“It’s changed my life not to have the continual worry of being warm” – health and wellbeing impacts of a local fuel poverty programme: a mixed-methods evaluation

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Background: Living in a cold home and being fuel poor can contribute to adverse physical and mental health. Energy efficiency interventions are considered the simplest ways of tackling fuel poverty and preventing associated negative health, wellbeing, and socio-economic consequences. The overall aim of the current study was to provide a greater understanding of the impact of a locally administered programme, which funded the installation of major heating/insulation measures in areas of high fuel poverty, on the health and wellbeing of beneficiaries of the programme.
Methods: A mixed-methods approach to explore the health and wellbeing impacts of a fuel poverty programme in East Sussex that took place between October 2016 and March 2018. Beneficiaries completed the Warwick-Edinburgh
Mental Wellbeing Scale before and after any heating/insulation work had been completed in their home. Beneficiaries were also asked to retrospectively rate their health pre- and post-installation. Interviews with 23 beneficiaries of the
programme were conducted to explore in-depth the impact of the programme on people’s health and wellbeing and the wider social determinants of health.
Results: A major heating/insulation measure was installed in 149 homes. The majority of measures installed were boilers (57.7%) and new central heating systems (32.2%). Self-rated health and wellbeing were significantly higher
post-installation. Interviewees described clear examples of the positive impacts on physical health and wellbeing such as fewer chest infections, reduced pain, feeling less anxious and depressed, and generally feeling happier and
more relaxed. Interviews also highlighted broader areas of impact such as reduced social isolation and increased use of domestic space. Many of the beneficiaries also reported a reduction in their energy bills since their new heating systems had been installed.
Conclusions: The findings from the evaluation suggest that the installation of major heating or insulation measures such as new boilers have substantial benefits for the health and wellbeing of beneficiaries. The findings also suggest
that the programme had a positive impact on wider determinants of health including reduction in stress and isolation that are likely to be part of the pathways between fuel poverty interventions and mental and physical health
Original languageEnglish
Article number786 (2022)
Number of pages16
JournalBMC Public Health
Publication statusPublished - 19 Apr 2022

Bibliographical note

Funding Information:
In East Sussex 8.2% of households are fuel poor compared with 7.5% in the South East and 13.4% in England. However, there is variation within East Sussex []. For example, the proportion of fuel poor households in Hastings is 10.8%, compared to 8.5% in Eastbourne. This has been attributed to the nature of the housing stock but also as a result of poor housing management in some areas and many households being on low incomes in Hastings. In October 2016, NHS Hastings and Rother Clinical Commissioning Group (H&R CCG) established an 18-month pilot project, known as the Healthy Homes programme, to fund installation of major heating and insulation measures, through the Winter Home Check Service (WHCS). The WHCS was commissioned by East Sussex County Council’s (ESCC) Public Health team and offered advice, home visit assessments, provision of small preventative measures and the coordination of installation of major heating/insulation measures (where funding allowed). The programme was targeted at poor condition properties in the private sector (owner-occupiers and private tenants) where fuel poverty was an issue due to unsatisfactory heating, poor thermal insulation, and generally poor energy efficiency. Major measures funded by the programme included: cavity wall insulation, hard-to-treat cavity works, loft insulation, floor insulation, solid wall insulation, full central heating systems, central heating boiler replacement, and storage heaters. The programme reached 149 properties between October 2016 and March 2018 in wards with the highest number of fuel poor households in Hastings and Rother.

Publisher Copyright:
© 2022, The Author(s).


  • Fuel poverty
  • Energy efficiency
  • Health
  • Wellbeing
  • Psychosocial
  • Mixed-methods
  • Deprivation
  • Inequality


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