Scottish Longitudinal Study
Development & Support Unit
Cold Related Deaths and the Effect of Nudging the Elderly: Evidence from the Longitudinal Studies
Ian Walker (Lancaster University/LUMS)
Maria Navarro Paniagua (Lancaster University/LUMS)
David Stott (Lancaster University/LUMS)
28 May 2013
Government policy has so far shied away from aged-related fuel subsidies and has focused on winter fuel payments (WFP), and on subsidies for insulation and for more efficient heating.
The existing official methodology to measure cold related deaths is crude – just a comparison of average mortality rates across seasons. Moreover extremely strong inferences have been made about the impact of cold through simple interpolation. Previous research has shown that although mortality does increase as it gets colder, temperature only explains a small amount of the variance in winter mortality, and high levels of excess winter mortality can occur during relatively mild winters (Christidis et al., 2010; ONS 2010, 2011; Wilkinson et al., 2011). US evidence suggests that latitude plays a role – places where it is usually cold have few cold related deaths. There is strong suggestion, although never formally tested, that the relationship is highly nonlinear and that unexpected cold is more dangerous than expected cold weather.
The most notable feature of this work is that there has been little attempt to disaggregate the results by observable characteristics. The literature has identified several risk factors associated with heat-related mortality, though the identification strategies used are sometimes questionable (Pattenden et al., 2003). Most of the risk factors appear to be related to socioeconomic status. While socioeconomic factors are strong predictors of heat-related mortality, other factors also appear important (isolation, urbanity). Klinenberg (2003) documents the effect of the 1995 Chicago heat wave on mortality. He argues that the reason that elderly mortality seems to be more sensitive to heat waves than the mortality of other age groups is isolation. In addition, persons living in densely population urban areas have higher risks than those living in rural or suburban areas because of the phenomenon known as the “urban heat island effect” (Landsberg, 1981).
There is no research that indicates at what point does weather start to have important effects on mortality. Nor is there any research that explicitly addresses what kinds of individuals are particularly temperature sensitive. Nor, is it known the extent to which weather surprises (for example, cold that has not been forecast accurately) have a disproportionate effect. The use of such large datasets, as proposed here, which contain information about housing, education, socioeconomic circumstances, as well as weather will enable us to address these issues.
In this project we will be looking directly at the reduced form relationship between winter fuel payments (WFP) and mortality – using the Scottish Longitudinal Study (SLS) merged with local level Met Office data. The work will exploit the regression discontinuities associated with the age related element of WFP, and natural experiments associated with reforms to the levels of WFP that have occurred over time, differentially for different age ranges. In the course of the work we will also be modeling the survival hazard (how mortality varies with age) and also the (probably highly nonlinear) impact of cold.
Christidis, N., G.C. Donaldson, and P.A. Stott (2010), “Causes for the recent changes in cold- and heat-related mortality in England and Wales,” Climatic Change, 102, 539-553.
Klinenberg, E. (2003), Heat Wave: A Social Autopsy of Disaster in Chicago, University of Chicago Press.
Landsberg, H.E. (1981), The Urban Climate (New York: Academic Press).
ONS (2010). “Excess winter mortality in England and Wales, 2009/10 and 2008/09,” Office for National Statistics, Statistical Bulletin.
ONS (2011). “Excess winter mortality in England and Wales, 2010/11 and 2009/10,” Office for National Statistics, Statistical Bulletin.
Pattenden, S., B. Nikiforov, and B. G. Armstrong (2003), “Mortality and Temperature in Sofia and London,” Journal of Epidemiology and Community Health, 57, 628-633.
Wilkinson, Paul., Landon, Megan., Armstrong, Ben., Stevenson, Simon., Pattenden, Sam., McKee, Martin and Tony Fletcher (2001). “Cold Comfort: The social and environmental determinants of excess winter deaths in England, 1986-96,” The Policy Press and the Joseph Rowntree Foundation.
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