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The Health Gains and Cost Savings of Eradicating Cold Housing in Australia
35 Pages Posted: 18 Jul 2022
More...Abstract
Background: Cold indoor temperature (<18 degrees Celsius) is associated with higher blood pressure and increased cardiovascular disease (CVD), respiratory disease, depression and anxiety.
Objectives: We estimated health, health inequality, health expenditure and income impacts of lifting the temperature in living areas of the home to 18 degrees Celsius in cold homes in the south-eastern States of Australia (N= 17 million).
Methods: A proportional multistate lifetable model was used to estimate health adjusted life years (HALYs), health expenditure and income earnings, over the remainder of the lifespan of the population alive in 2021. Multiple data sources were used including the prevalence of cold housing (5.87%; mean temperature 15 degrees Celsius), the effect of temperature to systolic blood pressure and then CVD, and the association of cold housing to respiratory disease, depression and anxiety.
Results: Eradicating cold housing leads to 86,900 (95% UI 39,200 to 175,000; 3% discount rate) lifetime HALYs gained, nearly half of which occurred from 2021 to 2040. Contributions to HALYs gained from respiratory disease (44%; 95% UI 15% to 74%) and mental illness (46%; 16% to 76%) had wide uncertainty due to imprecise estimates of the magnitude of their causal association with cold housing. Health gains per capita were 6.2 times greater (4.7 to 8.6) among the most compared to least deprived quintile. From 2021 to 2040, health expenditure decreased by AUD$1.09 billon (95% UI 0.45 to 2.27; 3% discount rate) and income earnings increased by AUD$3.86 billion (95% UI 1.36 to 9.21; due to healthier people earning more income).
Conclusion: Eliminating cold housing would lead to substantial health gains, reductions in health inequalities, savings in health expenditure, and productivity gains. Next steps require research to reduce uncertainty about the magnitude of causal associations of cold with mental and respiratory health, and cost-effectiveness studies of actual interventions.
Funding Information: This study was funded by a grant from the NHMRC Centre of Research Excellence in Healthy Housing (APP1196456; principal investigator [CI] Rebecca Bentley, Melbourne School of Population and Global Health, University of Melbourne) and NHMRC Ideas Grant (APP2004466; principal investigator [CI] Rebecca Bentley, Melbourne School of Population and Global Health, University of Melbourne).
Declaration of Interests: None to declare.
Keywords: Modelling, indoor cold, housing, cardiovascular diseases, respiratory diseases, mental health, australia
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