The connection between fuel poverty and health is based on the health implications of living in cold, damp homes.
Those who are fuel poor are more likely to turn their heating down below the level adequate for their well-being, and more likely to live in energy-inefficient homes which are poorly insulated and prone to dampness.
A World Health Organisation Report in 1985 established that there is a link between poor health and low indoor temperatures. Since then, further research has strengthened this finding and demonstrated that fuel poverty is today a contributing factor in a number of cold, and poor housing, related health conditions.
Damp and mould are widespread problems linked to poor efficiency and affordability, harming health and security of tenure, particularly for low income and rented households (Citizens Advice Scotland, ‘Left in the Cold’, Jun 2025).
Health implications of fuel poverty
Existing health conditions can be affected badly by cold and others can be brought on as a result of prolonged exposure to the cold. Respiratory disorders can be worsened by prolonged exposure to low indoor temperatures and people living in cold homes have an increased tendency to suffer colds, flu, bronchitis and pneumonia.
In addition, cold conditions in a home can contribute to condensation dampness and mould growth. This has a detrimental effect on some allergies. Mould spores and dust mites in the air can cause allergic reactions, which in turn can cause problems for people with respiratory illnesses such as asthma.
In Britain, a cold spell during an otherwise mild winter, depending on its duration, can see the following:
- After two days there is a sudden rise in heart attacks, by up to a third;
- After five days there is a big rise in the number of strokes;
- And twelve days into a cold spell there is a rise in respiratory illnesses.
Where a person is unable to heat their home to a good comfort level, it has a direct impact on their health. Even a slight decrease in indoor temperatures below 18°C could have a negative impact on health, it is not just at extremely cold temperatures health risks arise, but slight deviations have an effect as well (Gasparrini et al., 2015).
Fuel poverty has been associated with the development of early onset asthma in children, exacerbation of asthma, cognitive impairment, respiratory diseases, cardiovascular diseases, mental health issues, diseases amongst older groups and can have a number of other effects on the health of an individual (ScotPHN, 2016b).
Our health, housing and fuel poverty report explores the different health impacts that arise due to fuel poverty, including respiratory conditions, cardiovascular diseases, and mental health issues.
How low indoor temperatures impact health
Low indoor temperatures can result from inadequate home heating, either because households cannot afford sufficient heating or because the home is difficult to heat effectively due to factors such as poor insulation.
This is connected with several health issues, as most people spend more than 90% of their time indoors.
Decreasing indoor temperature below the comfort zone progressively influences the respiratory, cardiovascular and thermoregulatory systems and consequently the maintenance of good health.
The start of discomfort is likely to indicate the start of health risks, so the temperatures required for comfort and for health are broadly the same.
One group that may need higher temperatures is the sick and disabled. Restricted mobility inevitably results in more time spent in the home, and the reduced level of activity means that a higher temperature is needed to achieve comfort.
An important point to note is that many very old people find it harder to detect temperature changes than other age groups. In some cases, temperatures of 15-16°C may not be experienced as ‘cold’ by the old person but will nevertheless be harmful to health.
Temperature requirements for rooms
For comfort and health, the temperature of the main occupied room should average 21°C. For other areas such as bedrooms, bathrooms and halls 18°C is recommended.
| Indoor temperature | Effect on health |
|---|---|
| 18–24°C | The comfort zone, no risk to sedentary, healthy people |
| 16°C | Increasing risk of respiratory disorders |
| 12°C | Cardiovascular strain, increased blood pressure and viscosity |
| 9°C | Failing thermoregulation and risk of hypothermia, after two hours exposure as the deep body temperature falls |
Winter mortality
There were 2,704 “excess” deaths in Scotland during the winter of 2024/25. Fuel poverty is often hidden, but it is costing people in Scotland their lives and increasing pressure on our frontline services.
A lot of attention has quite rightly been given to tackling drug misuse, alcohol and road accident deaths. However, there were more excess winter deaths in a 4-month period than in the 12 months that the other types of deaths are registered.
Contributing factors include low income, inefficient heating systems, external temperature fluctuations, and excessive dampness and mould growth associated with poor housing stock.
In Scotland there are long and damp winters, which are worse for health than dry Scandinavian winters. Factors affecting excess winter mortality are varied and complex, but there is a strong relationship between thermal standards in housing and excess winter deaths.
The UK has much higher winter deaths rates than other countries with more severe winter climates, implying that it is not outdoor exposure to cold that is the key determinant. Northern Finland, where winter temperatures regularly drop to -20°C, has a significantly lower rate of excess winter deaths than the UK. However, Finnish buildings have historically had much higher levels of insulation and whole house central heating has been the norm for years.
It is generally accepted that the number of excess winter deaths could be reduced if everyone could be kept warm in their homes during the winter months.
The seasonal increase in mortality in the winter has been defined as the difference between the number of deaths in the four ‘winter’ months (December to March) and the average of the number of deaths in the two four-month periods which precede winter (August to November) and follow winter (April to July).
The annual statistics are available here from the National Records of Scotland.
The cost of fuel poverty
It seems vital that fuel poverty is eradicated as it negatively impacts the physical and mental health of all age groups, but also corresponds to an additional burden on NHS services through increased spending to deal with fuel poverty-related health issues.
It is estimated that fuel poverty costs Scotland £80 million annually (National Energy Action, 2020) and the National Housing Federation estimated that poor housing conditions costs the NHS £2.5 billion per annum (BRE, 2015).
Tackling fuel poverty would also achieve a cost saving for the NHS. In their 2008 report, Professor Christine Lidell identified that every £1 spent on reducing fuel poverty saved the NHS 42 pence.
This is why much more resources are needed to tackle the monumental risks fuel poverty poses to people’s lives, the health service and the economy.