Reducing Energy Poverty Is Good for the Heart

Many headlines and articles have been written in the media over the past few months about the political and social debate on energy poverty, reminding us of the vast number of families who are unable to maintain the minimum essential levels of warmth in their homes during the winter months. Surprisingly, the debate has not been accompanied by any mention of the scientific evidence that irrefutably shows the close link between room temperature and health, and the urgent need for public policies to be introduced which guarantee certain minimum thresholds in accordance with health needs.

The number of deaths and hospitalizations are higher on the coldest and hottest days, compared to days with milder temperaturesIf we look at basic health indicators, such as the daily number of deaths or emergency cases in hospitals, we see that the number of deaths and hospitalizations are higher on the coldest and hottest days, compared to days with milder temperatures. We know that on colder days, body temperature is maintained constant by a series of adaptive changes that take place such as an increase in arterial pressure and thickening of the blood. In old people and those with chronic pathologies, these changes increase the risk of suffering from serious diseases like heart attacks, an ictus or pulmonary embolism. Cold weather also reduces the immune system’s response, making us more vulnerable against infections like flu.

It is estimated that 40% of excess winter deaths are due to cardiovascular diseases and 33% to respiratory illnesses. Contrary to what we may think, those of us in southern European countries, with milder winters, are more vulnerable to the harmful effects of cold temperatures than those in northern countries. So for every 1 degree Celsius decrease in average winter temperature, the rate of cardiovascular mortality increases by an average of 2.2% in Mediterranean countries and 1.4% in countries in northern and central Europe. This phenomenon is probably due to the fact that those in northern countries adapt better to cold climates.

Although the effects of the cold are often associated with outdoor temperatures, there is a significant amount of evidence that shows how the cold inside our homes also has an important impact on health.  A study undertaken in the United Kingdom showed how the effects the temperature changes have on health are more acute in homes which have worse energy efficiency.Those of us in southern European countries, with milder winters, are more vulnerable to the harmful effects of cold temperatures than those in northern countries It was estimated that 22% of excess winter mortality could be avoided if the 25% coldest homes had the same temperature as the 25% warmest ones. Taking into account the existing evidence, the World Health Organisation (WHO) recommends keeping the homes at a temperature of 21C in the dining room or lounge and 18C in the bedrooms.

Last October, Eduardo Montes, president of the electricity association UNESA, made some controversial comments and stated the obvious when he said that general poverty and energy poverty are linked. So according to Montes, energy poverty must not be differentiated from general poverty and what we have to do is fight the latter. The scientific evidence refutes this argument, as different studies show that independently of the socioeconomic level, 1) there are certain health issues that are specifically attributable to energy poverty, and 2) actions undertaken to reduce energy poverty have a direct positive impact on health. 

Several studies have evaluated the impact of interventions aimed at combatting energy poverty and which increased indoor temperature.  These studies, carried out in countries like the United Kingdom, Ireland and New Zealand have shown positive results such as a reduction in the increase in mortality caused by cold weather, a decrease in heart diseases like hypertension, an improvement in the general state of health and physical wellbeing, a decrease in the symptoms of anxiety and depression, a reduction in problems caused by arthritis and rheumatism, and a reduction in cases of flu, colds and other respiratory problems as well as fewer days of sick leave.

There are certain health issues that are specifically attributable to energy povertyA particularly shocking aspect of energy poverty is that its effects are more prominent in children, especially but not only in terms of respiratory health. As in the case of adults, the studies on interventions deployed with children have shown a positive impact in the reduction of respiratory morbidity and in other indicators such as growth, emergency consultations or an improved caloric balance. It must be taken into account that children who live in colder homes need more calories than others to maintain adequate levels of growth. Therefore, energy poverty has an impact on food poverty, which is especially serious in children given that living conditions in childhood predict future risk of illnesses in adulthood.

This evidence should be enough to support the introduction of public policies specifically aimed at guaranteeing the minimum home temperature thresholds to protect people’s health and thus mitigate the effects of energy poverty. The interventions in this area ought to include an improvement in the information gathered on the affected population with special attention placed on the most vulnerable groups and especially on children. The absence of studies in our country is a reflection of the lack of attention paid to this problem. To take action towards the reduction of energy poverty is also a matter of social justice, another step that must be taken to reduce health inequalities.