health services, for example through the Warmer Homes, Advice and Money (WHAM) project at the Centre for Sustainable Energy.
Still, with the advent of COVID-19 there is mounting fear of what will happen when winter returns. “Especially if people start losing their jobs because of Brexit and the coronavirus crisis, you’re going to start seeing people who are managing at the moment becoming impoverished and falling into fuel poverty,” warns David Gordon. “The Bristol housing stock is quite old compared to other cities… if, this coming winter, people have to self-isolate in their own homes, and people have lost their jobs and their universal credit hasn’t arrived, or they’re on a low income anyway, then there are going to be mass deaths.
“That’s the grim reality – and a lot of suffering,” he adds. “People won’t be able to stay in their own homes, if their homes are too cold. Where will they go?”
People have rallied together at an unprecedented scale to combat this pandemic, mustering financial, health care and community support. Can we continue at least some of this effort to address ongoing deadly circumstances, such as cold homes which make people continually more vulnerable to such viruses, in the future? We can switch to more ethical, smaller suppliers and find cheaper tariffs or try joining energy co-operatives. But in the long-term, addressing cold homes will also require fairer incomes, government spending to retrofit buildings and on health care, as well as regulation ensuring more affordable energy bills.
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