Retrofitting houses with insulation: a cost-benefit analysis of a randomised community trial

Chapman, Ralph; Howden‐Chapman, Philippa; Viggers, Helen; O’Dea, Des; Kennedy, Martin A.

doi:10.1136/jech.2007.070037

Cited by 141 publications

(123 citation statements)

References 21 publications

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“…Zealand investigated the value of the health, energy and environmental benefits of retrofitting insulation into 1350 dwellings in a low-income community and where at least one occupant had symptoms of respiratory disease (Chapman et al, 2009). It assessed a range of potential benefits, including reduced visits to GPs, hospitalisations, days off school, and days off work, together with energy savings and CO 2 savings.…”

Section: Discussionmentioning

confidence: 99%

Health and thermal comfort: From WHO guidance to housing strategies

Ormandy

Ezratty²

2012

Energy Policy

271

153

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There are many references to the WHO guidance on thermal comfort in housing, but not to the original source material. Based on archive material, this paper gives the evidential basis for the WHO guidance. It then reports on evidence that some groups may be more susceptible to high or low indoor temperatures than others. It examines different methods for measuring thermal comfort, such as air temperature measurement, assessing resident's perception, and predicting satisfaction. Resident's perception was used effectively in the WHO LARES project, showing that self-reported poor health was significantly associated with poor thermal comfort.Tools to inform strategies directed at dealing with cold homes and fuel poverty are considered, including Energy Performance Certificates, Fuel Poverty Indicators, and the English Housing Health and Safety Rating System. Conclusions from a WHO Workshop on Housing, Energy and ThermalComfort are also summarised.The WHO view of thermal comfort, which is driven by protecting health from both high and low indoor temperatures, should be recognised in energy efficiency, fuel poverty and climate change strategies. While this is a major challenge, it could provide both health gains for individuals, and economic benefits for society.

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Section: Discussionmentioning

confidence: 99%

Health and thermal comfort: From WHO guidance to housing strategies

Ormandy

Ezratty²

2012

Energy Policy

271

153

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“…3,4 In the only comprehensive published study of the economics of housing modification to improve health, Chapman et al used costbenefit analysis alongside a randomised trial to show that retrofitting houses in New Zealand with insulation yielded benefits worth up to twice the cost. 5 More than one in 10 children between the ages of 5 and 14 years in the UK has asthma, and it is the most common longterm medical condition in children. 6 Asthma is estimated to cost the NHS £1000 million a year.…”

Section: Introductionmentioning

confidence: 99%

Enhancing ventilation in homes of children with asthma: cost-effectiveness study alongside randomised controlled trial

et al. 2011

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BackgroundThere has been little rigorous economic analysis of the relationship between asthma and improved housing. AimTo evaluate the cost-effectiveness of installing ventilation systems, and central heating if necessary, in homes of children with 'moderate' or 'severe' asthma. Design and settingAn incremental cost-effectiveness analysis alongside a pragmatic randomised controlled trial of a tailored package of housing modifications designed to improve ventilation and household heating in homes within Wrexham County Borough, Wales, UK. MethodA total of 177 children aged between 5 and 14 years, identified from general practice registers, were studied. Parents reported on the quality of life of their children over a 12-month period. General practices reported on healthservice resources used by those children, and their asthma-related prescriptions, over the same period. ResultsThe tailored package shifted 17% of children in the intervention group from 'severe' to 'moderate' asthma, compared with a 3% shift in the control group. The mean cost of these modifications was £1718 per child treated or £12 300 per child shifted from 'severe' to 'moderate'. Healthcare costs over 12 months following randomisation did not differ significantly between intervention and control groups. Bootstrapping gave an incremental cost-effectiveness ratio (ICER) of £234 per point improvement on the 100-point PedsQL ™ asthma-specific scale, with 95% confidence interval (CI) = £140 to £590. The ICER fell to £165 (95% CI = £84 to £424) for children with 'severe' asthma. ConclusionThis novel and pragmatic trial, with integrated economic evaluation, reported that tailored improvement of the housing of children with moderate to severe asthma is likely to be a costeffective use of public resources. This is a rare example of evidence for collaboration between local government and the NHS.

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“…In estimating the returns to improving the glazing, walls, roof and air tightness of these dwellings, an average payback period of 12 years is found across all homes built prior to 1977, although this rises incrementally when moving to newer cohorts of buildings, with a payback period of 45 years expected for dwellings built between 2005 and 2006. In evaluating the provision of grant aid, all-encompassing cost-benefit analyses tend to dominate the literature. For example, Chapman et al (2009) employ a cost-benefit analysis to evaluate the success of a retrofit grant aid scheme aimed at low-income households in New Zealand where a family member suffers from a respiratory disease. This study examined the total health, energy and CO2 improvements as a result of the scheme as a whole.…”

Section: Introductionmentioning

confidence: 99%

Value for money in energy efficiency retrofits in Ireland: grant provider and grant recipients

Collins

Curtis

2017

Applied Economics

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Retrofitting houses with insulation: a cost-benefit analysis of a randomised community trial

Cited by 141 publications

References 21 publications

Health and thermal comfort: From WHO guidance to housing strategies

Health and thermal comfort: From WHO guidance to housing strategies

Enhancing ventilation in homes of children with asthma: cost-effectiveness study alongside randomised controlled trial

Value for money in energy efficiency retrofits in Ireland: grant provider and grant recipients

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