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      Determinants of winter indoor temperatures in low income households in England

      , , ,
      Energy and Buildings
      Elsevier BV

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          Vulnerability to winter mortality in elderly people in Britain: population based study.

          To examine the determinants of vulnerability to winter mortality in elderly British people. Population based cohort study (119,389 person years of follow up). 106 general practices from the Medical Research Council trial of assessment and management of older people in Britain. People aged > or = 75 years. Mortality (10,123 deaths) determined by follow up through the Office for National Statistics. Month to month variation accounted for 17% of annual all cause mortality, but only 7.8% after adjustment for temperature. The overall winter:non-winter rate ratio was 1.31 (95% confidence interval 1.26 to 1.36). There was little evidence that this ratio varied by geographical region, age, or any of the personal, socioeconomic, or clinical factors examined, with two exceptions: after adjustment for all major covariates the winter:non-winter ratio in women compared with men was 1.11 (1.00 to 1.23), and those with a self reported history of respiratory illness had a winter:non-winter ratio of 1.20 (1.08 to 1.34) times that of people without a history of respiratory illness. There was no evidence that socioeconomic deprivation or self reported financial worries were predictive of winter death. Except for female sex and pre-existing respiratory illness, there was little evidence for vulnerability to winter death associated with factors thought to lead to vulnerability. The lack of socioeconomic gradient suggests that policies aimed at relief of fuel poverty may need to be supplemented by additional measures to tackle the burden of excess winter deaths in elderly people.
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            Temperature, housing, deprivation and their relationship to excess winter mortality in Great Britain, 1986-1996.

            To examine the associations between temperature, housing, deprivation and excess winter mortality using census variables as proxies for housing conditions. Small area ecological study at electoral ward level. Setting Great Britain between 1986 and 1996. Men and women aged 65 and over. Deaths from all causes (International Classification of Diseases, Ninth Revision [ICD-9] codes 0-999), coronary heart disease (ICD-9 410-414), stroke (ICD-9 430-438) and respiratory diseases (ICD-9 460-519). Odds of death occurring in winter period of the four months December to March compared to the rest of the year. During the study period (excluding the influenza epidemic year of 1989/90), a total of 1,682,687 deaths occurred in winter and 2,825,223 deaths occurred during the rest of the year among people aged > or =65 (around 30,000 excess winter deaths per year). A trend of higher excess winter mortality with age was apparent across all disease categories (P < 0.01). There was a significant association between winter mortality and temperature with a 1.5% higher odds of dying in winter for every 1 degrees C reduction in 24-h mean winter temperature. The amount of rain, wind and hours of sunshine were inversely associated with excess winter mortality. Selected housing variables derived from the English House Condition Survey showed little agreement with census-derived variables at electoral ward level. For all-cause mortality there was little association between deprivation and excess winter mortality, although lack of central heating was associated with a higher risk of dying in winter (odds ratio [OR] = 1.016, 95% CI : 1.009-1.022). Excess winter mortality continues to be an important public health problem in Great Britain. There was a strong inverse association with temperature. Lack of central heating was associated with higher excess winter mortality. Further work is needed to disentangle the complex relationships between different indicators of housing quality and other measures of socioeconomic deprivation and their relationship to the high number of excess winter deaths in Great Britain.
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              A national field survey of house temperatures

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                Author and article information

                Journal
                Energy and Buildings
                Energy and Buildings
                Elsevier BV
                03787788
                March 2006
                March 2006
                : 38
                : 3
                : 245-252
                Article
                10.1016/j.enbuild.2005.06.006
                3cde89cc-a40f-4e37-a2a1-e0faa9cf848e
                © 2006

                http://www.elsevier.com/tdm/userlicense/1.0/

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