The association of energy poverty with health, health care utilisation and medication use in southern Europe

Laura Oliveras; Lucia Artazcoz; Carme Borrell; Laia Palència; María José López; Mercè Gotsens; Andrés Peralta; Marc Marí-Dell'Olmo

doi:10.1016/j.ssmph.2020.100665

The association of energy poverty with health, health care utilisation and medication use in southern Europe

Laura Oliveras^*
, Lucia Artazcoz
, Carme Borrell
, Laia Palència
, María José López
, Mercè Gotsens
, Andrés Peralta
, Marc Marí-Dell'Olmo

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

71 Scopus citations

Abstract

Energy poverty (EP) is defined as the inability of a household to secure a socially and materially required level of energy services in the home. The main objective of this study was to analyse the association between EP and distinct indicators of health status, health services utilisation and medication use in southern Europe, using the city of Barcelona as a case study. We conducted a cross-sectional study using the data of the Barcelona Health Survey for 2016 (n = 3519, 53.3% women). We calculated EP percentages according to age, country of birth and social class. We analysed the association between EP and 26 health-related indicators through prevalence ratios (PR), and quantified the impact of EP on health at the population level by calculating the percentage of population attributable risk (PAR%). In Barcelona, 13.3% of women and 11.3% of men experienced EP. The most frequently affected groups were people born in low- and middle-income countries, those from more disadvantaged social classes, and women aged 65 years and older. We found a strong association between EP and worse health status, as well as higher use of health services and medication. For example, compared with women without EP, those with EP reported poor mental health 1.9 (95% CI: 1.6–2.4) times more frequently. Compared with men without EP, those with EP reported poor mental health 2.1 (95% CI: 1.6–2.8) times more frequently. The combination of high EP prevalence and the strong association between EP and negative health outcomes resulted in high PAR%, indicating the striking impact of EP on health and health services at the population level. EP is an important public health problem in southern European urban contexts that should be included in policy priorities in order to address its structural causes and minimise its unfair and avoidable health effects.

Original language	English
Article number	100665
Journal	SSM - Population Health
Volume	12
DOIs	https://doi.org/10.1016/j.ssmph.2020.100665
State	Published - Dec 2020
Externally published	Yes

Bibliographical note

Publisher Copyright:
© 2020 The Authors

Funding

The study is part of the PENSA Project (“Pobreza energética y salud desde multiples perspectivas: análisis individual, geográfico y temporal”), which received a research grant from the Carlos III Institute of Health, Ministry of Economy and Competitiveness (Spain) , awarded on the 2015 call under the Health Strategy Action 2013–2016, within the National Research Program oriented to Societal Challenges, within the Technical, Scientific and Innovation Research National Plan 2013–2016, with reference PI15/02006 , co-funded with European Union ERDF funds (European Regional Development Fund) ”. LO was supported by a Rio Hortega grant ( CM19/00184 – Contratos Rio Hortega/ Fondo Social Europeo) from the Carlos III Institute of Health . The funders were not involved in the research and preparation of the article, including study design; collection, analysis, and interpretation of data; writing of the article; nor in the decision to submit it for publication. The study is part of the PENSA Project (?Pobreza energ?tica y salud desde multiples perspectivas: an?lisis individual, geogr?fico y temporal?), which received a research grant from the Carlos III Institute of Health, Ministry of Economy and Competitiveness (Spain), awarded on the 2015 call under the Health Strategy Action 2013?2016, within the National Research Program oriented to Societal Challenges, within the Technical, Scientific and Innovation Research National Plan 2013?2016, with reference PI15/02006, co-funded with European Union ERDF funds (European Regional Development Fund)?. LO was supported by a Rio Hortega grant (CM19/00184 ? Contratos Rio Hortega/ Fondo Social Europeo) from the Carlos III Institute of Health. The funders were not involved in the research and preparation of the article, including study design; collection, analysis, and interpretation of data; writing of the article; nor in the decision to submit it for publication.

Funders	Funder number
Carlos III Institute of Health
European Union ERDF
Rio Hortega	CM19/00184
Ministerio de Economía y Competitividad	PI15/02006
European Regional Development Fund

Keywords

Energy poverty
Fuel poverty
Health
Health inequalities
Social determinants of health
Southern Europe
Urban

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.ssmph.2020.100665

Cite this

@article{246f7911408e4d8886b008b5641c225b,

title = "The association of energy poverty with health, health care utilisation and medication use in southern Europe",

abstract = "Energy poverty (EP) is defined as the inability of a household to secure a socially and materially required level of energy services in the home. The main objective of this study was to analyse the association between EP and distinct indicators of health status, health services utilisation and medication use in southern Europe, using the city of Barcelona as a case study. We conducted a cross-sectional study using the data of the Barcelona Health Survey for 2016 (n = 3519, 53.3\% women). We calculated EP percentages according to age, country of birth and social class. We analysed the association between EP and 26 health-related indicators through prevalence ratios (PR), and quantified the impact of EP on health at the population level by calculating the percentage of population attributable risk (PAR\%). In Barcelona, 13.3\% of women and 11.3\% of men experienced EP. The most frequently affected groups were people born in low- and middle-income countries, those from more disadvantaged social classes, and women aged 65 years and older. We found a strong association between EP and worse health status, as well as higher use of health services and medication. For example, compared with women without EP, those with EP reported poor mental health 1.9 (95\% CI: 1.6–2.4) times more frequently. Compared with men without EP, those with EP reported poor mental health 2.1 (95\% CI: 1.6–2.8) times more frequently. The combination of high EP prevalence and the strong association between EP and negative health outcomes resulted in high PAR\%, indicating the striking impact of EP on health and health services at the population level. EP is an important public health problem in southern European urban contexts that should be included in policy priorities in order to address its structural causes and minimise its unfair and avoidable health effects.",

keywords = "Energy poverty, Fuel poverty, Health, Health inequalities, Social determinants of health, Southern Europe, Urban",

author = "Laura Oliveras and Lucia Artazcoz and Carme Borrell and Laia Pal{\`e}ncia and L{\'o}pez, \{Mar{\'i}a Jos{\'e}\} and Merc{\`e} Gotsens and Andr{\'e}s Peralta and Marc Mar{\'i}-Dell'Olmo",

note = "Publisher Copyright: {\textcopyright} 2020 The Authors",

year = "2020",

month = dec,

doi = "10.1016/j.ssmph.2020.100665",

language = "English",

volume = "12",

journal = "SSM - Population Health",

issn = "2352-8273",

publisher = "Elsevier Ltd",

}

TY - JOUR

T1 - The association of energy poverty with health, health care utilisation and medication use in southern Europe

AU - Oliveras, Laura

AU - Artazcoz, Lucia

AU - Borrell, Carme

AU - Palència, Laia

AU - López, María José

AU - Gotsens, Mercè

AU - Peralta, Andrés

AU - Marí-Dell'Olmo, Marc

PY - 2020/12

Y1 - 2020/12

N2 - Energy poverty (EP) is defined as the inability of a household to secure a socially and materially required level of energy services in the home. The main objective of this study was to analyse the association between EP and distinct indicators of health status, health services utilisation and medication use in southern Europe, using the city of Barcelona as a case study. We conducted a cross-sectional study using the data of the Barcelona Health Survey for 2016 (n = 3519, 53.3% women). We calculated EP percentages according to age, country of birth and social class. We analysed the association between EP and 26 health-related indicators through prevalence ratios (PR), and quantified the impact of EP on health at the population level by calculating the percentage of population attributable risk (PAR%). In Barcelona, 13.3% of women and 11.3% of men experienced EP. The most frequently affected groups were people born in low- and middle-income countries, those from more disadvantaged social classes, and women aged 65 years and older. We found a strong association between EP and worse health status, as well as higher use of health services and medication. For example, compared with women without EP, those with EP reported poor mental health 1.9 (95% CI: 1.6–2.4) times more frequently. Compared with men without EP, those with EP reported poor mental health 2.1 (95% CI: 1.6–2.8) times more frequently. The combination of high EP prevalence and the strong association between EP and negative health outcomes resulted in high PAR%, indicating the striking impact of EP on health and health services at the population level. EP is an important public health problem in southern European urban contexts that should be included in policy priorities in order to address its structural causes and minimise its unfair and avoidable health effects.

AB - Energy poverty (EP) is defined as the inability of a household to secure a socially and materially required level of energy services in the home. The main objective of this study was to analyse the association between EP and distinct indicators of health status, health services utilisation and medication use in southern Europe, using the city of Barcelona as a case study. We conducted a cross-sectional study using the data of the Barcelona Health Survey for 2016 (n = 3519, 53.3% women). We calculated EP percentages according to age, country of birth and social class. We analysed the association between EP and 26 health-related indicators through prevalence ratios (PR), and quantified the impact of EP on health at the population level by calculating the percentage of population attributable risk (PAR%). In Barcelona, 13.3% of women and 11.3% of men experienced EP. The most frequently affected groups were people born in low- and middle-income countries, those from more disadvantaged social classes, and women aged 65 years and older. We found a strong association between EP and worse health status, as well as higher use of health services and medication. For example, compared with women without EP, those with EP reported poor mental health 1.9 (95% CI: 1.6–2.4) times more frequently. Compared with men without EP, those with EP reported poor mental health 2.1 (95% CI: 1.6–2.8) times more frequently. The combination of high EP prevalence and the strong association between EP and negative health outcomes resulted in high PAR%, indicating the striking impact of EP on health and health services at the population level. EP is an important public health problem in southern European urban contexts that should be included in policy priorities in order to address its structural causes and minimise its unfair and avoidable health effects.

KW - Energy poverty

KW - Fuel poverty

KW - Health

KW - Health inequalities

KW - Social determinants of health

KW - Southern Europe

KW - Urban

UR - https://www.scopus.com/pages/publications/85095786158

U2 - 10.1016/j.ssmph.2020.100665

DO - 10.1016/j.ssmph.2020.100665

M3 - Article

AN - SCOPUS:85095786158

SN - 2352-8273

VL - 12

JO - SSM - Population Health

JF - SSM - Population Health

M1 - 100665

ER -

The association of energy poverty with health, health care utilisation and medication use in southern Europe

Abstract

Bibliographical note

Funding

Keywords

UN SDGs

Access to Document

Other files and links

Cite this