Home energy efficiency improvements and health: observational before-and-after study of Dublin's Warmth & Wellbeing pilot scheme.

BACKGROUND: The Warmth & Wellbeing pilot scheme provided home energy efficiency measures to people aged 55 years and over with chronic respiratory conditions in Dublin, Ireland from 2016 to 2020. We performed an observational study to evaluate the impact of the pilot scheme on health and well-being. METHODS: 955 people were recruited to the research, of which 545 had the following before-and-after data: self-reported general health and winter thermal comfort through a questionnaire and the EuroQol-5 Dimension (EQ-5D), St George's Respiratory Questionnaire (SGRQ) and 36-Item Short Form Survey (SF-36) instruments, and monthly drug prescriptions. We analysed before-and-after differences using standard parametric methods. RESULTS: Health service contacts decreased after intervention, with general practitioner consultations over 6 months decreasing by 1.10 (95% CI 0.75, 1.44) and emergency room visits for respiratory conditions decreasing by 0.13 (95% CI 0.06, 0.21). Participants reported improvements in thermal comfort, temperature control, ability to pay fuel bills and comfort with inviting visitors to their home. There were improvements in physical health, general health, energy/fatigue and social well-being across most dimensions of EQ-5D, SGRQ and SF-36. For example, the EQ-5D summary score decreased by 5.36 (95% CI 2.68, 8.04). Monthly drug prescriptions in the year before intervention decreased by 0.14 (95% CI 0.06, 0.23) in the year afterwards. Most changes persisted for at least 2 years. CONCLUSIONS: Dublin's Warmth & Wellbeing pilot scheme resulted in improvements in self-reported health and probable reductions in health service contacts and drug prescriptions. The health rationale supports targeted home energy efficiency programmes as part of climate change and energy objectives.