Fuel poverty refers to the inability to afford to adequately heat the home. In the South West, it is estimated that 12.1% of households are living in fuel poverty (250,000 homes). Around half of these homes will house people over 65.
In the South West it is estimated that 2,300 avoidable winter deaths occur annually (2000-01 figures, ONS). Although not all of these can be attributed to cold homes, the fact that countries with much more severe winters than those in the UK, for example, Sweden, Germany and Canada, experience comparatively low variation of mortality across the seasons, suggests that poor housing standards and comparatively low incomes are a crucial factors. Ninety-three percent of excess winter deaths are in people over 65.
The National Service Framework for Older People (2001, DH) specifically advocates local initiatives to reduce fuel poverty. It specifically links tackling cold homes with reducing falls in the home and helping increase the provision of intermediate care to maximise independent living which obviously requires homes to be warm and comfortable.
There are a number of features of rural areas that increase the prevalence of fuel poverty and hence are particularly an issue in the South West. These include lack of access to a mains gas network, a high proportion of older houses without cavity walls and a high proportion of detached houses, leading to higher heat loss.
The South West has a relatively older population than the average for England. Despite the milder climate, the region has a higher excess winter mortality among the over-85 years age group than the rest of England and this gives the region the greater all-age excess winter mortality.
The response
The RPHG aims to raise the profile of fuel poverty issues and the related health links. It aims to ensure that work on decent homes and the Regional Housing Strategy includes action on reducing fuel poverty in the region.
The Department of Health has been working with the NHS and other agencies such as the Energy Saving Trust to encourage action on fuel poverty.
Primary Care Trusts have the responsibility for public health at the local level and they should actively seek to address fuel poverty through partnerships with the local authority, the voluntary sector and Warm Front scheme managers. Local health organisations must not only endorse the concept of tackling fuel poverty to reduce winter deaths but also positively contribute to local programmes.
