Press Release: Left Out in the Cold: The Hidden Impact of Cold Homes Institute of Health Equity

Nearly 10m households in crisis after decade of deepening health inequality from cold homes 


  • New analysis finds 9.6 million UK households are living in heat-leaking, poorly insulated homes and have incomes below the minimum required for an acceptable standard of living. 

  • Cold homes double the risk of adults developing new mental health conditions and put 1 in 4 children at risk of multiple mental health symptoms. 

  • The latest evidence of the urgent need to insulate the nation’s cold homes comes just weeks after the Labour Party dramatically revised down its spending commitment to tackle the crisis. 

  • Tens of billions of pounds a year in costs to the NHS and lost productivity, would be saved by investing £6bn annually in a national insulation programme, which is needed alongside urgent action to reduce hardship and address high fuel costs. 

The lack of meaningful action to tackle Britain’s cold homes over the last decade has only intensified existing inequalities and the level of harm being felt across the country – with many millions of households now at the point of crisis – according to a new review examining the health impacts of cold homes. 
The failure to upgrade the UK’s energy inefficient housing stock, alongside years of wage stagnation, soaring energy prices, exorbitant living costs and unaffordable housing, has left the hope of a warm and healthy home far out of grasp for too many. 

Produced as a follow-up to a seminal 2011 report, the new analysis finds a staggering 9.6 million UK households[1] are currently living in poorly insulated homes with incomes below the minimum level at which an acceptable standard of living is affordable – meaning that finding enough money to pay for decent housing, enough heating and the basic essentials of life will be out of reach for most – at stark detriment to their health and wellbeing. 
Led by the UCL Institute of Health Equity (IHE), on behalf of Friends of the Earth, the new report Left out in the cold: the hidden health costs of Britain’s cold homes’ comes just weeks after the Labour Party back-pedalled on its spending commitment to tackle the cold homes crisis if voted in at the next election. The current government’s spending pledge falls even further short of the urgent investment needed to address the scale of the problem. 


Professor Sir Michael Marmot, IHE’s Director, said: 
"That there are millions, in a rich country like ours, living in cold homes is a national disgrace. One third of all households in the UK, 9.6 million, can’t afford a decent standard of living and are in poorly insulated homes. Cold homes are a public health hazard: those living in them have much higher risk of developing poor physical and mental health and this is adding burden onto an already overstretched NHS, and contributing to poor productivity. We need urgent action to address poverty, the cost of fuel and to insulate the homes of the poorest, not just because the government has a moral duty to look after the health of its population, but also, frankly, because it makes economic sense too." 
According to the latest research, adults that experience prolonged cold temperatures at home double their risk of developing new mental health conditions, while the risk of exacerbating existing mental health issues triples. Meanwhile, an alarming 1 in 4 (28%) children that live in cold homes are at risk of multiple mental health symptoms, such as anxiety and depression [3]. Physical discomfort from the cold, financial stress, social isolation and loneliness are all thought to contribute to declining mental health. 
Cold homes are also associated with negative health outcomes more widely, including heightened risk of heart attacks, impairment in children’s lung and brain development and respiratory problems, which can be exacerbated by damp and mould. 
Nicki Myers, aged 50, lives in Cambridge. She is a palliative care patient and disabled rights activist who is bedbound due to Ehlers-Danlos Syndrome, a genetic condition that affects the connective tissue, and pulmonary fibrosis which causes scarring and thickening of lung tissue. She said: 


I’m in fuel debt, but when I tried to limit my energy use last winter I got hypothermia twice, so I don’t have any option but to heat my bedroom constantly in the winter. Lots of councils have installed access equipment to reduce the number of care hours they provide, but many disabled people can’t afford to use it anymore because it’s too expensive to run. What’s more, no funding is provided to heat the rooms that domiciliary care staff need to use. 

“There are so many sick and disabled people struggling to survive winters and heatwaves in the UK because of extortionate energy bills and not enough income. The final cost of living payments are being paid this month – I do not know what disabled people will do without them. I have no doubt that some of us will join the thousands who die every year from living in a cold home.” 
Nicki is not alone – at least one in five people out of work because of ill health are living in cold homes [3]. The impacts on children are also significant. It’s estimated that 1.7 million school days are missed across Europe each year due to illnesses associated with damp and mould[4], with rates among UK children 80% higher than the European average, at detriment to their long-term prospects and educational outcomes. 
Professor Ian Sinha is a paediatric lung consultant at Alder Hey Children’s Hospital in Liverpool. He said: 
“Whatever the outcome in children – health, education, or emotional wellbeing – cold and substandard homes are toxic risk factors. Childhood is a time when the foundations of a person’s body are laid down, and that is what they are left with for the rest of their life.  
“Babies in cold homes do not spend their calories on developing lung tissue, neural pathways, and other crucial physiological drivers of health - rather, they spend their calories trying not to die of hypothermia and hypoglycaemia. 
“In our clean air clinic we have spent the winter hearing about children who can see their breath in front of them, andcan’t sleep because of how cold their rooms are. The answer does not lie in families tinkering around the edges - it requires politicians at the highest level to recognise that the housing arena in the UK is an absolute shambles, the cost of heating is a cruel blow for families trying to get by, and to hold their hands up to say that yet again, we have let children down.” 
Through costs incurred to the NHS, mental health services, care costs and the lost economic contributions of those who develop illness associated with cold homes, researchers estimate cold homes are costing the UK economy tens of billions of pounds per year. 

This builds on earlier work by the Building Research Establishment (BRE) Group, which identified that just a fraction of the country’s coldest homes is costing society £15bn per year. When carbon costs are accounted for (effectively how much carbon emissions from cold homes are costing society through climate and environmental damage), this rises to £18bn. 

building on the work of BRE, and adding carbon costs, we estimate that the cost of cold homes to society is at least 18 billion but that this is likely to be a significant underestimate given that BRE only costed the impact of the worst 720, 000 cold homes. 
The UK has the oldest and least efficient housing stock in Europe. Since 2013, installation rates of energy saving measures and insulation have plummeted by 90%. 
Investment to upgrade UK homes would therefore go some way to alleviating the high number of people experiencing cold-related hardship, while also saving the economy billions each year in avoided health, climate, and economic productivity costs. This investment is also essential for meeting legally-binding carbon reduction targets and international climate commitments. 

Mike Childs, head of science, research and policy at Friends of the Earth, said: 
“There’s no getting away from the enormity of the cold homes crisis and the impact it’s having on millions of lives. This hard-hitting report should spur all political parties into action as we head towards the general election - both the Conservatives and Labour have gone backwards over recent months on this critical issue. Given the sheer scale of the problem, we need to see transformative levels of investment and action, to stem the huge social and economic costs of cold homes and ensure our internationally agreed climate targets are met.”   
The disproportionate impacts faced by marginalised and vulnerable communities, including those with pre-existing health conditions, people of colour, older people, young children and those on low incomes, requires targeted action to ensure they are adequately protected from harm. 
Researchers at The UCL Institute of Health Equity have calculated that a national scheme to insulate low-income UK homes to a suitable standard (Energy Performance Certificate grade C), would cost in the region of £74.5bn. Using regulations to ensure landlords upgrade heat-leaking homes to a suitable standard would mean that not all of this has to come from the public purse, although tax incentives would ensure costs aren't passed onto tenants as higher rents. 
Spread over ten years, the total cost is likely to be broadly aligned to the £6bn a year spending commitment originally proposed by Labour as part of its Warm Homes Plan – now just a fraction of what was first promised - which Friends of the Earth and The UCL Institute of Health Equity are urging all political parties to align with. 
Such a scheme should be part of a range of measures designed to eliminate cold homes, including higher wages, financial support for those on low incomes so they can afford to pay for heating, and a national drive to build more social homes in order to reduce housing costs and improve standards. 

For more information and interview requests: 

UCL Institute of Health Equity, Felicity Porritt, f.porritt@ucl.ac.uk Tel: 07739 419219 

Friends of the Earth press office on 020 7566 1649 or emailmedia@foe.co.uk. 
Notes to editors 
[1] An analysis of detailed data tables within the government’s English Housing Survey enabled researchers to calculate the number of homes with incomes below the Joseph Rowntree Foundation’s Minimum Income Standard (which varies between size of households) in England and the number of these that had poor insulation levels (EPC D, E and F). The figure was extrapolated to cover other UK nations to give a UK-wide estimate. 

[2] Section 1.3 of the main report provides details of recent studies in the effect of cold homes on mental health. 

[3] Figure 5 in the main report provides details on the characteristics of the household composition of people living in cold homes. 

[4] Section 3.2 in the main report provides details of studies on the correlation on lost school attendance and damp. 

  • A full copy of the report, Left out in the cold: the hidden health impacts of cold homes, can be downloadedhere. 

  • Researchers at The UCL Institute of Health Equity and Friends of the Earth have calculated that a national scheme to insulate low-income UK homes to a suitable standard (Energy Performance Certificate grade C), could cost in the region of £74.5bn, although significant savings could result from efficiencies of scale through a well-planned programme, which may bring the costs closer to the £6 billion a year 10-year programme previously championed by Labour. Alternatively, saving could be made by requiring landlords to undertake such upgrades (with tax incentives to ensure the cost doesn't lead to increased rents). These costs exclude any government costs to support insulation in higher income groups, for example through zero-interest loans. 

About Professor Sir Michael Marmot: He is Professor of Epidemiology at University College London, Director of the UCL Institute of Health Equity, and Past President of the World Medical Association. He is the author of The Health Gap: the challenge of an unequal world (Bloomsbury: 2015) and Status Syndrome: how your place on the social gradient directly affects your health (Bloomsbury: 2004). Professor Marmot holds the Harvard Lown Professorship for 2014-2017 and is the recipient of the Prince Mahidol Award for Public Health 2015. He has been awarded honorary doctorates from 21 universities. In 2021 Professor Marmot received BMJ's Outstanding Contribution to Health award. Professor Marmot has led research groups on health inequalities for over 40 years. 
About the UCL Institute of Health Equity: The IHE is confident enough to conclude that we have the evidence on what needs to be done to advance health equity, as laid out in our 2010 Marmot Review. The UCL Institute of Health Equity works in local partnerships nationally and globally to influence the delivery of interventions to ensure they incorporate action on health, social and economic inequalities. Organisations with which the IHE works include business, city authorities, voluntary sector, local government and healthcare services. 

About Friends of the Earth: Friends of the Earth is an international community dedicated to the protection of the natural world and the wellbeing of everyone in it. We bring together more than two million people in 75 countries, combining people power all over the world to transform local actions into global impact. Follow us at @friends_earth, or like our Facebook page. Save paper and send an e-card today, available athttp://foe.uk/ecogifting 

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