This document was written in response to a NICE (National Institute for Health and Care Excellence) 2014 consultation on producing guidelines for health authorities on tackling excess winter deaths and illnesses. It was written (mainly) by me, on behalf of the AECB, teaming up with Severn Wye Energy Agency and the STBA (Sustainable Traditional Buildings Alliance) – who also contributed information.
While at the time of this consultation the deleterious impact of cold living conditions on health were well known – prompting the consultation – poor indoor air quality was less discussed.
Yet of course, air quality can be very poor in cold homes: people will block out any draughts they can – including the intended fresh air supply from a ventilation fan or vent – especially if they are in fuel poverty. This only increases the risk of condensation and mould – already high in a dwelling with cold, uninsulated surfaces. And more and more evidence is piling up of just how bad mould in particular is for people’s health and wellbeing. Continue reading →
Simple home energy efficiency improvements (such as new boilers, cavity wall insulation etc) can bring valuable comfort and health benefits to the occupants of inefficient homes – especially those in fuel poverty – as the last article revealed (see here). However, energy, carbon and bill savings tend to be modest, rarely topping 15% or 20% – and sometimes energy use actually increases!
If housing is to contribute its share of the 80% cuts in carbon emissions this country is committed to, in order to play is part in tackling climate change, retrofits will need to go deeper – a lot deeper. But will occupants benefit from the extra work? And is it affordable?
In the first part of this article we looked at the damage fuel poverty and cold homes do to occupants’ health, and found good evidence that when these twin evils were tackled, occupants could enjoy measurable improvements in their health. Encouragingly, some local health bodies are recognising this and investing in home retrofit to help improve people’s health.
Fuel poverty causes misery and ill-health – and alleviating fuel poverty by retrofitting homes could potentially offer valuable savings to the health services. However, different approaches to retrofit are likely to have different impacts on health.
The first in this two-part series, published in Green Building in December 2014, looks at how cold, damp homes can harm people’s heath, and at the evidence to date that retrofit can improve matters. It also explores some pioneering efforts by concerned health organisations to tackle the ill health of their vulnerable patients where it starts – by fixing their cold homes.
The second part, due to be published in Spring 2015, will look a little more closely at different retrofit strategies, and the risks and benefits to occupants – and to the buildings themselves.
The National Institute for Health and Care Excellence (NICE) recently ran a consultation on the guidance they give to health bodies and local authorities on reducing the burden of winter deaths and illnesses from cold homes.
The response welcomed the idea that health professionals should be involved in identifying and tackling unhealthy homes. It also emphasised that excess winter deaths and illnesses were almost certainly due to a combination of low indoor temperatures and poor indoor air quality (exacerbated by cold surfaces in uninsulated homes, and by occupants restricting ventilation to keep out cold draughts), and that an emphasis on low temperatures alone could miss significant causes of ill-health – and valuable remedies.
Like many others, I am horrified that the government has scaled back aspects of the Energy Company Obligation mid-programme. You can read about some of the immediate, alarming consequences of this in a report from Inside Housing here.
However, as I’ve said before, it seems to me that long-term it makes little sense to restrict the national retrofit programme to what can be funded via a charge on energy bills. In summary, this is why:
Retrofit is about more than energy bills, it’s about health, education, social welfare and common decency. And about energy security and cutting emissions.
Because of the state of our housing and therefore, the scale of the need, a high spend is required.
Because of the scale and the range of the benefits, a major retrofit programme would bring tangible revenue savings to a range of bodies such as those tasked with improving economic, health, social welfare and educational outcomes, and delivering on our carbon targets.
Paying for retrofit through energy bills is regressive, hitting the poorest proportionally hardest, even at current spending levels.
The scale of the spending needs to expand many-fold. This would ramp up the regressiveness. In effect, every household, including the poorest, would be paying a substantial chunk of the costs for NHS, social welfare etc via their energy bills. This is not only likely to be politically untenable, it also undermines the accepted approach to progressive taxation in this country.
The creation of a third party obligation, ‘leaving it to the market’ to decide what to deliver on the basis of a very simplified understanding of costs and benefits, cuts informed stakeholders out of the equation. It excludes them from them any meaningful say over priorities, responsiveness to changing needs, and quality of interventions.
It also ignores the ‘beneficiary pays’ principle: health, education and welfare budgets would all benefit considerably, on the back of bill payers.
*The ECO recognises only two parameters of benefit, presumed carbon savings (calculated via RdSAP), and “affordability” again, calculated via RdSAP.