Evaluating the association between receipt of a winter fuel cash transfer and older people's care needs, quality of life, and housing quality: Evidence from England

Background: Exposure to cold temperatures is known to be associated with deterioration of physical and mental health as well as poorer well-being in many countries. The Winter Fuel Payment, an unconditional direct cash transfer of value between 250- pound 300 pound, was designed to help older people in England cover heating costs during the winter months, to counteract the particular vulnerability of older people to the effects of cold weather. Aims: We evaluated the impact of the Winter Fuel Payment scheme on subsequent prevalence of care needs such as being unable to eat or shower independently, quality of life and the likelihood of having cold-related housing conditions. We also explored the potential effects of the Winter Fuel Payment across different sub-samples (poorer/richer individuals, those living in newer/older properties, and in the North/South of England) to explore whether its benefits (if any) are spread equally across the eligible population. Data and methods: We used a regression discontinuity design approach with age as running variable to analyse seven waves of a nationally representative sample, the English Longitudinal Study of Ageing, covering the period 2002/2003 to 2016/2017, and consisting of 24,651 observations. Results: The Winter Fuel Payment had no overall effect on the outcomes of interest (care needs, quality of life, and cold-related housing problems). However, the Payment increased quality of life for poorer individuals, for those living in Northern regions of England, and for those living in newer dwellings. The likelihood of living in a property with at least one cold-related housing problem also decreased for those living in newer properties. Conclusions: Findings from this research provide important insights into the effectiveness of a winter cash transfer among the older population in England, and they are potentially relevant for other nations looking for strategies to deal with cold seasons and poorly insulated homes. In particular, this evaluation contributes to the 'universality versus targeting' policy debate and has implications for the development of energy-efficient policies.