̽��ֱ�� of Cambridge - poverty

Energy inefficiency and inability to downsize pose even bigger threat to low-income pensioners than loss of Winter Fuel Payments, study suggests

ta385 — Mon, 23 Sep 2024 09:32:48 +0000

̽��ֱ��study, published in Energy Research & Social Science, was completed shortly before the Winter Fuel Payment vote was taken, by researchers from the ̽��ֱ�� of Cambridge and Delft ̽��ֱ�� of Technology (TU Delft).

̽��ֱ��researchers raise particular concerns about the impact of the policy on pensioners with annual incomes of between £11,300–£15,000 for single pensioners and £17,300–£22,000 for couples.

Drawing on data from the English Housing Survey, which sampled nearly 12,000 households across all income groups, the study investigated how income, energy efficiency, home size, household type, and tenure status impacted on energy expenditure.

̽��ֱ��researchers found that an increase of £1 per year in income (after housing costs, tax and welfare payments) was associated with a marginal increase in heating spending of about one-tenth of a penny.

̽��ֱ��study also found that just a small energy efficiency improvement – a one-point increase in the SAP12 rating ( ̽��ֱ��Government's Standard Assessment Procedure for Energy Rating of Dwellings – had a major impact on households in energy poverty, offering an average reduction in annual heating costs of £21.59 per year.

Floor area also had an impact. ̽��ֱ��researchers found that a one square metre increase was associated with an annual increase in heating spend of £5.04 per year, for households facing energy poverty, making this the worst affected group. This compares with £4.18 per year for high-income households, £3.65 per year for low-income households, and £2.99 per year for very low-income households not in energy poverty.

“When low-income households receive more income, they generally spend a little more to warm their homes. But these households often have to spread any extra money they have across other essential needs including food,” said lead author, Dr Ray Galvin, affiliated with Cambridge Institute for Sustainability Leadership (CISL).

“A reduction in income like the loss of the Winter Fuel Payment could force low-income pensioners to cut back not only on heating but also on other basic necessities. This poses a significant risk to people who are particularly vulnerable to the effects of living in cold homes.”

Energy efficiency

Across all household types, the researchers found that the energy efficiency of the dwelling had by far the biggest impact on heating expenditure.

“ ̽��ֱ��most effective strategy to warm up the homes of people living energy poverty is to increase the energy performance of their dwellings,” said Professor Minna Sunikka-Blank, from Cambridge’s Department of Architecture.

Specifically, the authors advise that the SAP12 rating of homes need to be increased to at least 72.

Each increase in SAP12 energy efficiency rating corresponds to a reduction in heating costs of around £20 per year, meaning that for households in energy poverty, with an average SAP12 rating of 59.48, increasing the rating to the level of low-income households not in energy poverty, 71.45, could reduce heating costs by about £240 per year.

̽��ֱ��authors make clear that energy savings would not be sufficient to pay for these energy-efficiency upgrades. They would require targeted financial support.

Dr Galvin said: “Government and society may well find that these costs are paid back to the country through co-benefits of fewer days off work, longer lives and less strain on the health service.”

While this would not improve the finances of households in energy poverty as much as the direct monetary allowances such as the Winter Fuel Payment, it would, the authors argue, make a substantial, direct impact on cold, unhealthy homes.

Dr Galvin said: “There needs to be extra focus on developing policies for the long-term solution of retrofitting energy-inefficient homes. This can provide enduring reductions in energy bills while also improving thermal comfort. This approach may also align better with the goal of reducing carbon emissions and tackling climate change.”

Prof Minna Sunikka-Blank said: “Without retrofit initiatives, energy poverty will persist in the UK, because in low-income households immediate needs often take precedence over thermal comfort, even when incomes increase.”

Home size

̽��ֱ��study found that households in energy poverty have a 7.3% larger average floor area than low-income households not in energy poverty, and that floor area makes a substantial difference to heating energy costs (about half to two-thirds the impact that the SAP12 energy efficiency rating has).

Tijn Croon, from TU Delft said: “These findings suggest that inability to downsize may be a significant driver of energy poverty in the United Kingdom. Low-income households can save money and stay warmer living in smaller homes but downsizing is not always easy for older households whose dependants have left home and who find themselves with a large, older home that is very expensive to keep warm.”

One-person households spend less on heating

A surprising finding in the study is that across all income groups, one-person households tend to spend less on energy. And for households in energy poverty the reduction (£36.77 per year) was twice as large as for low-income households not in energy poverty (£15.65 per year).

Tijn Croon, from TU Delft, said: “This might suggest that many one-person households are able to control their energy consumption more strategically than a multi-person household can.”

Dr Galvin said: “Our study controlled for other factors so this is not just a case of low-income households living in smaller homes. Further research could survey one-person households to find out if they have skills and practices that could be transferred to multi-person households.”

Mitigating impact of Winter Fuel Payment cuts

̽��ֱ��authors suggest several potential solutions. Expanding Pension Credit eligibility to align with the government's low-income threshold would be the most comprehensive fix, though this may be financially unfeasible. Alternative measures could include a temporary application process for the Winter Fuel Payment for those just above the Pension Credit threshold or providing tax credits or rebates for low-income pensioners, which could be more easily managed since HMRC already holds income data.

While much attention has been given to the risk of energy poverty among pensioners, the authors also note that families with children and young adults are often equally vulnerable and may face even greater challenges in the housing market compared to pensioners.

̽��ֱ��authors are currently working on a follow-up research paper that will explore the recent reforms to the government’s Warm Home Discount scheme.

Reference

R. Galvin, M. Sunikka-Blank, T. Croon, ‘Juggling the Basics: How Much Does an Income Increase Affect Energy Spending of Low-Income Households in England?’, Energy Research & Social Science (2024). DOI: 10.1016/j.erss.2024.103766

̽��ֱ��UK Government’s policy to scrap Winter Fuel Payments could disproportionately affect low-income pensioners in England, new analysis suggests. But the same study argues that the energy inefficiency of homes and challenges involved in downsizing will have an even more harmful effect this winter.

Without retrofit initiatives, energy poverty will persist in the UK

Minna Sunikka-Blank

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Rooftops view from Totterdown to Bristol Centre

̽��ֱ��text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright © ̽��ֱ�� of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

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̽��ֱ��“zero-chance” doctor who now advises government

cg605 — Wed, 19 Oct 2022 11:47:38 +0000

Growing up on free school meals at one of the lowest performing state schools in the country, Raghib Ali went on to become a leading epidemiologist and OBE awardee. He’s determined to improve the life outcomes of children from poor backgrounds so that they too can reach their full potential.

Experts urge government to keep focus on levelling-up health

cjb250 — Fri, 30 Sep 2022 10:32:46 +0000

Writing in Public Health in Practice and based on a review of all the previous literature, the team sets out a five-point framework to help level-up health and tackle health inequalities, which they say have been exacerbated by the COVID-19 pandemic.

̽��ֱ��UK Government committed to a programme of ‘levelling-up’ to help left-behind areas and regions to recover and prosper to the same extent as other parts of the country, including a £4.8 billion Levelling Up Fund. With the departure of Boris Johnson as Prime Minister, the researchers urge the new Government to reaffirm their commitment to levelling up.

With the fallout from the pandemic and rise in the cost of living, the impact on health is expected to be substantial due to the long-term economic repercussions of the pandemic, including food and housing insecurity, debt, and poverty.

Dr John Ford from Cambridge Public Health at the ̽��ֱ�� of Cambridge said: “It feels like we’re at a pivotal point as the Government moves its focus away from levelling-up and towards economic growth. It’s crucial that they consider closing the health gap – which has only got worse during the pandemic – as an urgent priority.

“This will not be straightforward to achieve and will require cross-government – and cross-party – support and long-term planning. That’s why we’re setting out five evidence-based principles that will help ensure the success of any health levelling-up programmes.”

Dr Ford and colleagues carried out a review of the research literature to develop a practical, evidence-based framework to level up health that can be implemented across sectors, including governments or non-profits, and across a diversity of scales, from local to national, and a diversity of contexts.

̽��ֱ��five overlapping principles identified by the group are:

Make interventions healthy by default and easy to use – In other words, make healthy choices easier to make. Past examples that have proven successful include: taxing unhealthy foods and subsidising healthy foods was consistently documented as an intervention type; providing fluoride toothpaste for home use and daily toothbrushing supervision for 5-year-olds.
Focus on long-term solutions working across many sectors – For example, while tackling housing conditions may be important, this alone is unlikely to be effective when individuals are still impacted by other factors such as working conditions or access to healthy foods: housing interventions are more likely to be effective in improving health and reducing inequalities when there were multiple interventions targeting several social determinants of health.
Tailor initiatives at a local level – For example, flu vaccination programmes are likely to be more successful if they can be offered outside of traditional working hours, while including community-based infrastructure developments in physical activity interventions can make them more sustainable, maintain increased adult physical activity levels and reduce inequalities.
Target disadvantaged communities – Universally-applied programmes that do not also target disadvantaged communities or account for their particular needs, assets, and barriers to health are less effective in reducing health inequalities and may even widen them. Provision of benefits to disadvantaged groups may also reduce health inequalities, such as food subsidy programmes for women of low-socioeconomic status that aim to reduce inequalities in mean birth weight and food/nutrient uptake.
Allocate resources according to need – Studies have shown that allocating resources where they are most needed – for example, the allocation of NHS resources proportionate to geographic need, with more deprived areas receiving more resources – is most effective at reducing inequalities.

Professor Clare Bambra from Newcastle ̽��ֱ�� said: “Health inequalities have arisen over decades, if not centuries, but underlying them is often the same root cause: an unequal distribution of the wider determinants of health, such as access to resources, opportunities, wealth, education, and power.

“There is no silver bullet that will solve this problem. If we are serious about tacking this problem, then we’ll need a holistic approach, with long-term, collaborative and cross-government strategies that look beyond just one election cycle.”

̽��ֱ��research was commissioned by Public Health England and undertaken in collaboration with Newcastle ̽��ֱ��.

Reference
Davey, F et al. Levelling up health: A practical, evidence-based framework for reducing health inequalities. Public Health in Practice; 30 Sept 2022; DOI: 10.1016/j.puhip.2022.100322

Experts are calling on the Government to continue focusing on ‘levelling-up’ health, arguing that reducing the health gap is too important an agenda to abandon.

It’s crucial that the government considers closing the health gap – which has only got worse during the pandemic – as an urgent priority

John Ford

Richard Johnson (Getty Images)

High-rise council flats in housing estate in Port Glasgow, Inverclyde

̽��ֱ��text in this work is licensed under a Creative Commons Attribution 4.0 International License. Images, including our videos, are Copyright © ̽��ֱ�� of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

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Raise the floor: education that works for everyone

Anonymous — Mon, 24 Jan 2022 08:25:50 +0000

̽��ֱ��evidence that convinced the international community that putting disadvantaged children first creates education systems that work for everyone.

Public health experts urge government to put health at centre of levelling up agenda

cjb250 — Fri, 10 Dec 2021 00:01:22 +0000

Based on decades of research around tackling health inequalities at local and regional level, the guidance is aimed at central and local government as well as other agencies with a stake in improving health.

̽��ֱ��team has published its report on the Cambridge Research Methods Hub website. It sets out five principles and eight policy recommendations that are designed to be used together long-term across national, regional and local systems.

̽��ֱ��principles are:

Allocating resources proportionate to need;
Working in partnership with local communities;
Developing long-term, multisector and cross-government programmes;
Offering bespoke services to disadvantaged groups;
Ensuring initiatives are healthy-by-default and easy to use.

Each principle is supported by case studies, such as Healthy New Towns, the Big Local initiative, and New Deal for Communities.

Dr John Ford, lead author and Clinical Lecturer in Public Health at the Primary Care Unit, ̽��ֱ�� of Cambridge, said: “ ̽��ֱ��new guidance has been produced to show how to level up health. We already know that progress on closing the gap is possible. ̽��ֱ��previous cross-government health inequalities programme reduced the socio-economic gap in life expectancy by six months and improved overall life expectancy. This was achieved through sustained, multi-component, and cross-government action over more than 10 years.”

Policy recommendations include: health being a core part of levelling up; development of a cross-government health inequalities strategy; establishing a consensus around what levelling up health means; and a focus on the social and structural factors that determine health.

Importantly, the report recommends a move away from initiatives that require individuals to invest time and effort to benefit from, such as promoting gym membership, because they tend to increase inequalities. Rather, the researchers recommend initiatives that make healthy choices the default and require minimal effort from the individuals, such as fluoridation of water and opportunistic screening for health problems during vaccine appointments.

Furthermore, the report calls for an end to competitive bidding of local areas to allocate public funds. Instead, it recommends allocating funding based on population need.

Health inequalities in England mean that men and women in deprived areas live an average of ten and eight years less respectively than men and women in more affluent places. Area-level health inequalities like these are driven by the conditions in which we live. Education and employment opportunities, housing, opportunities for exercise and a good diet are just some of the factors that directly affect our health.

Left-behind neighbourhoods, which have not prospered as much as other areas, experience greater health inequalities and the health of disadvantaged areas in the Northern regions has been falling further behind. For example, a baby boy born today in Blackpool can expect an additional 17 years of poor health compared to a baby boy born in Richmond upon Thames.

̽��ֱ��pandemic has exacerbated inequalities, and deaths related to COVID-19 in the most deprived areas of the country are double those in the least deprived. ̽��ֱ��long-term repercussions of the pandemic for some people – food and housing insecurity, debt and poverty – are expected to disproportionally affect those living in areas of higher deprivation, causing further damage to wellbeing and health.

̽��ֱ��researchers say that work to address area-level health inequalities is critically important for the UK Government’s levelling up agenda.

̽��ֱ��team reviewed data from over 650 research studies and 19 published reports. ̽��ֱ��12 case studies were selected from 143 potentially relevant examples from across England showing what works.

Professor Clare Bambra, Professor of Public Health at the ̽��ֱ�� of Newcastle, said: “Levelling up needs to urgently focus on health inequalities by addressing the unequal conditions in which we live, work and age.

“For too long, a lack of investment in key services has meant that more deprived, ‘Left Behind Areas’ – particularly in the north – have suffered disproportionately. ̽��ֱ��COVID-19 pandemic has worsened these inequalities and it will cast a long shadow across our future heath and economic prosperity as a country unless we act now. That’s why levelling up health is so central to the government’s overall approach to levelling up the country.”

̽��ֱ��new guidance was commissioned by Public Health England.

Reference
John Ford, Vic McGowan, Fiona Davey, Jack Birch, Isla Kuhn, Anwesha Lahiri, Anna Gkiouleka, Ananya Arora, Sarah Sowden, Clare Bambra. Levelling Up Health: A practical, evidence-based framework. December 2021

Health needs to be at the heart of the Government’s levelling up agenda, say researchers at the Universities of Cambridge and Newcastle. ̽��ֱ��team have today published practical guidance on how to reduce health inequalities.

̽��ֱ��new guidance has been produced to show how to level up health. We already know that progress on closing the gap is possible

John Ford

Francis Heathcote

Blackpool

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Beyond the pandemic: rethink the menu and how much it costs

lw355 — Thu, 24 Sep 2020 08:30:12 +0000

Boris Johnson has urged the country “to lose weight to beat coronavirus” through exercise and healthy eating. Dr Jean Adams suggests that food policies should be sensitive to the fact that healthier diets are beyond the budget of too many people in the UK.

Beyond the pandemic: tackle the digital divide

lw355 — Thu, 13 Aug 2020 08:00:52 +0000

Increased working, learning and interacting online during the pandemic has widened the gap for those who lack digital skills or access, writes Gemma Burgess, an expert on social inequality and housing in the UK. She suggests strategies to tackle the digital divide and avoid millions of the poorest in the UK being left even further behind.

Deprivation strongly linked to hospital admissions

cjb250 — Wed, 18 Dec 2019 09:48:59 +0000

Despite increases in overall life expectancy there is still an inequality, with lower life expectancy observed more often in disadvantaged groups. It is well known that those in higher social classes have a typical life expectancy several years longer than those with the lowest. Similarly, life expectancy and levels of good health vary between UK cities and regions, with large variations in expected years of life in good health.

In research published in BMJ Open, a team led by researchers at the Cambridge Institute of Public Health examined whether there was a link between living in an area of deprivation and subsequent hospital use. To do so, they examined data from almost 25,000 individuals (11,000 men and 14,000 women) from the EPIC-Norfolk cohort across almost two decades, between 1999 and 2018.

̽��ֱ��researchers used the Townsend Index to measure the deprivation of individuals’ residential areas, stratifying people into five levels. ̽��ֱ��Index looks at levels of unemployment, number of households without a car, the percentage of households not owner-occupied, and the percentage of households with more than one person per room.

Participants completed a lifestyle questionnaire that included questions about their own and their partner’s current and past employment and a list of qualifications. ̽��ֱ��researchers used the employment information to assign each participant to either non-manual or manual social classes. Non-manual social class included those individuals who worked in professional, managerial, technical and non-manual skilled occupations; manual social class included those who worked in skilled, partly skilled and unskilled manual occupations. ̽��ֱ��qualifications marked were used to assign participants to lower or higher educational attainment categories.

̽��ֱ��researchers found that people who lived in areas of highest deprivation spent the most time in hospital, but the risk of a long hospital stay is seen disproportionately in people who also had low educational attainment or were in manual social class. While the average amount of time spent in hospital over the two decade period was around 28 days for people with high educational attainment, for those with low educational attainment, the average was around 37 days, rising steeply to 43 days in the group living in areas of highest deprivation.

̽��ֱ��picture relating to social class was similar, though the differences between social classes was not as pronounced as those between educational attainments. Those individuals in non-manual social classes spent between 29 and 31.5 days in hospital; in manual social classes, people in areas of less deprivation spent around 32 days in hospital, rising to 39.5 days in areas of highest deprivation.

“Regardless of your age and gender, or even lifestyle factors such as smoking and obesity, living in an area of high deprivation is a significant risk factor for spending time in hospital,” said Dr Robert Luben from the Department of Public Health and Primary Care at the ̽��ֱ�� of Cambridge, the study’s first author. “People living in areas at or below the national average for deprivation were more likely to spend more than 20 days in hospital or be admitted to hospital on more than seven occasions during the two decades that we examined.”

Senior author Professor Kay-Tee Khaw, also from the Department of Public Health and Primary Care, said: “People working in a manual occupation or with lower education level and living in more deprived areas had the greatest risk of hospitalisation. This suggests that hospitalisation is greatest when poorer individual socioeconomic factors are combined with residential deprivation.

“It isn’t clear why this should be the case, though we can speculate that it could in part be down to better education improving an individual’s ability to live a healthier life.”

Previous research from the group has examined the link between lifestyle factors, education and hospitalisation. This is the first to look at the link between deprivation at an area level and hospitalisation.

“It clearly is not enough just to focus on educating people and improving lifestyle factors at an individual level,” added Dr Luben. “A poor environment affects those least able to cope. Effective NHS and government policy also needs to address deprivation infrastructural levels – improving housing, transport, access to recreation and green space, for example.”

̽��ֱ��research was funded by the Medical Research Council and Cancer Research UK.

Reference
Luben, R et al. Residential area deprivation and risk of subsequent hospital admission in a British population: the EPIC-Norfolk cohort. BMJ Open; 16 Dec 2019; DOI: 10.1136/bmjopen-2019-031251

People who live in areas of higher than average deprivation are more likely to be admitted to hospital and to spend longer in hospital, according to new research from the ̽��ֱ�� of Cambridge. ̽��ֱ��difference was particularly pronounced among manual workers and those with lower education level.

Regardless of your age and gender, or even lifestyle factors such as smoking and obesity, living in an area of high deprivation is a significant risk factor for spending time in hospital

Robert Luben

Rosmarie Voegtli

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