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Exposure to cold weather has negative consequences on human health. Studies have been showing that the seasonality of mortality has an evident peak during winter months in European countries. However, the highest increases in mortality are registered in countries with mild winters. According to several studies winter deaths seem to be associated with low socioeconomic conditions. The main aims of this study are to identify the trends of mortality due to diseases of the circulatory system and excess winter deaths in Portugal and to assess the geographical pattern of seasonal mortality. In the 20 years under analyses, mortality due to diseases of the circulatory system increased 38% during winter months when compared to the non-winter period. Important regional disparities were found, the Excess Winter Death index ranged from 21% to 48%, the central regions tend to have better results. Our results indicate that although circulatory mortality is significantly decreasing inPortugal, the vulnerability to seasonal cold weather remains as an important public healthissue. These findings suggest that the exposure to cold weather is an important determinantof cardiovascular diseases that is still neglected in Portugal.

Cold homes contribute to 20,000 to 40,000 excess winter deaths each year in the UK and approximately 300,000 hospital admissions. Using fuel poverty as an identifier for those at risk does not always capture everyday exposure to cold homes due to variations in financial trade-offs and behavioural factors. Few fuel poverty studies have combined environmental measurements with qualitative data on lived experiences of fuel poverty and cold homes. This paper looks at strengths and limitations of using a mixed method, environmental and qualitative interviewing approach. A series of six discreet studies were conducted between 2001 and 2015 using a similar methodology with a mixed methods design, where in-depth interviews were conducted alongside temperature and humidity measurements. The research studies found that combining environmental monitoring with qualitative research methods allows both cross-validation and triangulation of data in order to provide a richer and more insightful examination into the lives of people living in cold homes. The studies demonstrate how a combined methodological approach can help explain the choices, decisions and behaviour of households experiencing cold homes and fuel poverty. The paper concludes with recommendations for future development and implementation of the research method. [ABSTRACT FROM AUTHOR]

Nudges are interventions that aim to change people's behaviour through changing the environment in which they choose rather than appealing to their reasoning. Nudges have been proposed as of possible use in relation to health-related behaviour. However, nudges have been criticized as ethically dubious because they bypass peoples reasoning and (anyway) are of little help in relation to affecting ill-health that results from social determinants, such as poverty. Reducing the rate of excess winter deaths (EWDs) is a public health priority; however, EWD seems clearly to be socially determined such that nudges arguably have little role. This article defends two claims: (i) nudges could have a place in tackling even the heavily socially determined problem of EWD. We draw on evidence from an empirical study, the Keeping Warm in Later Life Project (KWILLT), to argue that in some cases the risk of cold is within the person’s control to some extent such that environmental modifications to influence behaviour such as nudges are possible. (ii) Some uses of behavioural insights in the form of nudges are acceptable, including some in the area of EWD. We suggest a question-based framework by which to judge the ethical acceptability of nudges. [ABSTRACT FROM PUBLISHER]

The recent publication of the Scottish Index of Multiple Deprivation (SIMD) has allowed some tentative statistical correlations to be undertaken to assess the impact poverty may have on mortality and morbidity. During the period 1989 to 2001, Scotland registered around 51,600 excess winter deaths (EWDs). An EWD is taken as the additional deaths during December to March than occurred in the preceding and subsequent four-month periods. Almost all of these EWDs were in the population aged over 65. This represents 50 more deaths per day in January than in July. The SIMD measured five criteria by region: income; employment; health and disability; education, skills and training; and geographical access to services. Glasgow was the most deprived region with an SIMD score of 46.88 and East Dunbartonshire, the least deprived region, with a score of 9.07. For the over 65s, the chance of becoming an EWD in Glasgow is one in 36, rising to one in 68 for North Ayrshire. The SIMD is positively correlated with EWD by region (0.35 at the 5% confidence level). This correlation appears to go against the influence of climatic variations, house type, energy efficiency and access to the gas network which favours urban areas. Although some of the additional winter deaths have been ascribed to outdoor cold exposure - exacerbated by inappropriate clothing or culturally determined behaviour - the majority of EWDs are premature and essentially preventable if the elderly can be kept warm in their homes during the winter months. [ABSTRACT FROM AUTHOR]

The recent publication of the Scottish Index of Multiple Deprivation (SIMD) has allowed some tentative statistical correlations to be undertaken to assess the impact poverty may have on mortality and morbidity. During the period 1989 to 2001, Scotland registered around 51,600 excess winter deaths (EWDs). An EWD is taken as the additional deaths during December to March than occurred in the preceding and subsequent four-month periods. Almost all of these EWDs were in the population aged over 65. This represents 50 more deaths per day in January than in July. The SIMD measured five criteria by region: income; employment; health and disability; education, skills and training; and geographical access to services. Glasgow was the most deprived region with an SIMD score of 46.88 and East Dunbartonshire, the least deprived region, with a score of 9.07. For the over 65s, the chance of becoming an EWD in Glasgow is one in 36, rising to one in 68 for North Ayrshire. The SIMD is positively correlated with EWD by region (0.35 at the 5% confidence level).This correlation appears to go against the influence of climatic variations, house type, energy efficiency and access to the gas network which favours urban areas. Although some of the additional winter deaths have been ascribed to outdoor cold exposure - exacerbated by inappropriate clothing or culturally determined behaviour - the majority of EWDs are premature and essentially preventable if the elderly can be kept warm in their homes during the winter months. [ABSTRACT FROM PUBLISHER]