Fuel Poverty | Boltons Health Matters
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Fuel Poverty


This is the JSNA chapter on fuel poverty. Theme chapters summarises implications for commissioning, who is at risk and why, the level of need in the population, service provision and use, unmet needs, what works in terms of evidence, community views and priorities, any related equality impact assessments, unmet service needs/gaps and recommendations for further needs assessment work. 

People living in less energy efficient properties and those experiencing an excess cold hazard tend to be more affluent and with significant savings. They are likely to read customer magazines such as the Bolton Scene and are acceptable of receiving communications from local and national government. This suggests many may be amenable to making improvements themselves.

One of the more deprived Acorn groups ‘5.O Young hardship’ is at risk of living in a less energy efficient property or one with an excess cold hazard. Households in this group are also at risk of fuel poverty. These people may need more support to make improvements.

People living in more energy efficient properties tend to be more deprived and are more likely to live in social housing.

‘4.N Poorer Pensioners’ are likely to live in a more energy efficient property, but are also at risk of fuel poverty, it may be that more energy efficient social housing is having a protective effect on members of this group.

Overall people in fuel poverty tend to be more deprived, but are less likely to be among the very most deprived Acorn groups or types. The very most deprived Acorn types are more likely to be living in social housing which may be protecting them from the fuel poverty they might otherwise experience.

The change from 10% to LIHC definitions of fuel poverty produced the largest reduction in fuel poverty among the most affluent households. People in fuel poverty under LIHC are less likely to be retired and incomes are on average a little lower, but profiles are in general similar.

The housing stock model included the presence of a serious hazard under the Housing Health and Safety Rating System (HHSRS) and two specific hazards: excess cold and falls. The presence of disrepair was also included.

The Acorn groups most at risk of living in a property with multiple issues, including a serious hazard, a falls hazard, or disrepair are ‘4.L Modest means’ and ‘5.O Young hardship’. The group ‘5.O Young hardship’ is also at risk of an excess cold hazard. They tend to be younger people living in small terraced houses with modest incomes. They may need some support to make improvements to properties, or encourage their private landlords to do so.

Overall, people living in properties with an excess cold hazard tend to be more affluent and with significant savings, with which they may be able to make improvements.

The more deprived group ‘4.N Poorer Pensioners’ are also likely to live in a property with an excess cold hazard. The number of households is smaller, but older people are the group most likely to suffer harm from excess cold.


The cold weather collection gives advice to help prevent the major avoidable effects on health during periods of cold weather in England.

This collection of resources can be accessed by clicking here: http://bit.ly/1PuL2MH

Bolton Council commissioned BRE to undertake a series of modelling exercises on their housing stock. This report describes the modelling work and provides details of the results obtained from the dwelling level model and database. The database is also provided to the council to enable them to obtain specific information whenever required.  The detailed housing stock information provided in this report will facilitate the delivery of Bolton’s housing strategy and enable a targeted intervention approach to improving housing. In addition to this there are also several relevant government policies – the Housing Act 2004, Housing Strategy Policy, Local Authority Housing Statistics (LAHS) and the Green Deal/ECO.

The main aims of this work were to provide estimates of:

  • The percentage of dwellings meeting each of the key indicators1 for Bolton overall and broken down by tenure and then mapped by COA (private sector stock only)
  • Information relating to LAHS reporting for the private sector stock - category 1 hazards and information on EPC ratings

BRE Housing Stock Models were used to provide such estimates at dwelling level with a focus on private sector housing. The key indicators provide Bolton with detailed information on the likely condition of the stock and the geographical distribution of properties of interest.

Headline results for Bolton

  • 2,548 dwellings in the private rented sector have category 1 Housing Health and Safety Rating System (HHSRS) hazards. This equates to 15% of properties in the private rented sector. See full results
  • The highest concentrations of fuel poverty in the private sector are found in the wards of Halliwell, Farnworth and Great Lever.
  • The highest concentrations of excess cold are in Bradshaw, Halliwell and Horwich and Blackrod.
  • The highest concentrations of all HHSRS hazards in the private sector are found in the wards of Halliwell, Crompton and Tonge with the Haulgh.
  • The average SimpleSAP ratings for all private sector dwellings in Bolton is 60, which is better than both England and North West (55). For the owner occupied stock in Bolton the figure is 60 and for the private rented sector it is 58.
  • Maps by COA have been provided for the above key indicators.
  • The total cost of mitigating category 1 hazards in Bolton’s private sector stock is estimated to be £25.0 million.
  • 5.0% (4,772) of private sector dwellings and 7.4% (1,248) of private rented dwellings in Bolton are estimated to have an EPC rating below band

The guideline is for commissioners, managers and health, social care and voluntary sector practitioners who deal with vulnerable people who may have health problems caused, or exacerbated, by living in a cold home.

It will also be of interest to clinicians and others involved with at-risk groups, housing and energy suppliers.

This guideline makes recommendations on how to reduce the risk of death and ill health associated with living in a cold home. The aim is to help:

  • Reduce preventable excess winter death rates.
  • Improve health and wellbeing among vulnerable groups.
  • Reduce pressure on health and social care services.
  • Reduce ‘fuel poverty’ and the risk of fuel debt or being disconnected from gas and electricity supplies
  • Improve the energy efficiency of homes.

To access this resource, please click here: http://bit.ly/1CGnuQg

The cold weather plan is a collection of resources that gives advice on preparing for the effects of winter weather on people’s health. This collection can be accessed by clicking here: http://bit.ly/1vN2TVt

This briefing was commissioned by PHE and written by the Institute of Health Equity. It is a summary of a more detailed evidence review on the same topic and is intended primarily for directors of public health, public health teams and local authorities. This briefing and accompanying evidence reviews are part of a series commissioned by PHE to describe and demonstrate effective, practical local action on a range of social determinants of health.

You can view the briefing by clicking here: http://bit.ly/1ytu7CS .

The associated evidence summary is: Local action on health inequalities: Fuel poverty and cold home-related health problems

1. A household is in fuel poverty if it is on a low income and faces high costs of keeping adequately warm and other basic energy services. Fuel poverty is driven by three main factors: household income, the current cost of energy and the energy efficiency of the home.
2. Fuel poverty is associated with cold homes. England’s housing stock is made up of relatively energy inefficient properties which can result in homes that are difficult or costly to heat. However, households can be cold without being in fuel poverty if people choose not to heat their homes adequately where they have the means to do so.
3. A social gradient in fuel poverty exists; those on lower household incomes are more likely to be at risk of fuel poverty, contributing to social and health inequalities.
4. The most recent data on fuel poverty in England indicates that there were 2.28 million fuel-poor households in 2012
5. Cold homes can affect or exacerbate a range of health problems including respiratory problems, circulatory problems and increased risk of poor mental health. Estimates suggest that some 10% of excess winter deaths are directly attributable to fuel poverty and a fifth of excess winter deaths are attributable to the coldest quarter of homes.
6. Cold homes can also affect wider determinants of health, such as educational performance among children and young people, as well as work absences.
7. Tackling fuel poverty and cold home-related health problems is important for improving health outcomes and reducing inequalities in health in England. Local authorities and public health are well placed to address issues relating to fuel poverty.

This paper examines the evidence relating to the impact of fuel poverty on health and health inequalities and sets out some areas for action. It is intended for the interests of directors of public health and public health teams within local authorities, health and wellbeing boards, and other local authority officers.

This evidence review/briefing was commissioned by Public Health England and researched, analysed and written by the UCL Institute of Health Equity. These papers show evidence for interventions on social issues that lead to poor health, including ways to deal with health inequalities. You can use them to get practical tips for dealing with these issues. They also show examples from local areas showing interventions that have been used to improve health. The series includes eight evidence reviews and 14 short briefing papers.

The documents can be used by:

  • local authority professionals whose work has implications for health and wellbeing, such as children’s services and planning services
  • local authorities - particularly directors of public health and their teams - to build health and wellbeing strategies and Joint Strategic Needs Assessments
  • public health teams making a case for action on health inequalities
  • health and wellbeing boards making local public health strategies, including those covering service areas with health implications such as Local Plans and Growth Plans

This evidence summary can be accessed by clicking here: http://bit.ly/1rq5ttS

The full list of resources can be viewed on this page: http://bit.ly/YiMHgX

This evidence review focuses on the behaviours and attitudes of the fuel poor, and those at risk of fuel poverty, around energy use. There were a number of drivers for this review:

  • Continuing importance of dealing with fuel poverty given its impact on households, climate change commitments and economic growth;
  • The recent change in the definition of fuel poverty;
  • The desire to improve the attitudes and behaviour of fuel poor households in order to aid the design of future policies

The review summaries the evidence across 4 main areas:

  1. Knowledge and perception of energy efficiency;
  2. Current energy behaviours and concerns;
  3. Barriers and facilitators to change
  4. Organisational and community engagement

The full review can be downloaded by clicking here: bit.ly/1uD3JkW

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