Mishra Shiva Raj, Wilson Tim, Andrabi Hassan, Ouakrim Driss Ait, Li Ang, Akpan Edifofon, Bentley Rebecca, Blakely Tony
Scalable Health Intervention Evaluation (SHINE), Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
Scalable Health Intervention Evaluation (SHINE), Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
Soc Sci Med. 2023 Oct;334:115954. doi: 10.1016/j.socscimed.2023.115954. Epub 2023 May 5.
Cold indoor temperature (<18 °C) is associated with hypertension-related and respiratory disease, depression, and anxiety. We estimate total health, health expenditure and income impacts of permanently lifting the temperature in living areas of the home to 18 °C in cold homes in South-eastern Australia (N = 17 million).
A proportional multistate lifetable model was used to estimate health adjusted life years (HALYs), health expenditure and income earnings, over the remainder of the lifespan of the population alive in 2021 (3% discount rate). Multiple data were integrated including the prevalence of cold housing (5.87%; mean temperature 15 °C), the effect of temperature to hypertension-related, respiratory disease, depression and anxiety.
Eradicating cold housing was predicted to lead to 89,600 (95% UI 47,700 to 177,000) lifetime HALYs gained over the population's remaining lifespan, nearly half of which occurred from 2021 to 2040. Respiratory disease (32.4%) and mental illness (60.6%) made large contributions to HALYs gained, but also had large uncertainty (95% UI 30.0%-42.9% and 45.1%-64.6%, respectively) due to uncertain estimates of their magnitude of causal association with cold housing. Health gains per capita were 6.1 times greater (95% UI 4.7 to 8.1) among the most compared to least deprived quintile. From 2021 to 2040, health expenditure decreased by AUD$0.87 billion (0.35-1.98) and income earnings increased by AUD$4.35 billion (1.89-9.81).
Eliminating cold housing would lead to substantial health gains, reductions in health inequalities, savings in health expenditure, and productivity gains. Next steps require research to reduce uncertainty about the magnitude of causal associations of cold with mental and respiratory health.
室内低温（<18°C）与高血压相关疾病、呼吸系统疾病、抑郁症和焦虑症有关。我们估计了在澳大利亚东南部寒冷家庭（N = 1700万）中将家庭居住区域温度永久提升至18°C对总体健康、健康支出和收入的影响。
采用比例多状态生命表模型来估计2021年存活人口剩余寿命期间的健康调整生命年（HALYs）、健康支出和收入收益（贴现率3%）。整合了多个数据，包括寒冷住房的患病率（5.87%；平均温度15°C）、温度对高血压相关疾病、呼吸系统疾病、抑郁症和焦虑症的影响。
预计消除寒冷住房将使人口剩余寿命期间获得89,600（95% UI 47,700至177,000）个终身HALYs，其中近一半发生在2021年至2040年期间。呼吸系统疾病（32.4%）和精神疾病（60.6%）对获得的HALYs贡献很大，但由于其与寒冷住房因果关联程度的估计存在不确定性，也具有很大的不确定性（95% UI分别为30.0% - 42.9%和45.1% - 64.6%）。最贫困五分位数人群的人均健康收益比最不贫困五分位数人群大6.1倍（95% UI 4.7至8.1）。从2021年到至2040年，健康支出减少了8.7亿澳元（0.35 - 1.98），收入收益增加了43.5亿澳元（1.89 - 9.81）。
消除寒冷住房将带来显著的健康收益、减少健康不平等、节省健康支出并提高生产力。下一步需要开展研究，以减少寒冷与精神和呼吸健康因果关联程度的不确定性。
