As this article sets out, cold, damp homes drive up rates of respiratory illness, heart disease and poor mental health, while warm, efficient homes with clean heating protect the people living in them. Here, Gillian Campbell, director of Existing Homes Alliance Scotland, explains why upgrading Scotland’s homes tackles poverty, eases pressure on the NHS, supports economic growth and cuts emissions – all at once.

Everyone should have a warm, safe place to call home, and that means a home that is affordable to heat and healthy to live in. That is not a luxury - it is a basic condition for a healthy life. Yet in 2024, around 732,000 households in Scotland (more than one in four) were living in fuel poverty, and 357,000 of them in extreme fuel poverty. That is not acceptable in an energy rich country like Scotland.

When we talk about upgrading Scotland’s homes, the conversation often focuses on two things: cutting carbon and cutting bills. Both of these matter, but there is a third element that is often overlooked - our health. Making homes energy efficient and moving to clean, zero-emissions heating is good for the planet and good for the people living in them.

From a public policy value for money perspective, investing in upgrading our homes is exceptionally good value – it tackles poverty by easing the cost of living, it reduces the burden on the health service by making people healthier, it supports economic growth by creating jobs (generating tax revenue) and it cuts greenhouse gas emissions that are driving climate change.

The same investment is delivering against all of the First Minister’s top priorities for government (cost of living, NHS and growing the economy) and it cuts emissions too.

Cold homes make us ill

The link between cold homes and poor health is well established. A report by the Marmot Review Team for Friends of the Earth found that cold, damp home raises the risk of respiratory illness like asthma and chronic obstructive pulmonary disease (COPD), worsens conditions from heart disease to arthritis, and takes a real toll on mental health and wellbeing.

The World Health Organization recommends a minimum indoor temperature of 18°C precisely because dropping below it strains the heart and lungs. Research in Scotland found that indoor temperatures under 18°C accounted for around 9% of the population’s risk of high blood pressure. At its most extreme, this costs lives. It has been estimated that, in the UK, roughly one in ten excess winter deaths are directly attributable to fuel poverty.

Invest in upgrading, because a warm home is a healthy home

Insulation, draught-proofing and better windows keep heat in, so homes are warmer, drier and cheaper to heat. That matters for health, because a warmer home is a healthier one, but it also matters for affordability. In Scotland, homes rated Energy Performance Certificate (EPC) band C or better consistently have lower rates of fuel poverty than leakier, less efficient homes.

The way we heat our homes matters for our health too. Burning fossil fuels (such as gas and oil) at home releases pollutants like nitrogen dioxide and fine particulates that are linked to respiratory and cardiovascular disease. Recent research suggests that gas boilers contribute around 6% of all UK nitrogen oxides (NOx) emissions.

Moving off fossil fuels and switching to clean heating not only cuts carbon emissions but also removes a source of harmful pollution. Because heat pumps and other zero-emissions systems burn nothing where they operate, cleaner heating means cleaner air, not just inside the home, but for the whole community.

A cost-effective choice for Scotland

Upgrading Scotland’s homes is not a policy trade-off. A home that is warm, efficient and has clean heating is better for the climate, cheaper to heat, and healthier to live in. Those who stand to gain the most are the very people who are currently struggling the most - households on the lowest incomes who are carrying the heaviest health burden.

With the Scottish Government recently publishing their Programme for Government, and as they move forward with public service reform, there must now be clear recognition of the huge public health opportunities associated with upgrading our homes.

Warmer homes mean lower bills, cleaner air and healthier lives for everyone.