In many countries, children are more likely than any other age group to be living in fuel poverty. Almost half (46.3%) of all fuel-poor households in England have dependent children, a figure that plays out to more than one million households.
Unfortunately, children are the least well-equipped to cope with such conditions and their risk of experiencing ill health in cold homes is significantly heightened for numerous reasons. The first is simple physics: children have a large surface area compared to their weight (a high 'surface‐to‐mass' ratio). For example, an 8-year-old child who is 128 cm tall and weighs 25 kg has a surface-to-mass ratio of 380 square centimetres per kilogram (cm2/Kg). By contrast, for an adult who is 177 cm tall and weighs 64 kg, the ratio is 280 cm2/Kg. The net effect is that children have more skin area through which they can lose their own body heat when exposed to a cold environment.
The most prevalent child health issues linked to fuel poverty are increased incidence of common colds and flu, and other respiratory illnesses such as bronchitis. Statistics show that children living in inadequately heated homes are more than twice as likely to suffer from chest and breathing problems as those living in healthy temperatures. Other data show that doctor consultations for respiratory tract infections increase dramatically as indoor temperatures at home decline.
When families experiencing fuel poverty are forced to choose between buying food or paying energy bills, children tend to be the most affected. Both cold indoor temperatures and malnutrition have been associated with low developmental rates among babies, with ‘energy insecurity’ in the home being linked to low birth weights and low weight in young babies who are admitted to hospital (regardless of whether the given illness is cold-related). Small undernourished children, who may have little fat just beneath the skin (subcutaneous fat), are more at risk for frostbite and hypothermia.
Children living in damp, mouldy homes are up to three times more prone to coughing and wheezing than children in dry homes. Cold, damp homes also promote mould growth, and the spores released from moulding surfaces easily enter children’s lungs causing allergic reactions and varying degrees of asthma. In addition, running and playing in cold air increases the risk for exercise-induced asthma attacks.
Bath time in cold homes is extra risky. Water has a high rate of thermal conductivity – about 25 times that of air, which means the loss of body heat to cool water can be 25-30 times faster. Combined with the large surface area, and potentially low fat reserve, of small bodies, a cool bath can quickly bring down core body temperature. While a little shivering after bath-time is normal, if it becomes more severe and is coupled with goosebumps, numb fingers or a loss of coordination, the child may be experiencing mild hypothermia.
Whether these illnesses simply cause discomfort or are severe enough to trigger doctor visits or hospitalisation, they can set children up for a lifetime of ill health. They also interfere with a child’s ability to learn and develop. In the short term, attendance and ability to concentrate at school might drop; over the longer term, the child might miss out on acquiring basic skills or be too unwell to succeed on more difficult lessons and tasks, which can affect future prospects.
The good news is that action to fix cold homes quickly delivers better health results for these vulnerable little ones. One study carried out in the United States compared children in families benefiting from the Low‐Income Home Energy Assistance Program (LIHEAP) against those who had not received assistance. The group whose houses had been warmed up through retrofit efforts were 20% less likely to be underweight for age or length, and 30% less likely to require admission on the day of visiting a hospital emergency room. Installing new heating systems in homes with asthmatic children can reduce the number of sick days off school by between 15% and 80%, while also reducing need for doctor consultations or other treatment.
While beyond the scope of this blog, multiple studies demonstrate that fixing up cold homes where children live is economically wise and deliver a wide range of short- and long-term benefits for health and well-being.