Psychosocial routes from housing investment to health: Evidence from England's home energy efficiency scheme

Over the past decade the Warm Front Scheme has been the English Government's principal programme for improving domestic energy efficiency and reducing fuel poverty. This paper reports on a cross-sectional survey of low income householders participating in the Warm Front Scheme in five urban areas of England. Surveys were conducted of 2685 individuals, before and or after intervention. Pathways to self reported health were modelled by logistic regression. Of all the dimensions of health examined, only self reported mental health is directly associated with Warm Front measures. Intermediary variables associated with Warm Front intervention were shown to be significantly correlated with more dimensions of self reported health status. Higher temperatures, satisfaction with the heating system, greater thermal comfort, reductions in fuel poverty and lower stress were significantly correlated with improved health. Alleviating fuel poverty and reducing stress appeared to be the main route to health. We conclude there are complex and indirect relationships linking energy efficiency measures to outcomes on all dimensions of health which contribute to significant material and psychosocial benefits. The impact of the Warm Front Scheme cannot be fully understood by a limited analysis which merely relates indoor temperature and property characteristics to physiological health outcomes. (C) 2012 Elsevier Ltd. All rights reserved.