Article Text
Abstract
Background An estimated 9000 people died during the winter 2014–2015 in England and Wales from living in a cold home. Older people are susceptible to cold, but it is unclear how to identify those who particularly find it hard to keep warm in winter. The aim of this study was to identify individual factors associated with self-reported measures of cold homes among older people.
Methods Data were from the British Regional Heart Study (BRHS) of older men, who were aged 74–95 when completing a questionnaire in 2014. This included four self-reported measures of cold housing during the previous winter (outcomes): (i) having difficulties in meeting the heating/fuel costs; (ii) staying in bed longer in order to stay warm; (iii) turning the heating off even when cold because of worries about the costs; (iv) keeping the living room comfortably warm. Individual data, including demographic characteristics, health and lifestyle factors were also collected. Cross-sectional associations between individual factors and measures of cold housing were analysed using logistic regression models.
Results Descriptive statistics showed that (i) 327 out of 1608 (20.6%) men had difficulties in meeting the heating/fuel costs; (ii) 210 (13.3%) stayed in bed longer in order to stay warm; (iii) 157 (10.2%) turned heating off because of worries about the costs, and (iv) 54 (3.4%) could not keep comfortably warm in the living room. In full adjusted logistic models, some individual factors were independently associated with the four outcomes (p<0.05): manual social class, having more financial difficulties, feeling isolated from others, and being not married. The relationship between reporting general financial difficulties and difficulties in meeting the heating/fuel costs was particularly strong (Odds Ratio [OR]=4.9, 95% Confidence Interval [CI] 3.9; 6.1). Also, men with mobility limitations were twice as likely to stay in bed longer in order to stay warm (OR=2.0, 95% CI 1.4; 2.9). Other individual factors, such as living in a house centrally heated and types of house insulation, as well as a proxy measure of the house energy efficiency (Energy Efficiency rating, aggregated from households within participants’ Lower Super Output Area) were not related to self-reported measures of vulnerability to cold.
Conclusion Findings suggested that in older people financial difficulties and social class are key factors associated with cold housing in winter.