Original articleCan we identify older people most vulnerable to living in cold homes during winter?
Section snippets
Background
Excess winter mortality in the United Kingdom has been partially attributed to cold housing [1], [2], with an extra 5500 more deaths occurring annually in the coldest homes than would occur if those homes were warm [3]. Greater susceptibility of older people to cold has been suggested [4] as they have worse cardiovascular and respiratory profiles at lower indoor [5] and outdoor [6] temperatures. However, it is unclear how to identify older people who particularly find it hard to keep warm in
Sample
The British Regional Heart Study (BRHS) is a prospective, population-based cohort study following up 7735 men (99% Caucasian) recruited from primary care practices in 24 British towns in 1978–1980. In 2014, 2820 surviving men aged 74–96 years were invited to complete a comprehensive health status and life style questionnaire including self-reported measures of cold homes [14]. Thousand six hundred fifty-five men responded (99% between April and October), and 1402 had complete data on all
Results
We found (1) 288 (20.7%) men had difficulties in meeting the heating/fuel costs; (2) 173 (12.4%) stayed in bed longer to stay warm; (3) 47 (3.3%) could not keep comfortably warm in the living room, and (4) 130 (9.4%) turned heating off because of worries about the costs. Manual social class, increasing financial difficulties, poor health in general, and being not married were more common in men who were having difficulties in meeting the heating/fuel costs (Table 1). Similar findings were found
Discussion
To our knowledge, this is the most comprehensive investigation of associations of individual factors (sociodemographic, economic, health, and house conditions) with self-reported measures of cold homes in older men and reports of cold homes related to mortality.
Conclusions
Identifying older people who find it hard to keep warm in winter and have an increased mortality risk is possible. Increasing financial difficulties and lower social class are not the only factors that increase older people's difficulties in keeping warm during winter. With an increasing aging population, U.K. policies need to tackle the adverse effect of multiple risk factors that increase with age and are more common in people living in cold homes, such as social isolation, poor respiratory
Acknowledgments
This article presents independent research funded by the National Institute of Health Research School for Primary Care Research (NIHR SPCR grant reference number 281). The NIHR programme grant was awarded to R.W.M. and supported C.S. and P.T. D.S.L is funded by the NIHR Oxford Biomedical Research Centre. The British Regional Heart study is supported by a British Heart Foundation programme grant (RG/13/16/30528). The funders had no role in the design and conduct of the study; collection,
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The authors report no relationships that could be construed as a conflict of interest.