On moral responsibility: Preventing people from dying due to cold homes

Having born in a country (Finland) where winters are usually cold, I was sad to learn about winter deaths in Britain (for this short post I only use statistics from England). I recently wrote a column about this in Finnish for the journal of the Finnish Association of Physiotherapists.

Last winter, according to study conducted at my Alma mater UCL, saw the highest number of deaths due to low indoor temperatures in fifteen years. A total of 9000 people died which is a fifth of all winter deaths. Not because of last winter was colder than usual (it wasn’t). These excess deaths happen because of fuel poverty: people can’t afford to heat their homes.

The charity Age UK estimates that there are around 2.4 million households in fuel poverty, and 1.14 million old people live in fuel poverty in England alone. They estimate that the costs of fuel poverty to the NHS are around £1.36bn every year. The problem is obvious and so is the solution: let’s heat the homes.

In 2000, the government did agree a legally-binding objective to eradicate fuel poverty by 2016 (Warm Homes and Energy Conservation Act 2000). However, England saw an increase in fuel poverty between 2003-2010.

According to BBC Panorama, the government changed their definition for a fuel poor household: it used be those households that spend more than 10% of their income on heating their home. In 2013, three years before the target was to be met, the government changed how it measured fuel poverty in England to the Low Income High Costs (LIHC) indicator. Fuel poverty according to LIHC is based on whether keeping up a decent standard of indoor heat would leave the household below the poverty line. According to Panorama, about 13 million people would be classified as fuel poor if the old definition was still in place. When the new calculation tactic is used, the number of fuel poor people drops to around 5 million.

Clever.

Whether the old or the new definition is more accurate, people will still die. According to the National Institute for Health and Care Excellence (NICE), all health, public health and social care practitioners should be equipped to recognize vulnerable people to the health problems associated with a cold home such as older people (56% of deaths in cold homes are people aged 85 or older; 27% are between ages 75-84). People with poor immune system are also at risk: living in a cold home increases the risk of heart attack, strokes and respiratory infections.

The conclusion? The moral responsibility to clean up the mess of growing inequalities is left to the health care practitioners.