Evaluating the health effects of household energy efficiency measures

Evaluating the health effects of household energy efficiency measures on young children and older adults in Scotland

Good housing is fundamental to health, but the UK’s housing stock, among the oldest in Western Europe, is making people sick. Given the links between poor housing and adverse health, governments are increasingly using energy efficiency measures aimed at reducing carbon emissions and energy bills to also address housing-related health issues. 

Since 2015, the Scottish Government-backed Warmer Homes Scotland (WHS) and Area Based Schemes (ABS) have delivered energy improvements to low-income households living in hard-to-treat properties and in areas of high fuel poverty. Despite the government’s continued investment in the programmes, the health impacts of WHS and ABS remain unknown. Moreover, while the evidence suggests that energy efficiency measures can improve health, important methodological limitations remain.

Research Focus

This project evaluates the health impacts of WHS and ABS for adults 65 years and older and children 6 years and younger living in Scotland. We use linked national administrative data to compare health outcomes before and after intervention between homes that received energy efficiency improvements and comparable homes that did not. The findings from this study will provide robust evidence about how improving the energy efficiency of an ageing housing stock can provide sustainable and healthy homes for all.

Project aims

1. To describe how the health of older adults and young children living in Scotland varies by household and property characteristics (e.g., overcrowding, energy efficiency).

2. To estimate the effects of home energy efficiency measures on the health of adults aged 65 and over, including cardiovascular disease, respiratory disease and infections, unintentional injuries, and death.

3. To estimate the effects of home energy efficiency measures on the health of children under 6, including child development, unintentional injuries, allergies and skin conditions, dental registration and treatments, and immunisations.

4. To understand which property, household and socioeconomic factors modify these effects (e.g., property type).

Linking Data Sources

Person-level: Scottish morbidity records -01 (hospital admissions). Scottish morbidity records 02 (birth records). Prescribing Information System (community prescribing). National Records of Scotland: Births (births). National Records of Scotland: Deaths (mortality). Child Health Surveillance Programme Pre-School (child development). Scottish Immunisation & Recall System (immunisations). Management Information and Dental Accounting System (dental registration and treatment).

Property-level: Home Energy Efficiency Database. Energy Performance Certificates. Annual electricity and gas consumption.

Area-level: Area Based Scheme allocation and spending records (local authority level). Properties not connected to the gas grid (small area level). Children in Low Income Families (small area level). Scottish Index of Multiple Deprivation (small area level). Rural/urban classification (small area level).

Individual-Property lookup file: CHI-UPRN Lookup file.

Potential Public and Policy Benefit

By linking property level improvements with individual records for a range of under-examined health outcomes, this study is one of the largest of its kind. 

Using natural experimental methods, it will provide methodologically robust evidence on how home upgrading interventions affect older adults and young children, among those most harmed by poor housing. This evidence will support decision-making, including expanding eligibility around health need. 

The results will be relevant to decision-makers in Scotland and other countries interested in the health co-benefits of improving ageing, energy-inefficient housing stock.

Research Team

Dr Michal Shimonovich (principal investigator), Patricia Maria Ayala Genes, Professor Peter Craig (project supervisor), Professor Nick Bailey, Professor Vittal Katikireddi.

Funding: This project is funded by a British Academy Postdoctoral Fellowship, with additional support from the University of Glasgow’s Lord Kelvin Adam Smith Leadership Fellowship. Colleagues from ADR Scotland are part of the Research Team.

Publications:

Upcoming: Household energy efficiency measures and health: a systematic review and meta-analysis [PROSPERO registration number: CRD42023418031]