The Effects on Health of a Publicly Funded Domestic Heating Programme: A Prospective Controlled Study

Objective: To assess the effect of a publicly funded domestic heating programme on self-reported health. Design, setting and participants: A prospective controlled study of 1281 households in Scotland receiving new central heating under a publicly funded initiative, and 1084 comparison households not receiving new heating. The main outcome measures were self-reported diagnosis of asthma, bronchitis, eczema, nasal allergy, heart disease, circulatory problems or high blood pressure; number of primary care encounters and hospital contacts in the past year; and SF-36 Health Survey scores. Results: Usable data were obtained from 61.4% of 3849 respondents originally recruited. Heating recipients reported higher scores on the SF-36 Physical Functioning scale (difference 2.51; 95% CI 0.67 to 4.37) and General Health scale (difference 2.57; 95% CI 0.90 to 4.34). They were less likely to report having received a first diagnosis of heart disease (OR 0.69; 95% CI 0.52 to 0.91) or high blood pressure (OR 0.77; 95% CI 0.61 to 0.97), but the groups did not differ significantly in use of primary care or hospital services. Conclusions: Provision of central heating was associated with significant positive effects on general health and physical functioning; however, effect sizes were small. Evidence of a reduced risk of first diagnosis with heart disease or high blood pressure must be interpreted with caution, due to the self-reported nature of the outcomes, the limited time period and the failure to detect any difference in health service use.