The social cost of cold homes in an English city: developing a transferable policy tool.

BACKGROUND Although there is substantial epidemiological evidence implicating cold homes in death and morbidity, evidence for the UK on the nature and scale of the costs involved is fragmentary. Policy making in this area is thus not well-informed of the benefit of interventions which arises in the form of costs averted. METHODS This pilot study presents estimates of the social cost of harms to health caused by cold homes in the City of Sheffield. All costs are monetized and are for 1 year. Different elements of social cost are distinguished as are different types of harms to health. Because all estimates are derived from readily available secondary data the estimating framework is readily transferable to any other English local authority area. RESULTS The social cost arising from losses of well-being are shown to dominate other elements of social cost including National Health Service and Social Care costs, and the social cost arising from mental illness is shown to dominate that arising from other harms to health including death. DISCUSSION The implications of the results for the application of fiscal rate-of-return and social cost-benefit tests are discussed. Several areas are identified in which research reported in this pilot study could be improved on and expanded.