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The European Journal of Public Health Advance Access published online on September 12, 2005
The European Journal of Public Health, doi:10.1093/eurpub/cki186
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© The Author 2005. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
Received November 8, 2004
Accepted August 12, 2005

Article

Does usage of domestic heating influence internal environmental conditions and health?*

Jeremy J. Walker 1*, Richard Mitchell 1, Stephen D. Platt 1, Mark P. Petticrew 2, and Jane Hopton 3

1 Research Unit in Health, Behaviour and Change, The University of Edinburgh, Edinburgh, UK
2 MRC Social and Public Health Sciences Unit, Glasgow, UK
3 General Practice Section, The University of Edinburgh, Edinburgh, UK

* To whom correspondence should be addressed.
Jeremy J. Walker, E-mail: jeremy.walker{at}ed.ac.uk


  Abstract

Background: Housing conditions are recognised as an important determinant of health. In the UK, interventions to improve domestic heating are in place with the expectation that they will improve health. As a component of evaluating such policies, this study assesses whether specific health outcomes are significantly associated with the extent and duration of domestic heating use, either directly or via a possible mediating effect of internal environmental conditions. Methods: Baseline data from a prospective controlled study evaluating the health effects of a publicly-funded programme of heating improvements in Scotland were used to assess associations among heating use, internal conditions, and three specific health outcomes. Results: There were significant associations (P < 0.01) between measures of heating use and the presence of environmental problems in the home, such as mould and condensation. The presence of such problems was, in turn, found to be significantly predictive of two health outcomes derived from the SF-36 (P < 0.01) and of adult wheezing (P < 0.05). The direction of significant associations was highly consistent: greater levels of heating were associated with reduced likelihood of environmental problems, and the presence of environmental problems was linked to poorer health status. Heating use was not directly associated with the health outcomes considered. Conclusions: The study findings are consistent with a conceptual model in which health may be influenced by usage patterns of domestic heating, via the mediating effect of poor internal environmental conditions. Since these findings are based on cross-sectional data, interpretation must be carried out cautiously. However, if confirmed by planned future work they have important implications for policy initiatives relating to domestic heating and fuel poverty.

* Work described in this paper has previously been presented orally at the ENHR International Housing Conference (Cambridge; 2-6 July 2004) and at the WHO Second International Housing and Health Symposium (Vilnius; 29 September-1 October 2004).
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