Book Cover -- Half-Title -- Title -- Copyright -- Editors' note and acknowledgements -- Contents -- Abbreviations -- About the authors -- Cutting the cost of cold -- Introduction -- Part One: Current research -- 1 Cold weather, cold homes and winter mortality -- 2 Housing and winter death: epidemiological evidence -- 2.1 Introduction -- 2.2 Seasonal variation in mortality -- 2.3 Relationship with housing -- 2.4 Affordable warmth -- 2.5 Impact on excess winter death of housing improvements -- 2.6 Conclusions -- 3 Cold, cold housing and respiratory illnesses -- 3.1 Introduction -- 3.2 Cold environment and the respiratory system -- 3.3 Cold housing and respiratory health -- 3.4 House temperatures in Great Britain -- 3.5 Hygrothermal conditions, mould growth and allergies -- 3.6 Transmission of infections -- 3.7 The elderly and vulnerable groups -- 3.8 Seasonal respiratory mortality -- 3.9 Conclusion -- 4 Cold stress, circulatory illness and the elderly -- 4.1 Introduction -- 4.2 Winter morbidity and mortality -- EXCESS WINTER DEATHS -- EXCESS WINTER DEATHS AND AGE -- CAUSES OF WINTER DEATH -- 4.3 Temperature and excess winter deaths -- LABORATORY STUDIES -- FIELD AND CLINICAL STUDIES -- 4.4 Cold stress and behavioural risk -- 4.5 Role of physical activity -- SEASONAL DIFFERENCES IN ACTIVITY -- PHYSICAL ACTIVITY AND BLOOD PRESSURE -- IMPLICATIONS FOR HEALTH -- 4.6 Conclusions -- 5 Dust mite allergens, indoor humidity and asthma -- 5.1 The rising incidence in asthma -- 5.2 Housing and health -- 5.3 Hygrothermal changes in the domestic environment -- 5.4 The house dust mite -- HOUSE DUST MITE ALLERGENS -- 5.5 Asthma-pathology, sensitizers and triggers of asthma -- 5.6 Prevention measures -- 5.7 Meta-analysis -- 5.8 An interventionist double-blind placebo controlled trial -- GENERATING THE SAMPLE -- HOUSE PERFORMANCE -- DUST MITE LEVELS.

ASTHMA MONITORING -- 5.9 Remedial strategies -- STEAM -- FANS -- BEDDING -- SAMPLE SPLIT -- 6 Impact of fuel poverty on health in Tower Hamlets -- 6.1 The sample -- 6.2 Basic links with health -- 6.3 The results -- PAYMENT OF BILLS -- HOUSING CONDITIONS -- HEALTH PROBLEMS -- 6.4 Correlations between illnesses and housing problems (relating to aspects of fuel poverty) -- 6.5 Children's health -- 6.6 Conclusions -- 7 Tolerant building: the impact of energy efficiency measures on living conditions and health status -- 7.1 Introduction -- 7.2 Aim of the Sheffield study -- 7.3 Research design -- 7.4 Results: Energy consumption and temperature -- 7.5 Results: Moisture production, damp and mould -- 7.6 Results: Health status -- 7.7 Conclusion -- Part Two: Tools for research and practice -- 8 The Affordable Warmth Index -- 8.1 Introduction -- 8.2 The development of the AWI -- 8.3 The technical definition of the AWI -- INCOME -- FUEL RUNNING COST -- AFFORDABLE WARMTH INDEX SCALE -- 8.4 Applications of the AWI -- PENSIONERS' ENERGY PLAN -- 8.5 Conclusions -- Appendix 8.1: AWI case studies -- EAGA -- NATIONAL ENERGY ACTION (NEA) -- CAMBRIDGE HOUSING SOCIETY (CHS) -- CAMBRIDGE CITY COUNCIL -- MID SUFFOLK DISTRICT COUNCIL (MSDC) -- ABERDEEN CITY COUNCIL -- DONCASTER METROPOLITAN BOROUGH COUNCIL -- WARM FRONT PROJECT, ECSC -- FIRST REPORT -- 9 Mould Index -- 9.1 The problem -- 9.2 Conditions for mould growth and dust mites -- 9.3 Micro environmental conditions -- 9.4 Moisture production and movement in dwellings -- MOISTURE PRODUCTION -- MOISTURE TRANSPORT -- 9.5 Internal temperature -- 9.6 Relative humidity modelling -- 9.7 Sensitivity -- 9.8 Mould Index -- 9.8 Conclusions -- 10 Winter morbidity and fuel poverty: mapping the connection -- 10.1 Changing priorities -- 10.2 Housing and health -- 10.3 Development of the methodology.

10.4 An indicator for ill health related to cold -- 10.5 Low income indicator -- 10.6 Housing energy performance -- 10.7 Winter severity -- 10.8 Conclusions -- 11 Modelling the health cost of cold damp housing -- Introduction -- 11.1 Prevalence of cold or damp housing -- 11.2 Health, use of health services and cold, damp housing -- 11.3 Modelling the costs -- 11.4 General assumptions and limitations within the model -- 11.5 Asthma, rhinitis, and bronchitis and bronchiolitis associated with damp housing -- 11.6 Mental health problems associated with damp housing -- 11.7 Ischaemic heart disease, heart failure and strokes associated with cold housing -- 11.8 Estimated cost savings -- 11.9 Limitations of this modelling approach -- 11.10 Comparisons with other published estimated costs -- 11.11 Recommended methodologies to guide policy -- Part Three: Inter-agency partnership in practice -- 12 Asthma: lessons of the Cornwall Housing Intervention Study -- 12.1 Introduction -- 12.2 The Cornwall Housing Intervention Study -- CHOOSING THE TARGET GROUP -- CHOOSING THE STUDY DESIGN -- CHOOSING THE OUTCOME MEASURES -- IDENTIFYING THE CHILDREN -- CHOOSING THE INTERVENTION -- 12.3 Effects on housing, symptoms and school attendance -- 12.4 Effects on health service and medication use -- 12.5 Interpretation of findings -- 12.6 Economic considerations for the occupants -- 12.7 Policy considerations -- 12.8 The future -- Acknowledgements -- 13 Treating cold, damp and asthma with affordable warmth -- 13.1 Background -- 13.2 The Study -- 13.3 Partners' roles and responsibilities -- 13.4 Results -- 13.5 A partnership-real or imagined? -- 13.6 The relationship in the partnerships -- 13.7 Funding partners -- 13.8 Operational partnership -- 14 Promoting partnership: the Nottingham example -- 14.1 Health in your environment' strategy -- 14.2 Planning for success.

14.3 Outcomes from the Energy Efficiency, Health and Environment Seminar -- 14.4 Enabling joint work in Nottingham Health District -- 14.5 Potential barriers to progress -- 14.6 Overcoming difficulties -- 14.7 Building on success -- 15 Urban care: working in partnership with communities -- 15.1 Urban decline -- 15.2 An alternative approach -- 15.3 Consultation -- 15.4 Urban care strategy -- 15.5 Partnership -- 15.6 Information, advice and practical assistance -- 15.7 Health -- 15.8 Community training -- 15.9 Tool loan -- 15.10 Community builders' list -- 15.11 Resourcing work -- 15.12 Young people -- 15.13 Communication -- 15.14 Achievements -- 15.15 Conclusion -- 16 Working in partnership: lessons from ten case studies -- 16.1 Introduction -- 16.2 Research -- 16.3 Case studies -- A. HECACTION FOR IMPROVED HEALTH AND HOUSING -- B. HEALTH AND ENERGY COMBINED ACTION -- C. ENERGY ACTION FOR HEALTH -- D. ENERGETIC HOMES -- E. ENERGY EFFICIENCY TRAINING FOR PRIMARY CARE WORKERS -- F. BEAT THE COLD -- G. 'SNUG' SCHEME -- H. ENERGY, HOUSING AND HEALTH -- I. CORNWALL AND ISLES OF SCILLY -- J. OXFORD CITY COUNCIL -- 16.4 Multi-agency working: Barriers and opportunities -- BENEFITS OF MULTI-AGENCY WORKING -- BARRIERS TO MULTI-AGENCY WORKING -- HOW BARRIERS COULD BE OVERCOME -- 16.5 Recommendations -- 16.6 Conclusions -- Part Four: Ways forward -- 17 The cost of poor housing-and how to reduce it -- 17.1 The origins of the research -- 17.2 The CEHI research programme -- 17.3 Poor quality housing and 'exported costs' -- 17.4 A matrix of 'exported costs' -- 17.5 Case studies and empirical findings -- IN CENTRAL STEPNEY -- PADDINGTON-A COMPARATOR AREA -- WORK IN HOLLY STREET HACKNEY -- 17.6 Steps to 'design out' high service cost outcomes -- ENSURE BETTER HEATING AND INSULATION -- PROGRESSIVELY REDUCE 'SPATIAL FRACTURING' -- FACILITATE BETTER NUTRITION.

SENSITIVE NEIGHBOURHOOD AND HOUSING MANAGEMENT -- COMMUNITY RESOURCE CENTRES -- SMALL-SCALE VOLUNTARY ACTIVITIES -- 'DESIGN OUT' CRIME -- 17.7 Conclusions -- 18 Healthier homes: the role of health authorities -- 18.1 Introduction -- 18.2 Cold damp housing and health -- 18.3 Use of NHS resources -- 18.4 Understanding the evidence -- 18.5 Using local health information -- 18.6 Health service organisation and policy -- 18.7 Elements of work by Local Health Authorities -- 18.8 Assessing health and housing needs -- ASSESSING MEDICAL PRIORITIES: -- HEALTH PROMOTION -- JOINT INVESTMENTS IN HOME ADAPTATIONS OR IMPROVEMENT -- REGENERATION INITIATIVES -- EVALUATION -- 18.8 Making the strategic links -- 19 The unavoidable imperative cutting the cost of cold -- A funding model -- Private rented accommodation -- References -- Keyword index.