Despite the relatively mild climate, the UK has higher levels of winter excess deaths – deaths related to cold weather – than many colder countries. This greater exposure to the cold, despite the milder weather, is associated with poorer housing quality, higher cost of heating homes and poverty.
We know a lot about how living in a house that you can’t get enough heat can affect your physical health. For example, cold temperatures suppress the immune system. But we know relatively little about the effects on mental health. Our new research shows that living in a cold home poses a significant mental health risk.
Living in a cold home can affect your mental health in several ways. For many, heating costs are a source of stress and financial stress. Not being able to keep your home and family comfortably warm reduces the sense of control and independence in your environment. People who are unable to heat their homes often adopt coping mechanisms that limit social contact – for example, not inviting friends and going to bed early to keep warm. And a lot of people are exhausted by the hard work of the whole winter from the pesky cold.
Using data from a large, representative sample of UK adults, we followed people over many years and tracked the impact on mental health of not being able to keep your home warm.
When people’s homes became cold, their risk of severe psychological stress increased dramatically. For people who did not previously have mental health problems, the odds of experiencing acute psychological distress doubled when they had a cold home, while the risk tripled for those who had some (but not severe) mental health symptoms (see chart below). We found these effects even after accounting for many other factors associated with mental health, including income.
The odds of reporting severe psychological distress after moving to cold housing compared to those who remained in warm homes
Unfortunately, the risk of living in a cold home varies greatly among UK residents. Single parents and people who are unemployed or sick for a long time are more likely to live in cold homes. There is also a huge disparity between ethnic groups – more than 12% of blacks live in cold homes compared to less than 6% of white Britons, for example. Those who rent rather than own their homes are more likely to live in cold homes. For social renters, this is despite the high quality and efficiency of social rented homes.
One more sweater won’t be enough to woo many in the UK this coming winter. And psychological distress is just one result. Cold homes cause problems with significant personal and societal costs – from individual health impacts to increased pressure on the NHS, as well as the broader economic toll from absenteeism. Rishi Sunak’s new government needs to help people live in adequately warm homes this winter. but how?
The advancing age of housing in the UK is heavily implicated in the rise in cold levels in the UK. Supporting energy efficiency improvements is therefore a possible way to reduce cold homes. This will also mean addressing the so-called “fragmentation incentive” in the private rented sector, which includes a large percentage of households. Retail incentive refers to the challenge of the benefits of improvements being faced not by landlords but by tenants, which reduces the incentive for owners to invest. This results in poor quality and more expensive homes for renters.
Heat or eat? Most of them can’t stand either
The high proportion of cold homes in the social housing sector—despite having the best average energy efficiency due to insulation and building types (apartments)—suggests that energy efficiency improvements alone will not eliminate cold. Income in the UK is declining. Benefit levels are painfully low and made worse by policies including maximum benefits, a two-child limit, and penalties. Years of cuts and less than rising inflation mean that the term “keep or eat,” used to describe difficult spending decisions for low-income families, is now outdated, with neither one able to be afforded by many.
The combination of low household incomes and high energy costs has created devastating pressure on household budgets. While the energy cap had limited energy cost increases below worst estimates, energy bills still more than doubled last year. Prepaid meters mean those who get the lowest pay the most.
Therefore, there are many areas for potential government intervention, and there is clear evidence that non-intervention will cause harm to health.