What are the effects of energy poverty and interventions to ameliorate it on people's health and well-being?: A scoping review with an equity lens

Several studies have shown how energy poverty (EP) increases morbidity and mortality, being a growing problem worldwide. We conducted a scoping review to synthesize the state of knowledge on the relationship between energy poverty (EP) and health, analysing the results according to different axes of inequality (gender, age, ethnicity/country of birth, social class, territory). We searched different bibliographic databases (MeSH and free-text terms);Eligibility criteria: 1] studies or interventions related to EP or its different expressions (inadequate temperatures;financial strain, inadequate housing conditions, composite indicators, heating and energy efficiency improvements);2] health or health risk outcomes;3] OECD countries;4] English or Spanish language;5] published before July 2020. We selected 38 studies out of 2768 (23 observational and 15 interventions). Almost all were quantitative (89.5%) and almost half were conducted in the UK (47.4%). The most studied EP expression was inadequate temperature. Eleven studies disaggregate the analyses by at least one axis of inequality and 21 target a vulnerable group. The studies linked EP to poorer general health, poorer mental health, poorer respiratory health, more and worse controlled chronic conditions, higher mortality, higher use of health services and higher exposure to health risks, with worse results for vulnerable groups across dimensions of inequality. Current scientific evidence should guide structural changes and immediate interventions to ameliorate EP. Future research must take into account the effects of inadequate warm temperatures and social inequalities, especially in the current context of climate and social crisis, the latter being exacerbated by the covid-19 pandemic.

Mediational Occupational Risk Factors Pertaining to Work Ability According to Age, Gender and Professional Job Type.

The predictive value of work ability for several health and occupational outcomes is well known. Maintaining the ability to work of all employees has become an important topic in research although some evidence suggests that some groups of workers need greater attention than others. Healthcare workers (x¯ = 54.46 ± 5.64 years) attending routine occupational health checkups completed their work ability, occupational risk and sociodemographic measures. An analysis examined whether work ability differed according to gender, age and professional category. Mediation of these relationships by occupational risk variables, such as work-family conflict, was examined. Females and older adults had worse work ability than their counterparts. Professional group was not independently associated. Gender-related differences were mediated by current and historic ergonomic risk, psychosocial risk and work-family conflict. Age-related differences were mediated by violence/discrimination at work. All job risk variables, apart from current ergonomic risk, mediated associations between professional category and work ability. The present study identified the importance of risk variables for the work ability of health workers according to gender, age and professional job type. Perceptions of work-family conflict and violence-discrimination seem particularly important and should be considered when targeting improvements in work ability.

Influence of the Covid-19 pandemic on out-of-hospital cardiac arrest. A Spanish nationwide prospective cohort study.

AIMS: The influence of the COVID-19 pandemic on attendance to out-of-hospital cardiac arrest (OHCA) has only been described in city or regional settings. The impact of COVID-19 across an entire country with a high infection rate is yet to be explored. METHODS: The study uses data from 8629 cases recorded in two time-series (2017/2018 and 2020) of the Spanish national registry. Data from a non-COVID-19 period and the COVID-19 period (February 1st-April 30th 2020) were compared. During the COVID-19 period, data a further analysis comparing non-pandemic and pandemic weeks (defined according to the WHO declaration on March 11th, 2020) was conducted. The chi-squared analysis examined differences in OHCA attendance and other patient and resuscitation characteristics. Multivariate logistic regression examined survival likelihood to hospital admission and discharge. The multilevel analysis examined the differential effects of regional COVID-19 incidence on these same outcomes. RESULTS: During the COVID-19 period, the incidence of resuscitation attempts declined and survival to hospital admission (OR = 1.72; 95%CI = 1.46-2.04; p < 0.001) and discharge (OR = 1.38; 95%CI = 1.07-1.78; p = 0.013) fell compared to the non-COVID period. This pattern was also observed when comparing non-pandemic weeks and pandemic weeks. COVID-19 incidence impinged significantly upon outcomes regardless of regional variation, with low, medium, and high incidence regions equally affected. CONCLUSIONS: The pandemic, irrespective of its incidence, seems to have particularly impeded the pre-hospital phase of OHCA care. Present findings call for the need to adapt out-of-hospital care for periods of serious infection risk. STUDY REGISTRATION NUMBER: ISRCTN10437835.