Eligibility criteria for the UK Winter Fuel Payment: are we targeting the right people?
Abstract
Background: 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.
Methods: We analysed cold-related mortality in adults aged ≥75 across 324 local authority districts in England (2007–2019) 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.
Results: 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 < 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 ≥75 were attributable to fuel poverty.
Conclusions: 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.
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BibTeX
@article{wan2026eligibility,
title = {{Eligibility criteria for the UK Winter Fuel Payment: are we targeting the right people?}},
author = {K Wan and J Taylor and M Quijal-Zamorano and J Ballester and S Hajat},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.665},
url = {https://doi.org/10.1093/eurpub/ckag169.665},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Eligibility criteria for the UK Winter Fuel Payment: are we targeting the right people?
AU - K Wan
AU - J Taylor
AU - M Quijal-Zamorano
AU - J Ballester
AU - S Hajat
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.665
UR - https://doi.org/10.1093/eurpub/ckag169.665
AB - Background: 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. Methods: We analysed cold-related mortality in adults aged ≥75 across 324 local authority districts in England (2007–2019) 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. Results: 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 < 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 ≥75 were attributable to fuel poverty. Conclusions: 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.
SN - 1101-1262
SN - 1464-360X
ER -