Contribution of Cold Versus Climate Change to Mortality in London, UK, 1976-2019.

Objectives. To quantify past reductions in cold-related mortality attributable to anthropogenic climate change. Methods. We performed a daily time-series regression analysis employing distributed lag nonlinear models of 1 203 981 deaths in Greater London, United Kingdom, in winter months (November-March) during 1976 to 2019. We made attribution assessment by comparing differential cold-related mortality impacts associated with observed temperatures to those using counterfactual temperatures representing no climate change. Results. Over the past decade, the average number of cold days (below 8 °C) per year was 120 in the observed series and 158 in the counterfactual series. Since 1976, we estimate 447 (95% confidence interval = 330, 559) annual cold-related all-cause deaths have been avoided because of milder temperatures associated with climate change. Annually, 241 cardiovascular and 73 respiratory disease deaths have been avoided. Conclusions. Anthropogenic climate change made some contribution to reducing previous cold-related deaths in London; however, cold remains an important public health risk factor. Public Health Implications. Better adaptation to both heat and cold should be promoted in public health measures to protect against climate change. In England, this has been addressed by the development of a new year-round Adverse Weather and Health Plan. (Am J Public Health. 2024;114(4):398-402. https://doi.org/10.2105/AJPH.2023.307552).

Indicators to support local public health to reduce the impacts of heat on health.

Heat exposure presents a significant weather-related health risk in England and Wales, and is associated with acute impacts on mortality and adverse effects on a range of clinical conditions, as well as increased healthcare costs. Most heat-related health outcomes are preventable with health protection measures such as behavioural changes, individual cooling actions, and strategies implemented at the landscape level or related to improved urban infrastructure. We review current limitations in reporting systems and propose ten indicators to monitor changes in heat exposures, vulnerabilities, heat-health outcomes, and progress on adaptation actions. These indicators can primarily inform local area decision-making in managing risks across multiple sectors such as public health, adult and social care, housing, urban planning, and education. The indicators can be used alongside information on other vulnerabilities relevant for heat and health such as underlying morbidity or housing characteristics, to prioritise the most effective adaptation actions for those who need it the most.

The summer indoor temperatures of the English housing stock: Exploring the influence of dwelling and household characteristics.

As the high temperatures experienced during the summer of 2018 may become commonplace by 2050, adaptation to higher indoor temperatures while minimising the need for mechanical cooling is required. A thorough understanding of the factors that influence indoor temperatures can enable the design of healthier and safer dwellings under a warming climate. The aim of this paper is to provide further insight into the topic of indoor overheating through the analysis of the largest recent sample of English dwellings, the 2011 Energy Follow-Up Survey, comprised of 823 dwellings. Following the pre-processing stage, the indoor overheating risk of 795 living rooms and 799 bedrooms was quantified using the criteria defined within CIBSE's Technical Memorandum 59. Approximately 2.5% of the dwellings were found to exceed Criterion 1, with this figure approaching 26% when Criterion 2 was considered. Subsequently, the indoor temperatures were standardised against external weather conditions and the correlation of 11 dwelling and 9 household characteristics was examined. Factors such as the main heating system, tenure and occupant vulnerability were all found to have a statistically significant association with the indoor temperatures. Further analysis revealed multiple correlations between household and dwelling characteristics, highlighting the complexity of the indoor overheating problem. Practical application : By applying the criteria in CIBSE's TM59, 26% of the dwellings monitored during the 2011 Energy Follow-Up Survey were found to overheat. Since 2011 was a cool summer and future temperatures are expected to be warmer, even more dwellings are expected to fail these criteria in the future. Multiple dwelling and household characteristics were associated with higher indoor temperatures, including: dwellings with a SAP rating > 70, more recently built and with communal heating. Thus, it is crucial to consider indoor overheating risk at the building design or refurbishment stage to prevent the possible consequences of uncomfortably high indoor temperatures.