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Evidence of what works

Adults :: Excess winter deaths :: Evidence of what works

Evidence on this topic suggests many different interventions may be beneficial, but stops short of quantifying what level of reduction in mortality might be expected by introducing various interventions. Risk reductions for example, are not calculated.

It is widely accepted that pre-seasonal vaccination is effective in reducing the more serious manifestations of influenza, as has vaccination of health care workers. Campaigns to increase uptake of immunisation have been relatively successful amongst target groups in Medway, but uptake amongst health care workers remains poor. There is some evidence that early use of anti-virals amongst the very aged in residential and care home settings could limit the spread of influenza in institutional environments.[1]

The large, cross-European study found robust relationships between energy efficiency levels and excess winter deaths, although they were still significant at the 5% level (cavity wall insulation p=0.02, double glazing p=0.02 and floor insulation p=0.03). The four countries with the poorest standard of housing in this respect (Portugal, Greece, Ireland and the UK) all score highly for excess winter deaths. The authors suggest that their findings support the theory that EWM can be reduced through not just targeted improvement of energy efficiency, but also socioeconomic progress (such as looking at poverty, income inequalities, fuel poverty and deprivation).[2]

The research also suggests that interventions will be most effectively focused on the private housing sectors — both owner occupiers and private rented accommodation. Older people living in older housing, particularly those without central heating are particularly at risk.[3]

National research has also shown that as well as the energy efficiency of the house, the way a householder uses the house (e.g. use of heating system, opening windows at night etc) is of crucial importance in maintaining a healthily warm home.

There is some evidence to suggest that the Met Office runs a 'Healthy Outlook' service which is a preventative measure, aimed at helping people with Chronic Obstructive Pulmonary Disease (COPD) to stay well in cold weather is effective in reducing hospital admissions. It is operated through GP practices.


[1]   Health Protection Agency. A Winters Tale: coming to terms with Winter respiratory illness 2003; Health Protection Agency.
[2]   Healy J. Excess winter mortality in Europe: a cross country analysis identifying key risk factors Journal of Epidemiology & Community Health 2003; 57(10): 784-9.
[3]   Dinsdale H, Williams DE, Adur DF. Technical Report: Excess Winter Mortality 2006; South East public Health Observatory.