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Reducing the health risks of severe winter weather among older people in the United Kingdom: an evidence-based intervention

Published online by Cambridge University Press:  22 October 2009

CLAIRE GASCOIGNE
Affiliation:
Division of Psychology, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
KEVIN MORGAN*
Affiliation:
Division of Psychology, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
HARRIET GROSS
Affiliation:
Department of Psychology, University of Lincoln, Lincoln, UK.
JAMES GOODWIN
Affiliation:
Age Concern and Help the Aged, London, UK.
*
Address for correspondence: Kevin Morgan, Division of Psychology, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK. Email: k.morgan@lboro.ac.uk

Abstract

Excess winter morbidity and mortality among older people remain significant public health issues in those European countries which experience relatively mild winter temperatures, particularly the United Kingdom (UK), Ireland, Portugal and Spain. In the UK, episodes of severe winter weather, when ambient temperatures fall below 5° C, are associated with peaks in general practitioner consultations, hospital admissions, and cardiovascular deaths among those aged over 65. While research indicates that such health risks could be substantially reduced by the adoption of appropriate behavioural strategies, accessible and credible advice on how older people can reduce risk during ‘cold snaps’ is lacking. This paper describes a programme of research that aimed: (a) to translate the relevant scientific literature into practical advice for older people in order to reduce health risk during episodes of severe winter weather; and (b) to integrate this advice with a severe winter weather ‘Early Warning System’ developed by the UK Met Office. An advice booklet was generated through a sequential process of systematic review, consensus development, and focus group discussions with older people. In a subsequent field trial, a combination of the Met Office ‘Early Warning System’ and the advice booklet produced behavioural change among older people consistent with risk reduction. The results also show that long-held convictions about ‘healthy environments’ and anxieties about fuel costs are barriers to risk reduction.

Type
Articles
Copyright
Copyright © Cambridge University Press 2009

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References

Aylin, P., Morris, S., Wakefield, J., Grossinho, A., Jarup, L. and Elliot, P. 2001. Temperature housing deprivation and their relationship to excess winter mortality in Great Britain, 1986–1996. International Journal of Epidemiology, 30, 5, 1100–8.CrossRefGoogle ScholarPubMed
Braun, V. and Clarke, V. 2006. Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 2, 77–101.CrossRefGoogle Scholar
Carson, C., Hajat, S., Armstrong, B. and Wilkinson, P. 2006. Declining vulnerability to temperature-related mortality in London over the 20th century. American Journal of Epidemiology, 161, 1, 7784.CrossRefGoogle Scholar
Dey, I. 1993. Qualitative Data Analysis. Routledge, London.Google Scholar
Donaldson, G. C., Rintamäki, H. and Näyhä, S. 2001. Outdoor clothing: its relationship to geography, climate, behaviour and cold-related mortality in Europe. International Journal of Biometeorology, 45, 1, 4551.CrossRefGoogle ScholarPubMed
Ebi, K. L. 2007. Towards an early warning system for heat events. Journal of Risk Research, 10, 5, 729–44.CrossRefGoogle Scholar
Elliot, A. J., Cross, K. W. and Fleming, D. M. 2008. Acute respiratory infections and winter pressures on hospital admissions in England and Wales 1990–2005. Journal of Public Health, 30, 1, 91–8.CrossRefGoogle Scholar
Guy, W. A. 1858. On the annual fluctuations in the number of deaths from various diseases, compared with like fluctuations in crime and in other events within and beyond the control of human will. Journal of the Statistical Society, 21, 5286.Google Scholar
Hajat, S., Kovats, R. S. and Lackowycz, K. 2007. Heat-and-cold-related deaths in England and Wales: who is at risk? Occupational and Environmental Medicine, 64, 2, 93–100.CrossRefGoogle ScholarPubMed
Healy, J. D. 2003. Excess winter mortality in Europe: a cross-country analysis identifying key risk factors. Journal of Epidemiology and Community Health, 57, 10, 784–89.CrossRefGoogle ScholarPubMed
Jones, R. L. 2006. ‘Older people’ talking as if they are not older people: positioning theory as an explanation. Journal of Aging Studies, 20, 1, 7991.CrossRefGoogle Scholar
Keatinge, W. R. and Donaldson, G. C. 1997. Cold exposure and winter mortality from ischaemic heart disease, cerebrovascular disease, respiratory disease, and all causes in warm and cold regions. The Lancet, 349, 10, 1341–6.Google Scholar
McGregor, G. R. 2004. Winter North Atlantic Oscillation, temperature and ischaemic heart disease mortality in three English counties. International Journal of Biometeorology, 49, 3, 197204.CrossRefGoogle ScholarPubMed
Met Office 2007. COPD Forecasting for Anticipatory Care. Available online at http://www.metoffice.gov.uk/health/copd_forecasting.html [Accessed 17 July 2007].Google Scholar
Met Office 2009. UK Climate; 3: Regional Climate of the UK. Available online at http://www.metoffice.gov.uk/education/secondary/teachers/ukclimate.html#1.2 [Accessed 19 March 2009].Google Scholar
Minichiello, V., Browne, J. and Kendig, H. 2000. Perceptions and consequences of ageism: views of older people. Ageing and Society, 20, 3, 253–78.CrossRefGoogle Scholar
Morgan, K., Haslam, R., Havenith, G., Brace, C. and Tucker, I. 2004. Forecasting the Nations' Health. Internal Report prepared for Help the Aged, Loughborough University, Loughborough, UK.Google Scholar
Murphy, N. K., Black, N. A., Lamping, D. L., McKee, C. M., Sanderson, C. F. B., Askham, J. and Marteau, T. 1998. Consensus development methods, and their use in clinical guideline development. Health Technology Assessment, 2, 3, iiv, 188.CrossRefGoogle ScholarPubMed
Ritchie, J., Spencer, L. and O'Connor, W. 2003. Carrying out qualitative analysis. In Ritchie, J. and Lewis, J. (eds), Qualitative Research Practice. Sage, London, 219–62.Google Scholar
Townsend, J., Godfrey, M. and Denby, T. 2006. Heroines, villains and victims: older people's perceptions of others. Ageing and Society, 26, 6, 883900.CrossRefGoogle Scholar
Wilkinson, P., Pattenden, S., Armstrong, B., Fletcher, A., Kovats, S. R., Mangtani, P. and McMicheal, A. J. 2004. Vulnerability to winter mortality in the elderly in Great Britain: population based study. British Medical Journal, 329, 7467, 647–51.CrossRefGoogle ScholarPubMed
Yardley, L., Donovan-Hall, M., Francis, K. and Todd, C. 2006. Older people's views of advice about falls prevention: a qualitative study. Health Education Research, 21, 4, 508–17.CrossRefGoogle ScholarPubMed