A choice between heating and eating: how fuel poverty affects child health
One thing after the other
In August, the Office of Gas and Electricity Markets (Ofgem) announced that the energy price cap would increase for the 15 million customers it protects. As such, from October 2021, households will see an increase of £159 to their energy bills. This is one in a series of financial blows; from inflation driving up the cost of living, to price rises due to the HGV driver crisis, and the end of the furlough scheme. Campaigners have highlighted the difference the £20-a-week made to millions of families as the cut to Universal Credit went ahead on 6 October, and media coverage has reported food banks are bracing themselves for a rush of people needing emergency support. All these issues have created a ‘perfect storm’ this winter. “It’s one thing after the other at the moment- food then fuel then housing, school, Wi-Fi access…” says Dr Ian Sinha, a respiratory paediatrician, “Everything is building up.”
Families who were already struggling before the pandemic will now be hit even harder.
Fuel poverty
A combination of factors led to price hikes for heating homes and generating electricity ahead of the colder months in the UK, and internationally. But raising the price cap means it will be felt by UK consumers, particularly those who can least afford it. Families who were already struggling before the pandemic will now be hit even harder. Reduced income, being below the poverty line, or having a home that is difficult to heat with a low energy efficiency rating means making stark choices between paying energy bills and other essentials such as food, falling into debt, or living in a cold home which brings negative impacts on physical and mental health, particularly for the elderly and for younger children. Fuel poverty is predominant in rented homes with an estimated 1.9m of those in renting households suffering physical and mental problems as a result of poor housing conditions as well as the uncertainty caused by struggling with other living costs.
We know that one of the drivers and risk factors for babies and children getting infections is poor housing quality
Fuel poverty isn’t new. In 2019, over 13% of households in England were fuel poor, driven by key factors of energy efficiency, residual income, and energy prices. However, this winter it is accompanied by an additional squeeze on household budgets and a predicted surge in respiratory illnesses in children. The combination is worrying for paediatricians. “We know that one of the drivers and risk factors for babies and children getting infections is poor housing quality,” says Ian, “One of the key things that’s important is the warmth of your house. There’s going to be millions of children in cold houses this winter and, coupled with the higher levels of viral infection, it couldn’t have come at a worse time.”
Housing
COVID-19 has highlighted ventilation as a key mitigation measure to help stop viruses from spreading. The spread of viruses is also amplified in a cold or poorly heated house and is one of the reasons why we see seasonal epidemics like colds and flu, and respiratory illnesses like bronchiolitis in children. “The droplets that we exhale when we breath, talk or cough can spread more easily when it’s cold,” says Ian, “But obviously people are not going to be opening their window if their hard-earned cash is going to, literally, go out the window.”
The longer term effect of fuel poverty on child health is rooted in inequality.
Opening windows and being able to ventilate your house avoids a build-up of humidity and moisture, damp and house dust mites. “Damp and mould are hugely worrying for children with developing airways and developing lungs,” says Ian, “For children with asthma, mould can trigger attacks, and living in damp housing can increase the chances that you develop asthma quite significantly.”
Child health and inequalities
In England, single parent households make up a third (28%) of households likely to be fuel poor, and couples with children make up 17%. The geographical spread is also disproportionate, with the highest level of fuel poor households in the West Midlands. Fuel poverty echoes the unequal spread of deprivation in the country.
There will be a cohort of babies that this affects for the rest of their lives and that is just as much of a concern to me as how busy it is in ED at the moment
The longer term effect of fuel poverty on child health is rooted in inequality. Ian says, “These things compound themselves. The kids that are going to be hit the hardest by fuel poverty are the kids who are already living in the worst houses, with damp and cold. So now it’s going to be even worse for them.” Growing up in poverty significantly impacts the health and wellbeing of children. The State of Child Health 2020 report indicates that child poverty is linked to a wide range of health outcomes including low birth weight, chronic conditions, obesity, and poor mental health problems. Furthermore, fuel poverty can directly impact infant growth and development. “It affects how your brain, lungs and heart develop, how big you grow, how robust you are for fighting against things like infections,” says Ian, “You have a window of opportunity for babies to grow and get healthy, and once you’ve missed it, you’ve missed it.”
He is particularly worried about the surge of respiratory illnesses this winter and the babies who are still to be born: “The babies who are going to be the sickest with bronchiolitis haven’t even been born yet, and they are going to go home to houses that are freezing cold. The calories that they should be spending on growing strong are going to be spent on keeping their body temperature up. There will be a cohort of babies that this affects for the rest of their lives and that is just as much of a concern to me as how busy it is in ED at the moment.”
In the UK there are an estimated 4 million children living in poverty — one in three of all children. That number is projected to rise to as much as five million by 2030 while national targets to reduce child poverty have been abolished. It is expected that the cap on energy bills will rise again in spring 2022, with millions of households potentially facing a second even larger jump in their bills. “That £20 can make all the difference when it comes to things like fuel poverty,” says Ian.
