Excess Winter Deaths and Winter Fuel Payments (WFP)

The CLAHRC WM Director loved this paper [1] because:

  1. He is enamoured of studies of policy changes.
  2. It deals with a really important issue – excess winter deaths – defined as the difference between death rates in December through March vs. the sum of the four months preceding and following. This is a health measure on which the UK does quite badly in comparison with other countries.
  3. The statistical analysis of the time series straddling the introduction of WFP is elegant.
  4. The paper includes an overview of literature concerning other interventions such as home-improvement – a topic of study under CLAHRC WM.

Excess winter deaths have been falling in the UK over the last 70 years. However, there was a step change over the period when WFPs were introduced (1997-2000) that accounts for half of the reduction observed since then.

The Director has one criticism – the study controlled for average indoor temperatures (based on a yearly national sample) as well as for outdoor temperature. He would not have controlled for indoor temperature, since it is on the plausible causal pathway between explanatory and outcome variable. That said, it is remarkable that a reduction is noted despite making this adjustment. Also, no cost-effectiveness analysis was attempted and the Director wonders if one is planned?

— Richard Lilford, CLAHRC WM Director

Reference:

  1. Iparraguirre J. Have winter fuel payments reduced excess winter mortality in England and Wales? J Public Health (Oxf). 2015; 37(1):26-33.
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