The impact of fuel poverty on cold-related mortality in England and Wales: disentangling the effects of fuel price, income, and energy efficiency

Abstract Cold temperatures have been widely acknowledged as an important burden of poor health in many parts of the world including the UK. Although the temperature is expected to increase in the future due to climate change, the latest UK Health Effects of Climate Change (HECC) report projected that the number of cold-related deaths in the UK is expected to be more than 2 times of heat in the 2070s even under a high emission climate change scenario (RCP8.5). Therefore, it is still imperative to take intervention to reduce the health impacts of cold. People spent more than 90% of their time indoor and hence being able to stay in warm homes is crucial for reducing the impact of cold. However, some people may not be able to warm their home enough, a problem known as fuel poverty. Multiple factors can contribute to fuel poverty, including low income, poor housing performance, high fuel price as well as competing interest in fuel consumption and other essential living expenses. These challenges have been witnessed markedly during the cost of living crisis since 2021. This research investigates the effect of fuel poverty on cold-related mortality risk in England and Wales using small areal data. The underlying contributing factors of fuel poverty are explored to study the main mechanisms. The findings can support the identification of those who may be mostly affected by fuel poverty, and hence improve policies and interventions on reducing fuel poverty and protecting the public health from low temperatures.