Improving the thermal comfort of homes has health benefits for older residents and makes financial sense

Author: Dr Katie Page¹, Dr Lutfun Hossain¹, Dr Dan Liu¹, Dr Toby Cumming², Professor Kees van Gool¹, Professor Rosalie Viney¹

1. Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney, Australia.
2. Sustainability Victoria, Victoria, Australia.

Poor quality housing is associated with an increased risk of morbidity and mortality. Vulnerable people, particularly the elderly, and those with a disability or chronic illness, are at higher risk because they are likely to spend most of their time at home and, therefore, be more exposed to health risks associated with cold homes. Home upgrades that increase indoor temperature have the potential to provide health and energy benefits, but currently, there is no robust evidence of these benefits in an Australian context.

The Victorian Healthy Homes Program was a state government-funded program to upgrade 1000 homes whose residents were elderly and with a chronic health condition.  It was also a randomised control trial where half of the homes were assigned to receive their upgrade before winter and the other half after winter. The program aimed to demonstrate energy and health benefits and the economic costs and benefits over winter.

Analysis showed that a comparatively low-cost home upgrade (average AU$2,809) had several benefits over the winter period. Average indoor temperatures increased by a third of a degree across the day, with the strongest effects in the morning, when temperatures are lowest. Exposure to cold temperatures (<18⁰C) was reduced by 43 minutes per day. Moreover, householders who received their upgrades before winter were more than twice as likely as non-upgraded householders to report that their homes felt warmer over winter. Householders reported being warmer despite a significant reduction in gas use in the upgraded homes and no change in electricity use.

The home upgrade was also associated with several health benefits, including reduced breathlessness and improved quality of life, particularly concerning mental health and social care. Health benefits of the upgrade were reflected in the cost savings, with AU$887 per person saved in the healthcare system over the winter period. Cost-benefit analysis showed that home upgrades would be cost-saving within three years and produce a net saving of AU$4,783 over ten years due to savings in both energy and health. Savings were heavily weighted towards healthcare: for every AU$1 saved in energy, more than AU$10 is saved in health.

This program is the first in Australia, implemented alongside an innovative and rigorous research program. Evaluation and outcomes are significant and positive for energy and health savings at a low cost. It is rare to have randomised controlled trials in this area of public policy. Data from this study can significantly impact state and national government housing policy, which is of ever-increasing importance because of the growing recognition of the impact of climate and housing on health and well-being.