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

现有的官方方法衡量与感冒相关的死亡人数是粗糙的——只是对各个季节的平均死亡率进行比较。此外，通过简单的插值对冷的影响也作出了非常有力的推论。先前的研究表明，尽管随着天气变冷，死亡率确实会上升，但温度只能解释冬季死亡率变化的一小部分，而在相对温和的冬季，冬季死亡率可能会过高。美国的证据表明，纬度起了一定作用——通常寒冷的地方很少有与寒冷有关的死亡。有一种强烈的暗示，尽管从未正式测试过，但这种关系是高度非线性的，意外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。特别是动态效应和非线性关系需要引起高度重视。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支付（WFP）如何影响这种关系。世界粮食计划署的想法是提供现金，让老年人在寒冷的时候保持温暖，让他们保持健康。因此，如果世界粮食计划署“起作用”，它的作用是通过“推动”家庭在燃料上的支出，从而提高供暖水平，并减少寒冷对健康的不利影响——其作用超过国家养老金的同等幅度增长。有关转移支付标签在多大程度上影响其支出方式的证据不一，但有关政策可以“推动”个人决策的讨论很多。粮食计划署提供了一个机会来证明这种想法的有效性。事实上，由于其实施的性质，它提供了一个不同寻常的“干净”测试-特别是，它没有经济状况调查，而且入学率接近100%，因此没有选择问题需要考虑。此外，英国提供了一个很好的环境来测试它影响死亡率和天气之间关系的命题，而不是一般的死亡率效应，因为它是一个很长的国家，全国各地的天气模式变化很大。世界粮食计划署是向居住在英国的60岁或以上的个人提供的免税款项，以帮助他们支付冬季的取暖费用。老年人之所以成为攻击目标，是因为他们在冬季特别容易受到寒冷天气的影响，而且更有可能有固定收入。英国有超过1200万人（其中110万人在苏格兰）获得了基本的冬季燃料补贴。去年的总成本超过27亿英镑。粮食计划署的费用约占平均退休家庭每年燃料账单总额的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.