Cold Related Deaths and the Effect of Nudging the Elderly: Evidence from the Longitudinal Studies

现有的官方方法来衡量与感冒相关的死亡人数是粗略的--只是对不同季节的平均死亡率进行比较。此外，还通过简单的插值法对寒冷的影响作出了极其有力的推断。之前的研究表明，尽管死亡率确实随着天气变冷而增加，但气温只解释了冬季死亡率的一小部分差异，而且在相对温和的冬季可能会出现高水平的过冬死亡率。美国的证据表明，纬度起到了一定作用--在通常寒冷的地方，与感冒有关的死亡人数很少。有一个强烈的暗示，尽管从未经过正式测试，但这种关系是高度非线性的，意想不到的寒冷比预期的寒冷天气更危险。因此，温度和死亡率之间的关系是复杂的。特别是，这种关系中的动态效应和非线性需要认真关注。我们建议对寒冷对死亡率的影响进行详细的调查--考虑到动力学、非线性和社会经济特征。此外，我们的目标是调查冬季燃料付款(粮食计划署)如何影响这种关系。世界粮食计划署的想法是提供现金，让老年人在天气寒冷时取暖--从而使他们身体健康。因此，如果世界粮食计划署“奏效”，它通过“推动”家庭在燃料上的支出来做到这一点，从而提高气温水平，并减少感冒对健康的不利影响--通过相当于增加国家养老金的方式。关于转移支付的标签对支出方式的影响程度，证据喜忧参半，但有很多人谈到，政策可以“推动”个人决策。粮食计划署提供了一个机会来证明其中一个想法的有效性。事实上，它提供了一个不同寻常的“干净”测试，因为它的实施性质--特别是，它不需要经济状况调查，而且接受率接近100%，因此不存在需要考虑的选择问题。此外，英国提供了一个很好的环境来测试这一命题，即它影响死亡率和天气之间的关系，而不是一般的死亡率影响，因为它是一个很长的县，全国各地的天气模式差异很大。世界粮食计划署是向居住在英国的60岁或以上的个人免税支付的，以帮助他们支付冬季几个月的取暖费。老年人成为目标，因为他们在冬季特别容易受到寒冷天气的影响，而且更有可能靠固定收入生活。英国向1200多万人支付了基本冬季燃料费用(其中110万人在苏格兰)。去年的总成本超过了27亿GB。世界粮食计划署的燃料费约占退休家庭年平均燃料费的10%。粮食计划署的历史提供了许多机会来调查粮食计划署在多大程度上对死亡率的季节和天气模式产生了因果影响。

The existing official methodology to measure cold-related deaths is crude - just a comparison of average mortality rates across seasons. Moreover extremely strong inferences have been made about the impact of cold through simple interpolation. Previous research has shown that although mortality does increase as it gets colder, temperature only explains a small amount of the variance in winter mortality, and high levels of excess winter mortality can occur during relatively mild winters. US evidence suggests that latitude plays a role - places where it is usually cold have few cold related deaths. There is a strong suggestion, although never formally tested, that the relationship is highly nonlinear and that unexpected cold is more dangerous than expected cold weather. Thus, the relationship between temperature and mortality is complex. In particular, the dynamic effects and nonlinearities in the relationship requires serious attention. We propose to provide a detailed investigation of the impact of cold on mortality - taking account of dynamics, nonlinearities, and socio-economic characteristics. In addition we aim to investigate how winter fuel payments (WFP) affects the relationship. The idea of WFP is to provide cash to keep old people warm when it's cold - so as to keep them well. So, if WFP "works", it does so by "nudging" household spending on fuel, so raising heat levels, and reducing the adverse effects of cold on health - by more than an equivalent rise in the state pension . Evidence on the extent to which the labeling of transfers affects how they are spent is mixed but there has been much talk of policy that can "nudge" individual decision making . WFP provides an opportunity to demonstrate the effectiveness of one such idea. Indeed, it provides an unusually "clean" test because of the nature of its implementation - in particular, it is not means-tested and the take-up rate is close to 100% so there is no selection issue to take account of. Moreover, the UK provides an excellent environment to test the proposition that it affects the relationship between mortality and weather separately from a general mortality effect because it is a long county and has wide variation in weather patterns across the country.WFP is a tax-free payment made to individuals aged 60 or over living in GB to help them with their heating costs over the winter months. Older people are targeted since they are particularly vulnerable to the effects of cold weather during the winter months and are more likely to be on fixed incomes. The basic Winter Fuel payment is made to more than 12 million people in GB (of which 1.1m are in Scotland). The total cost was over £2.7 billion last year. WFP amounts to about 10% of an average retired household total annual fuel bill. The history of WFP provides a number of opportunities to investigate the extent to which WFP has had a causal impact on the seasonal and weather patterns in mortality.