The Impact of Housing Quality Retrofits on the Health and Well-Being of Older People: An Analysis of the English Longitudinal Study of Ageing

Research question Do improvements to the quality of people’s homes resulting from energy efficiency retrofits have a favourable impact on the health and well-being of older people in England? Background to the research Much of the housing stock in the UK is old and of poor quality. Lack of insulation makes homes difficult and expensive to heat, and problems of damp and mould are common. Poor housing has an impact on mental health and long-term conditions. Problems related to housing are particularly important for older people because they are at greater risk of long-term conditions, and because they often spend much of their time at home. The Government and energy suppliers have introduced several schemes to support home improvements to increase energy efficiency. Aims and objectives Our aims are to discovery whether housing energy efficiency retrofit interventions improve the mental and physical health of older people living in England, reduce health inequalities, are economically viable, and inform progress towards net zero. We will assess whether retrofits positively impact energy use and measures of damp, mould, and cold in winter. We will also study effects on short (up to 3 years) and longer (3-8 years) measures of hospital admissions, incident long-term conditions, mental health and quality of life. We will determine whether retrofits reduce socioeconomic disparities in health, and will model the health impact of further upgrading of home modifications to reach 2050 net zero targets. Methods This project involves analysis of existing real-world data. We will use the English Longitudinal Study of Ageing (ELSA), a study of men and women aged 50 – 90+ living in England that started in 2002. The study sample is representative of the country in terms of social and economic background and geographical location. We have linked each ELSA participant’s address with the National Energy Efficiency Data-Framework (NEED), a UK Government database on energy efficiency retrofits that covers the vast majority of retrofits. Participants in ELSA who live in homes that had retrofits between 2004 and 2019 will be compared with people who have not had these home modifications using Difference-in-Difference analyses and propensity matching. Health outcomes up to 2024 will be studied using Hospital Episode Statistics and mortality linkage. An economic analysis will evaluate the costs and benefits of home improvements to the government and individuals. We will also carry out statistical modelling to study the effects of further improvements to the housing stock to reach national net-zero targets. Timelines The project will start in October 2025. Primary analyses of the impact of retrofits on housing quality will be completed in Oct-Dec 2026 and associations with health in Jan-Mar 2027. Economic evaluations will be completed by Oct-Nov 2027. Final health and housing analyses will be done by April-June 2028, and net zero modelling in July 2028. Impact and dissemination Findings will be disseminated to the public using infographics, summary briefings, podcasts and social media activity through the ELSA media and communications network. We will use contacts with the Departments of Health and Social Care, and Energy Security and Net Zero to ensure findings are communicated to central government. We will also connect with local government and with third sector organisations involved in ageing, social housing, and net zero.