Fuel poverty and how does it contribute to health inequalities?

Fuel poverty means that some people are unable to afford to heat their homes to a level that is healthy and safe2. Fuel poverty arises as a result of the relationship between household income, energy efficiency of the dwelling, and fuel prices.

determinants of fuel poverty

People in fuel poverty frequently live in cold, damp and mouldy houses. Fuel poverty has important direct and indirect effects on health and contributes to health inequalities in the following areas:

  • elderly lady at firesideIncreased risk of death in cold weather (excess winter mortality)
  • Increased risk of respiratory illness
  • Increased blood pressure and cardiovascular events
  • Worsening arthritis
  • Increased risk of accidents at home
  • Social isolation
  • Impaired mental health
  • Adverse effects on children’s wellbeing

International research reports higher levels of excess winter mortality in Ireland and Northern Ireland than in the rest of Europe. In Ireland around 70% of excess winter mortality from cardiovascular disease and respiratory disease arises in the poorest socio-economic groups.

Fuel poverty also had adverse social outcomes including debt, disconnection of supply and increasing poverty and social exclusion.

 IPH Fuel poverty portfolio

In 2004-2005 we evaluated the Warming Up project. This targeted older people on low income and was jointly led by Belfast Health and Social Care Trust and National Energy Action (NEA) Northern Ireland. Life Doesn’t Revolve Around Lighting a Fire Anymore: An Evaluation of the Warming Up Project and Recommendations for Future Action.

IPH contributed to a fuel poverty action research programme in Donegal and Cork. This research assessed changes in health, energy efficiency and household economy in low income households who have energy efficiency measures installed.

In 2003-2004, we conducted an evaluation of Armagh and Dungannon Health Action Zone (HAZ)’s energy efficiency scheme, Home is Where the Heat is. Engaging Communities: An Evaluation of a Community Development Approach to Tackling Rural Fuel Poverty

On behalf of the Energy Saving Trust , NEA and IPH produced a Strategic Review of the Health and Social Care Sector in Northern Ireland for the Energy Efficiency Sector in 2004.

We published an All-Ireland Policy Paper on Fuel Poverty and Health in late 2007.
This was followed by an Annual Update on Fuel Poverty and Health (2008). A joint report with University of Ulster called Annual Update on Fuel Poverty and Health was published in 2009.

IPH is represented on the Interdepartmental Group on Affordable Energy chaired by the Department of Communications, Energy and Natural Resources and the Department of Social Protection. We have presented to the Joint Committee on Social and Family Affairs at the Oireachtas in 2008 and 2009.  In Northern Ireland, we link with the Interdepartmental Group on Fuel Poverty and the Northern Ireland Fuel Poverty Advisory Group.

How can I learn more about fuel poverty and health inequalities?


  2 Acceptable indoor temperatures have been defined by the World Health Organization (WHO) as 210 C in the living room and 180 C in all other rooms.  For older people, higher indoor temperatures are recommended.  There are a number of more specific definitions of fuel poverty - some relate to the proportion of income being spent on heating, others relate to the subjective account of the householder.