Description
Objectives
This systematic review intended to assess the effectiveness of financial support interventions for household fuel poverty in the UK in terms of reducing adverse impacts on health and wellbeing of recipients.
Methods
Bibliographic databases and grey literature sources were searched from the UK evaluating health and wellbeing of participants following financial support to optimise indoor heating. Two independent reviewers carried out screening, data extraction and quality assessment of the articles. The outcomes included direct health-related outcomes such as Excess Winter Mortality (EWM), physical/mental health, health services utilization, well-being, and quality of life. Indirect health related outcomes included temperature, condensation/mould/dampness (CMD), fuel efficiency/expenditure and satisfaction with warmth. Due to the heterogeneity of interventions and outcomes, a narrative synthesis of the data was carried out.
Results
Twenty studies were included in the review: randomised controlled trials (n=1), before and after evaluation of interventions (n=14), ecological studies (n=1) and modelling studies (n=4). The studies assessed short term impacts of home energy efficiency improvements (HEEI) (n=17) and long-term impacts of Winter Fuel Payment (WFP) (n=4). HEEI improved indoor temperatures (n=4) and reduced CMD (n=8). Studies reported recipient satisfaction with HEEI (n=6) and significantly improved thermal comfort (n=9). There were significant improvements to self-perceived general health (n=3), wellbeing (n=3), physical health (n=2), mental health (n=5), reduced new health events (n=2), improved existing medical conditions (n=2), reduced health services usage (n=1) and reduced lost school time (n=1) following HEEI. HEEI were cost effective with added years to life (n=2). HEEI reported no association with EWM (n=1). WFP was found to significantly reduce EWM (n=2) and fibrinogen levels (n=1).
Conclusions
Financial support interventions for fuel poverty have positive impacts on health and wellbeing. Implementation of these interventions will require cross-sector collaborations, with consideration of which populations are most likely to benefit, alongside robust evaluations of long-term health gains and cost effectiveness.
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