Buckingham Palace with crowds on the Mall

As winter approaches, with fuel bills and inflationary pressures endangering the lives of the old and poor, the UK government should rightly be concerned to provide relevant advice and help.

However, governments have not always been certain about how to do this. Back in the 1960s medical opinion was sharply divided as to whether the increased death rate in the winter months was caused solely by a breakdown in the body’s vascular mechanics for preserving heat, or by environmental factors such as cold living conditions.

To resolve this issue, in 1973 the market research firm Opinion Research Centre secured funding from the National Institute of Medical Research, the Rowntree Memorial Trust and the Nuffield Foundation to conduct a survey among 1,000 old people nationwide, and another 1,000 in the Camden area of London. Since a high level of cooperation by respondents was needed, an innovative field force mainly comprised of State Registered Nurses was trained in interviewing techniques. They were required not only to measure the home environmental conditions of each respondent but also more intimately their core body temperature via a urine sample.

A report on the project, published in the British Medical Journal and freely accessible in the Archive, settled the argument by indicating that there could be several million old people living in an environment below the recommended heating level, up to half a million of them suffering from the cold.  And 10% of the population aged 65+ (or 800,000 people) were at risk on account of their low core body temperatures or hypothermia.

As a result, the government was prompted to create a new ‘Winter Heating Allowance’ for old people (which still exists today). Also, building regulations were revised to ensure better insulation of new homes.

To bring things more up-to-date, a Guidance Note was published in November 2020 by Public Health England estimating that approximately 35,000 excess deaths in each winter are attributable to a cold home environment leading to hypothermia, which is defined as a low body temperature of 35 Centigrade or less. Especially at risk are people who are isolated, frail, housebound, on low incomes, suffering with fuel poverty, or homeless.  The government’s ‘Cold Weather Plan for England’ and the ‘Cold Weather Alert Service’ may alleviate the dangers, but these measures need to be updated as it concludes that “fuel poverty is one of the major causes of cold homes.”  In the aftermath of Covid with rising inflation and energy costs, relevant action is needed more than ever in the past.


A description of the project is available free to download from the AMSR Archive, in the MRS Newsletter Issue 087, June 1973 (link opens in new tab). The original paper, ‘Socio-medical Research into Hypothermia among the Elderly’ is only obtainable from ESOMAR as a paper delivered at the ESOMAR/WAPOR Congress, Budapest, 1973, pp 163-176.

Contributed by Peter Bartram
Date posted: 7th October 2022


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