Intended for healthcare professionals


The health impacts of cold homes and fuel poverty

BMJ 2011; 342 doi: (Published 11 May 2011) Cite this as: BMJ 2011;342:d2807
  1. Keith B G Dear, senior fellow,
  2. Anthony J McMichael, professor
  1. 1National Centre for Epidemiology and Population Health, College of Medicine, Biology and Environment, Australian National University, Canberra, ACT 0200, Australia
  1. keithdear4{at}

Three reasons to act: the health burden, inequity, and mitigation

On 12 May Michael Marmot and his team published their report, “The heath impacts of cold homes and fuel poverty,” commissioned by Friends of the Earth.1 The report highlights an obvious, well known, and largely ignored fact—that cold homes waste energy and harm their occupants—and identifies an opportunity for simultaneous gains on three fronts. By improving the thermal efficiency of British homes the government would reduce carbon dioxide (“greenhouse”) emissions, avoid a major burden of ill health, and reduce health inequity, which—as the report shows—maps closely with social and economic disadvantage. The report delivers three messages. Firstly, improving the energy efficiency of the housing stock—to spread “affordable warmth”—would bring multiple health gains, directly and through improved home finances. Secondly, fuel poverty as a result of poor housing stock causes avoidable health inequality and is unjust. Thirdly, reduced fuel use would bring environmental gains, in the short term through reduced air pollution and in the longer term in helping to mitigate climate change.

The same is true of Australia, which is perhaps often envied by inhabitants of northern Europe as a land of sand, sunshine, and seasonal tropical monsoons that bring welcome warm rains …

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