How real are the health effects of residential energy efficiency programmes?

Howden‐Chapman, Philippa

doi:10.1016/j.socscimed.2015.03.017

Cited by 11 publications

(6 citation statements)

References 10 publications

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“…The final achieved samples of n = 364 for the intervention group and n = 418 for the control group provide 80% statistical power to detect effect sizes of d = n = 0.18 at the 5% significance level, which is in line with effect sizes observed in comparable field studies examining the short-term health effects of housing improvements. 48,51,107 Statistical methods …”

Section: Study Sizementioning

confidence: 99%

The health impacts of energy performance investments in low-income areas: a mixed-methods approach

et al. 2018

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BackgroundCold homes and fuel poverty contribute to health inequalities in ways that could be addressed through energy efficiency interventions.ObjectivesTo determine the health and psychosocial impacts of energy performance investments in low-income areas, particularly hospital admissions for cardiorespiratory conditions, prevalence of respiratory symptoms and mental health status, hydrothermal conditions and household energy use, psychosocial outcomes, cost consequences to the health system and the cost utility of these investments.DesignA mixed-methods study comprising data linkage (25,908 individuals living in 4968 intervention homes), a field study with a controlled pre-/post-test design (intervention,n = 418; control,n = 418), a controlled multilevel interrupted time series analysis of internal hydrothermal conditions (intervention,n = 48; control,n = 40) and a health economic assessment.SettingLow-income areas across Wales.ParticipantsResidents who received energy efficiency measures through the intervention programme and matched control groups.Main outcome measuresPrimary outcomes – emergency hospital admissions for cardiorespiratory conditions, self-reported respiratory symptoms, mental health status, indoor air temperature and indoor relative humidity. Secondary outcomes – emergency hospital admissions for chronic obstructive pulmonary disease-related cardiorespiratory conditions, excess winter admissions, health-related quality of life, subjective well-being, self-reported fuel poverty, financial stress and difficulties, food security, social interaction, thermal satisfaction and self-reported housing conditions.MethodsAnonymously linked individual health records for emergency hospital admissions were analysed using mixed multilevel linear models. A quasi-experimental controlled field study used a multilevel repeated measures approach. Controlled multilevel interrupted time series analyses were conducted to estimate changes in internal hydrothermal conditions following the intervention. The economic evaluation comprised cost–consequence and cost–utility analyses.Data sourcesThe Patient Episode Database for Wales 2005–14, intervention records from 28 local authorities and housing associations, and scheme managers who delivered the programme.ResultsThe study found no evidence of changes in physical health. However, there were improvements in subjective well-being and a number of psychosocial outcomes. The household monitoring study found that the intervention raised indoor temperature and helped reduce energy use. No evidence was found of substantial increases in indoor humidity levels. The health economic assessment found no explicit cost reductions to the health service as a result of non-significant changes in emergency admissions for cardiorespiratory conditions.LimitationsThis was a non-randomised intervention study with household monitoring and field studies that relied on self-response. Data linkage focused on emergency admissions only.ConclusionAlthough there was no evidence that energy performance investments provide physical health benefits or reduce health service usage, there was evidence that they improve social and economic conditions that are conducive to better health and improved subjective well-being. The intervention has been successful in reducing energy use and improving the living conditions of households in low-income areas. The lack of association of emergency hospital admissions with energy performance investments means that we were unable to evidence cost saving to health-service providers.Future workOur research suggests the importance of incorporating evaluations with follow-up into intervention research from the start.FundingThe National Institute for Health Research Public Health Research programme.

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Section: Study Sizementioning

confidence: 99%

The health impacts of energy performance investments in low-income areas: a mixed-methods approach

et al. 2018

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“…Sustainable housing has been identified as a critical element in the transition to a low carbon and equitable future within the UN's Sustainable Development Goals [1], the Intergovernmental Panel on Climate Change's assessment reports [2] and other key research [3,4]. Increasingly, sustainable housing is about more than reducing resource consumption; it is also about broader social and financial benefits delivered for households and society, such as reducing fuel poverty and improving health and wellbeing outcomes [5][6][7][8][9][10]. Despite the benefits of sustainable housing, most new and existing housing around the world falls short of what is required for a low carbon future [2,11].…”

Section: Introductionmentioning

confidence: 99%

The Uncommon Nightingale: Sustainable Housing Innovation in Australia

Moore

Doyon

2018

Sustainability

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There is a need to deliver more environmentally and socially sustainable housing if we are to achieve a transition to a low carbon future. There are examples of innovative and sustainable housing emerging around the world which challenge the deeper structures of the existing housing regime. This paper uses the analysis of socio-technical dimensions of eco-housing presented by Smith to explore the development of an emerging sustainable housing model known as Nightingale Housing in Australia within a sustainability transitions framing. While there were several similarities to Smith’s analysis (e.g., establishment of guiding principles, learning by doing), there were also some key differences, including the scaling up of sustainable housing while using tried and tested design principles, materials and technologies, and creating changes to user relations, policy, and culture. Smith’s dimensions remain a good framework for understanding sustainable housing development, but they must be located within a scaling up sustainable housing agenda. What is required now is to develop a better understanding of the processes and opportunities that such housing models offer policy makers, housing researchers, and building industry stakeholders to achieve a broader scale uptake of sustainable housing both in Australia and globally.

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“…Historically, the public health and housing literature has well established the connection between physical conditions of a house—such as inadequate ventilation, lack of protection from extreme temperatures, pest infestation, exposure to toxins, and poor infrastructure—and health outcomes 81–83 . For example, poor air ventilation can be linked to mold buildup, which is strongly associated with respiratory diseases like asthma and allergies 84,85 .…”

Section: Adequate Housingmentioning

confidence: 99%

Without Affordable, Accessible, and Adequate Housing, Health Has No Foundation

Mehdipanah

2023

Milbank Quarterly

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Today's housing disparities are rooted in the increasing commodification of housing that has taken precedence over the need for shelter, a basic human right. With rising housing costs across the country, more residents are finding their monthly income going to rent, mortgage payments, property taxes, and utilities, leaving little for food and medication. Housing is a determinant of health, and with increasing housing disparities, action must be taken to ensure no individual is displaced, communities remain intact, and cities continue to thrive.

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How real are the health effects of residential energy efficiency programmes?

Cited by 11 publications

References 10 publications

The health impacts of energy performance investments in low-income areas: a mixed-methods approach

The health impacts of energy performance investments in low-income areas: a mixed-methods approach

The Uncommon Nightingale: Sustainable Housing Innovation in Australia

Without Affordable, Accessible, and Adequate Housing, Health Has No Foundation

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