Dr. Anne OFarrell * , Professor Anthony Staines ** , Professor - - PowerPoint PPT Presentation

• Dr. Anne O’Farrell*, Professor Anthony Staines**,

Professor Patrick Goodman†, Mr. Charles Roarty^ &

• Dr. Robert Conway*

*Health Intelligence Unit, HSE ** Dublin City University (DCU) † Technological University Dublin. ^ Energy Action Ireland, Dublin.

Definition of fuel poverty:

 Fuel poverty = when someone is unable to afford to

heat their home to a level that is healthy and safe.

 Households are considered to be in ‘fuel poverty’ if

they have to spend >10% of their household income on fuel to keep their home warm.

Determinants of fuel poverty:

Carbon Tax in Ireland:

 Carbon tax introduced in Ireland in 2010 but solid fuel

exempted.

 Solid Fuel Carbon Tax (SFCT) introduced in 2013 and

is an excise duty that applies to coal and peat supplied in Ireland on or after 1 May 2013:

 €10 per tonne of CO2 emitted from May 1st 2013  €20 per tonne of CO2 emitted effect from May 1st 2014.  €26 per tonne of CO2 emitted effect from May 1st 2020

Impact of carbon tax:

 Ireland is committed to increasing the price of carbon

from €20 to €80 per tonne by 2030.

 €6 increase on 1st May 2020  This increase will have bigger impact on solid fuels

such as coal & briquettes.

 The most vulnerable are likely to use these type of

fuels to heat their homes.

Type of heating vs. risk of poverty:

Background:

 Excess Winter Hospitalisations (EWHs) have

been observed in Ireland and in other European countries.1

 Previous studies found EWHs are greatest in

• lder persons with respiratory conditions.
• Goodman et al (2011) Understanding fuel poverty in the Elderly
• Population. Research Brief.

Aim:

 Determine whether excess winter

hospitalisations increased in Ireland over study period 2012-2018.

 Post-introduction of the Carbon Tax on Solid

Fuel in Ireland in 2013 and 2014.

Method:

All emergency in-patient hospitalisations

with principal diagnosis for Respiratory diseases by month extracted from HIPE via Health Atlas:

Aged ≥ 65 yrs 2012-2018

Analysis:

Statistical analyses were carried out

in:

JMP Statsdirect

Excess winter hospitalisations WHO calculation:

 Winter hospitalisations = hospitalisations occurring in

the 4 months of winter (Dec-Mar)

 Non-Winter hospitalisations = hospitalsations

• ccurring the 4 months preceding (Aug-Nov) the

Winter period and the 4 months following on from the Winter (Apr-July)

 𝐹𝑦𝑑𝑓𝑡𝑡 𝑋𝑗𝑜𝑢𝑓𝑠 𝐼𝑝𝑡𝑞𝑗𝑢𝑏𝑚𝑗𝑡𝑏𝑢𝑗𝑝𝑜𝑡 = a − (𝑐

2)

where a =number of winter hospitals and b = number of non-winter hospitals

Excess Winter Hospitalisation Index:

 EWHI = the excess winter hospitalisations

expressed as a percentage of the average number

• f hospitalisations in non-winter months.

 𝐹𝑋𝐼𝐽 =

EWH (Average of Non−Winter Hospitalisations) ∗ 100

• 𝟘𝟔 % 𝑫𝑱 = 𝐅𝐗𝐈 𝐣𝐨𝐞𝐟𝐲 ± 𝟐. 𝟘𝟕 𝐲 (√𝐅𝐗𝐈 𝑱𝒐𝒆𝒇𝒚

#𝑭𝑿𝑰

)

Excess winter hospitalisations for respiratory disease among elderly:

N=22,075 excess emergency hospitalisations for respiratory diseases for those aged ≥65 yrs in 6 year study period.

2,846 3,866 3,702 3,369 4,177 4,115 500 1000 1500 2000 2500 3000 3500 4000 4500 2012/13 2013/14 2014/15 2015/16 2016/17 2017/18 Excess winter hospitalisations for respiratory diseases

Excess winter hospitalisations for respiratory disease among elderly:

41.8% excess hospitalisations in 2017/18 vs. 33.6% in 2012/13

33.6% 49.1% 41.8% 35.8% 42.7% 41.8% 0% 10% 20% 30% 40% 50% 60% 2012/13 2013/14 2014/15 2015/16 2016/17 2017/18 Percentage excess hospitalisations

Results:

 Excess winter hospitalisations for respiratory

conditions among those aged ≥65 years exists in Ireland today:

 Increased from 2,846 in 2012/13 to 4,115 in

2017/18

 33.6% excess hospitalisations in 2012/13 vs.

41.8% in 2017/18

Discussion:

 Cold homes are likely one of the causes of

excess winter hospitalisations for respiratory illness in the elderly.

 These are potentially avoidable admissions.  Norway vs. Ireland similar size Norway colder

winters but:

 Much less winter morbidity and mortality.

 Housing stock in Norway much better.

What is being done:

 Fuel Allowance:

 372,259 households in receipt of means-tested fuel

allowance in 2019.

 Recipients currently get €22.50 per week for 28

weeks; will now rise to €24.50 per week.

 This increase should ameliorate the effect of an

increase in carbon tax in the short term.

 Open-ended increases in fuel allowance without

retro-fitting properties to improve energy efficiency is likely to be unsustainable in the longer term.

What is being done:

 Warmer homes scheme:  A free home insulation service to qualifying

households.

 Low-income households  Elderly households  Vulnerable households*

 Improve the energy efficiency and comfort

conditions of homes.

 €52.8 million– more than double the initial allocation

for 2019.

*Those receiving either winter fuel allowance, job seekers allowance for over 6 months (and

with children <7yrs); those receiving family income support and other mean-tested supports.

Table 1. Disbursement of Additional Carbon Tax Receipts in 2020.

What more will be done:

 As outlined in Table 1 money from the increase

in carbon tax will be ring-fenced for:

 Increased fuel allowance: - Extra €21m

 Retro-fitting of poor housing stock:

 Extra €13m allocated in this years budget for energy

poverty efficiency upgrades.

 Warmer homes  Reduced Carbon emissions\Improved air quality

 Extra €20m allocated for aggregated housing

upgrade scheme targetted at the Midlands:

 Upgrade social housing stock in the region.  Support 400 jobs.

Conclusions:

 We welcome these measures as they:

 Support the households likely to be most impacted

by the increase in carbon tax.

 Short –term by increasing fuel allowance  Longer-term by improving energy efficency in retro-

fitted homes.

 Leading in time to:

 Reduced hospitalisations for respiratory conditions  Reduced carbon emissions  Reduced carbon emissions leading to improved air quality.

Conclusions:

 Energy Action Ireland are to be commended for their

work in alleviating fuel poverty:

 By providing high quality free insulation services in the

homes of older people and the disadvantaged.

 By providing work opportunities for long term

unemployed in this area.

Acknowledgements:

 HPO, Health Atlas and CSO for data  Co-authors  Energy Action Ireland