In from the cold

Shock­ingly, al­most 1600 Kiwi deaths each win­ter are at­trib­uted to our cold houses. Here’s what we can do to ward off the worst of win­ter.

New Zealand Listener - - CONTENTS - By Ruth Ni­chol

Shock­ingly, al­most 1600 Kiwi deaths each win­ter are at­trib­uted to our cold houses. Here’s what we can do.

The first cold snap of win­ter is al­ways a shock, es­pe­cially af­ter an in­dif­fer­ent sum­mer such as the one we’ve had. It’s the first re­minder of how well – or how badly – your home in­su­la­tion and heat­ing mea­sure up to the com­ing chal­lenge. And it’s a rude wake-up call for those – al­most half of us, ac­cord­ing to a re­cent Sta­tis­tics New Zealand sur­vey – who say they live in a cold house. In some cases, the houses of the 48% of Ki­wis who are shiv­er­ing are ex­tremely cold. Re­search pub­lished in 2010 by the Build­ing Re­search As­so­ci­a­tion (Branz) found that the av­er­age evening tem­per­a­ture of New Zealand liv­ing rooms dur­ing the win­ter was 17.8°C – be­low the World Health Or­gan­i­sa­tion’s rec­om­mended min­i­mum of 18°C. But some were a chilly 10°C. This year, Branz found that al­most a third of rental houses feel damp, com­pared with just 11% of owner-oc­cu­pied houses.

Damp houses are much harder to heat than dry ones and the health con­se­quences of cold, damp houses are well known.

Chil­dren, in par­tic­u­lar, are at in­creased risk of res­pi­ra­tory prob­lems. Just this week, a re­port pub­lished by the Child Poverty Ac­tion Group (see box op­po­site) sin­gled out bron­chioec­ta­sis, a life-threat­en­ing dis­ease that re­sults from re­peated chest in­fec­tions in early child­hood.

The re­port quotes Asthma and Res­pi­ra­tory Foun­da­tion fig­ures show­ing the in­ci­dence of bron­chioec­ta­sis, which causes life­time lung dam­age, al­most tre­bled be­tween 2001 and 2015. Sub­stan­dard hous­ing, it said, has been iden­ti­fied as “the most im­por­tant risk fac­tor” in a range of child­hood res­pi­ra­tory dis­eases.

Older peo­ple, too, are at higher risk of car­dio­vas­cu­lar ill­ness from liv­ing in cold

“Their blood pres­sure was much higher, be­cause their bod­ies were strug­gling to keep warm.” “Even in much colder Canada, Scan­di­navia and Rus­sia, few such win­ter deaths oc­cur.”

houses. Ac­cord­ing to Philippa How­denChap­man, pro­fes­sor of pub­lic health at the Univer­sity of Otago, that’s be­cause be­ing cold stresses the im­mune sys­tem, puts a bur­den on the car­dio­vas­cu­lar sys­tem and makes the mus­cles work harder in the form of shiv­er­ing, which helps the body gen­er­ate heat.

“We know that be­ing cold has an im­pact on older peo­ple’s cir­cu­la­tion, in par­tic­u­lar be­cause the blood gets more vis­cous and is more likely to form plaques, and peo­ple are more likely to have atrial fib­ril­la­tion, or stroke and mal­func­tion­ing of their heart.”

Her re­search has found many New Zealan­ders re­port shiv­er­ing in their houses; a re­cent study in­volv­ing 656 teenagers from 17 low-decile schools, for ex­am­ple, found that 70% re­ported shiv­er­ing at least once dur­ing the win­ter. And she says the time-hon­oured New Zealand tra­di­tion of putting on an­other jer­sey or pil­ing more blan­kets onto your bed is not the an­swer. A re­cent Ja­panese study com­pared a group of healthy vol­un­teers who slept at a tem­per­a­ture of 22°C with those who slept at 12°C but with ac­cess to as many blan­kets as they wanted.

“When mem­bers of the sec­ond group got up in the morn­ing, their blood pres­sure was much higher, be­cause their bod­ies were strug­gling to keep warm.”

Those find­ings are echoed in a 2014 Scot­tish study that found that peo­ple liv­ing in houses with tem­per­a­tures be­low 18°C were more likely to suf­fer from high blood pres­sure than those liv­ing in houses where the tem­per­a­ture was 18°C or higher. The risk was even higher once the tem­per­a­ture dropped be­low 16°C.

How­den-Chap­man, the di­rec­tor of the univer­sity’s He Kainga Oranga Hous­ing and Health Re­search Pro­gramme, has been in­stru­men­tal in putting the spot­light on the poor qual­ity of many New Zealand houses. In her 2015 book, Home Truth: Con­fronting New Zealand’s Hous­ing Cri­sis, she wrote that she was of­ten em­bar­rassed by the re­ac­tion of over­seas au­di­ences when she talked about New Zealand hous­ing and our high win­ter mor­tal­ity rate.

About 1600 deaths each win­ter are at­trib­ut­able to cold hous­ing, most of them from res­pi­ra­tory and cir­cu­la­tory prob­lems among older peo­ple. New Zealand is not alone in this, she wrote, “but it is one of only a few coun­tries – the others be­ing Scot­land, Ire­land, Por­tu­gal and Greece – that have no­tice­able win­ter deaths. Even in much colder, con­ti­nen­tal coun­tries such as Canada, the Scan­di­na­vian coun­tries and Rus­sia, few such win­ter deaths oc­cur.”

She says we could achieve the same out­comes as in those cold coun­tries if our houses had proper in­su­la­tion and en­ergy-ef­fi­cient heat­ing to keep them at the WHO-rec­om­mended tem­per­a­ture of 18-21°C.

And she has the ev­i­dence to prove it. In 2012, she worked with non-profit re­search in­sti­tute Motu Eco­nomics to eval­u­ate the first 45,000 homes retro­fit­ted with in­su­la­tion un­der the Gov­ern­ment-funded Warm Up New Zealand pro­gramme. They found that the pro­gramme had a 6:1 ben­e­fit-to­cost ra­tio for chil­dren and older peo­ple, and a 4:1 ra­tio over­all. In other words, ev­ery dol­lar spent on in­su­la­tion pro­vided $4-6 worth of ben­e­fits, mainly by way of re­duc­tions in health ex­pen­di­ture be­cause of fewer hospi­tal stays and lower phar­ma­ceu­ti­cal costs. The pro­gramme also saved lives: one for ev­ery 1000 in­su­lated houses.

Warm Up New Zealand pro­vides sub­si­dies of 33-60% to­wards the cost of retrofitti­ng homes with ceil­ing and un­der­floor in­su­la­tion. It’s had sev­eral it­er­a­tions since it be­gan in 2009 and by the end of June 2016 had pro­vided a to­tal of $447 mil­lion to help in­su­late 291,000 New Zealand houses.

The pro­gramme’s lat­est – and, at this point, fi­nal – ver­sion, which is funded to the tune of $18 mil­lion and ends in July 2018, fo­cuses on land­lords with ten­ants who have Com­mu­nity Ser­vices Cards or health con­di­tions caused by cold, damp hous­ing. The sub­sidy is in­tended to help land­lords meet the re­quire­ment to in­su­late their rental prop­er­ties by July 1, 2019.

By the end of March, the En­ergy Ef­fi­ciency and Con­ser­va­tion Au­thor­ity (EECA), which ad­min­is­ters the pro­gramme, had paid

out 2946 grants to cover half the cost of retrofitti­ng in­su­la­tion in rental prop­er­ties.

How­den-Chap­man is dis­ap­pointed that given its proven health ben­e­fits, Warm Up New Zealand is wind­ing down, par­tic­u­larly as she es­ti­mates that there are still 600,000900,000 New Zealand houses with no or in­ad­e­quate in­su­la­tion.

“It’s very dif­fi­cult with the type of houses we have, es­pe­cially with the older ones, to keep them warm. That means it’s ab­so­lutely es­sen­tial that all homes are in­su­lated, which

is why I lament the Gov­ern­ment’s de­ci­sion.”

Arthur Grimes, se­nior fel­low at Motu Eco­nomics and former chair­man of the Re­serve Bank, agrees that it makes fi­nan­cial sense to con­tinue with some tar­geted in­su­la­tion sub­si­dies, es­pe­cially for home­own­ers aged 60 or older who are at the great­est risk of de­vel­op­ing cir­cu­la­tory prob­lems.

“This is where you get the big­gest bang for your buck when it comes to in­su­la­tion. They might not have heart dis­ease now, but they may get it later, and I would say that as

a group they should be tar­geted.”

HEALTH PAY­OFF

Many peo­ple as­sume that in­stalling in­su­la­tion will re­duce their power bills, but Grimes says that in most cases peo­ple spend much the same on en­ergy – but they are much warmer and health­ier. “That was a pretty cru­cial find­ing we made when we did the eval­u­a­tion, and it was dif­fer­ent from what the of­fi­cials were ex­pect­ing, which was sav­ings in en­ergy bills. They did fall a min­i­mal

From top, pub­lic health pro­fes­sor Philippa How­den-Chap­man; econ­o­mist Arthur Grimes.

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