{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:37:49Z","timestamp":1787017069591,"version":"build-2736575974"},"reference-count":22,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2025,12,25]],"date-time":"2025-12-25T00:00:00Z","timestamp":1766620800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["NIHR 200909"],"award-info":[{"award-number":["NIHR 200909"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Epidemiol Community Health"],"accepted":{"date-parts":[[2025,12,5]]},"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cold weather remains a serious health threat in the UK and elsewhere, particularly for older adults. The Winter Fuel Payment has been a key government strategy to mitigate health risks linked to cold homes in the UK, but recent policy shifts have raised questions about whether income-based eligibility criteria effectively identify those most at risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analysed cold-related mortality in adults aged \u226575 across 324 local authority districts in England (2007\u20132019) using distributed lag non-linear models in a spatial Bayesian framework. Multivariate meta-regression was used to evaluate modification of cold effects by deprivation, income-based pension credit uptake, home energy efficiency and fuel poverty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Areas in the highest quartile of fuel poverty had significantly greater cold-related mortality risk than those in the lowest quartile, with a 15.3% versus 13.1% increase in mortality risk at the first compared with the 50th percentile of wintertime temperature, ie, an absolute difference of 2.2% (p&lt;0.001). This effect was stronger than the corresponding differences for energy efficiency (1.7%, p=0.04), income as indicated by pension credit uptake (0.6%, p=0.39) and deprivation-based measures, for which differences were minimal. Overall, an estimated 17% of cold-related deaths among people aged \u226575 were attributable to fuel poverty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Fuel poverty, an indicator designed to capture both low-income and housing energy efficiency, is a stronger predictor of cold-related mortality than income (as indicated by pension credit update) or deprivation-based indicators alone. Winter energy support schemes should consider fuel poverty metrics in their targeting to more effectively reduce health risks associated with cold homes and improve equity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jech-2025-224619","type":"journal-article","created":{"date-parts":[[2025,12,25]],"date-time":"2025-12-25T18:20:29Z","timestamp":1766686829000},"page":"432-435","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Eligibility criteria for the UK Winter Fuel Payment: are we targeting the right people?"],"prefix":"10.1136","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1044-1374","authenticated-orcid":false,"given":"Kai","family":"Wan","sequence":"first","affiliation":[{"name":"London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathon","family":"Taylor","sequence":"additional","affiliation":[{"name":"Department of Civil Engineering, Tampere University, Tampere, Pirkanmaa, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcos","family":"Quijal-Zamorano","sequence":"additional","affiliation":[{"name":"ISGlobal, Barcelona, Spain"},{"name":"University of Bern Institute of Social and Preventive Medicine, Bern, BE, Switzerland"},{"name":"University of Bern Oeschger Centre for Climate Change Research, Bern, BE, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Ballester","sequence":"additional","affiliation":[{"name":"ISGlobal, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shakoor","family":"Hajat","sequence":"additional","affiliation":[{"name":"London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,12,25]]},"reference":[{"key":"2026050806500662000_80.6.432.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijheh.2005.03.003"},{"key":"2026050806500662000_80.6.432.2","unstructured":"Institute of health equity, the health impacts of cold homes and fuel poverty. Department of Epidemiology & Public Health, University College London; 2011. Available: https:\/\/www.instituteofhealthequity.org\/resources-reports\/the-health-impacts-of-cold-homes-and-fuel-poverty [Accessed 30 Jul 2024]."},{"key":"2026050806500662000_80.6.432.3","unstructured":"Wilkinson P , et al . Cold comfort: the social and environmental determinants of excess winter deaths in England. The Policy Press and Joseph Rowntree Foundation; 2001. Available: https:\/\/www.researchgate.net\/publication\/291430980_Cold_comfort_the_social_and_environmental_determinants_of_excess_winter_death_in_England_1986-1996 [Accessed 30 Jul 2024]."},{"key":"2026050806500662000_80.6.432.4","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2021-069435","article-title":"Home energy efficiency under net zero: time to monitor UK indoor air","volume":"377","author":"Petrou","year":"2022","journal-title":"BMJ"},{"key":"2026050806500662000_80.6.432.5","unstructured":"Lee A , Sinha I , Boyce T , et al . Fuel poverty, cold homes and health inequalities in the UK. Institute of Health Equity; 2022. Available: https:\/\/www.instituteofhealthequity.org\/resources-reports\/fuel-poverty-cold-homes-and-health-inequalities-in-the-uk [Accessed 24 Jul 2024]."},{"key":"2026050806500662000_80.6.432.6","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1093\/eurpub\/ckad108","article-title":"Assessing the impact of energy and fuel poverty on health: a European scoping review","volume":"33","author":"Champagne","year":"2023","journal-title":"Eur J Public Health"},{"key":"2026050806500662000_80.6.432.7","unstructured":"Department for Energy Security & Net Zero . Fuel poverty methodology handbook (low income low energy efficiency). 2025. Available: https:\/\/assets.publishing.service.gov.uk\/media\/67e3d47bdcd2d93561195be6\/Methodology_Handbook_2025.pdf"},{"key":"2026050806500662000_80.6.432.8","unstructured":"Department for Business, Energy & Industrial Strategy . Fuel poverty methodology handbook (low income high costs). 2020. Available: https:\/\/assets.publishing.service.gov.uk\/media\/603fcdaee90e077dd08f15e6\/Fuel_Poverty_Methodology_Handbook_2020_LIHC.pdf"},{"key":"2026050806500662000_80.6.432.9","unstructured":"House of commons library, fuel poverty in the UK. 2025. Available: https:\/\/commonslibrary.parliament.uk\/research-briefings\/cbp-8730 [Accessed 15 May 2025]."},{"key":"2026050806500662000_80.6.432.10","unstructured":"Information, D.o.L.a.A., ECh\u00e8que \u00e9nergie (gaz, chaleur, \u00e9lectricit\u00e9) [Energy 248 voucher (gas, heat, electricity)]. 2024. Available: https:\/\/www.service-public.fr\/particuliers\/vosdroits\/F33667 [Accessed 8 Aug 2025]."},{"key":"2026050806500662000_80.6.432.11","unstructured":"MITECO . Bono Social de electricidad (Social Electricity Bonus). Ministerio para la Transici\u00f3n Ecol\u00f3gica y el Reto Demogr\u00e1fico (The Ministry for the Ecological Transition and the Demographic Challenge of Spain). Available: https:\/\/www.miteco.gob.es\/es\/energia\/energia-electrica\/bono-social.html [Accessed 8 Aug 2025]."},{"key":"2026050806500662000_80.6.432.12","doi-asserted-by":"crossref","first-page":"1354","DOI":"10.1002\/hec.3666","article-title":"The health benefits of a targeted cash transfer: The UK Winter Fuel Payment","volume":"27","author":"Crossley","year":"2018","journal-title":"Health Econ"},{"key":"2026050806500662000_80.6.432.13","unstructured":"Department for work & pensions, income-related benefits: estimates of take-up: financial year ending 2023. 2024. Available: https:\/\/www.gov.uk\/government\/statistics\/income-related-benefits-estimates-of-take-up-financial-year-ending-2023\/income-related-benefits-estimates-of-take-up-financial-year-ending-2023 [Accessed 6 Aug 2025]."},{"key":"2026050806500662000_80.6.432.14","unstructured":"Department for work & pensions, income-related benefits: estimates of take-up: financial year 2018 to 2019. 2020. Available: https:\/\/www.gov.uk\/government\/statistics\/income-related-benefits-estimates-of-take-up-financial-year-2018-to-2019\/income-related-benefits-estimates-of-take-up-financial-year-2018-to-2019?utm_source=chatgpt.com [Accessed 6 Aug 2025]."},{"key":"2026050806500662000_80.6.432.15","unstructured":"Gross A , Pickard J . UK cut to fuel payments will push up to 100,000 pensioners into poverty. Financial Times; 2024. Available: https:\/\/www.ft.com\/content\/dd421e3d-e439-4162-b6a0-5d0771f1cb17?utm_source=chatgpt.com [Accessed 23 Apr 2025]."},{"key":"2026050806500662000_80.6.432.16","unstructured":"European centre for medium-range weather forecasts, ERA5-land hourly data from 1950 to present. Climate Data Store; 2025. Available: https:\/\/cds.climate.copernicus.eu\/datasets\/reanalysis-era5-land?tab=overview [Accessed 21 Nov 2025]."},{"key":"2026050806500662000_80.6.432.17","doi-asserted-by":"crossref","DOI":"10.1093\/ije\/dyae061","article-title":"Spatial Bayesian distributed lag non-linear models (SB-DLNM) for small-area exposure-lag-response epidemiological modelling","volume":"53","author":"Quijal-Zamorano","year":"2024","journal-title":"Int J Epidemiol"},{"key":"2026050806500662000_80.6.432.18","unstructured":"Department for energy security and net zero, fuel poverty in England: subregional. Available: https:\/\/www.data.gov.uk\/dataset\/f3009590-2bc9-40d9-8dc3-571e6fddae45\/fuel_poverty_sub-regional_statistics [Accessed 21 Nov 2025]."},{"key":"2026050806500662000_80.6.432.19","unstructured":"BEIS . Sustainable warmth protecting vulnerable households in England. Department for Business, Energy & Industrial Strategy; 2021. Available: https:\/\/assets.publishing.service.gov.uk\/media\/6024fcabd3bf7f031e1bdc80\/CCS207_CCS0221018682-001_CP_391_Sustainable_Warmth_Print.pdf"},{"key":"2026050806500662000_80.6.432.20","doi-asserted-by":"crossref","first-page":"105551","DOI":"10.1016\/j.eneco.2021.105551","article-title":"Energy poverty indicators: Inconsistencies, implications and where next?","volume":"103","author":"Deller","year":"2021","journal-title":"Energy Economics"},{"key":"2026050806500662000_80.6.432.21","unstructured":"DESNZ . Warm home discount: eligibility statement England and Wales from 2024\/25. Department for Energy Security & Net Zero; 2024. Available: https:\/\/assets.publishing.service.gov.uk\/media\/66dafb47608fb761b68111cf\/warm-home-discount-eligibility_statement-2024.pdf?utm_source=chatgpt.com"},{"key":"2026050806500662000_80.6.432.22","doi-asserted-by":"crossref","first-page":"584","DOI":"10.3390\/ijerph14060584","article-title":"Health, Well-Being and Energy Poverty in Europe: A Comparative Study of 32 European Countries","volume":"14","author":"Thomson","year":"2017","journal-title":"IJERPH"}],"container-title":["Journal of Epidemiology and Community Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jech-2025-224619","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T05:50:23Z","timestamp":1778651423000},"score":1,"resource":{"primary":{"URL":"https:\/\/jech.bmj.com\/lookup\/doi\/10.1136\/jech-2025-224619"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,25]]},"references-count":22,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,5,8]]},"published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1136\/jech-2025-224619"],"URL":"https:\/\/doi.org\/10.1136\/jech-2025-224619","relation":{},"ISSN":["0143-005X","1470-2738"],"issn-type":[{"value":"0143-005X","type":"print"},{"value":"1470-2738","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,25]]}}}