Elderly poor suffering hypothermia in Australia

By Margaret Rees
13 July 2019

A record-breaking winter in Australia’s southern state of Victoria in 2015 prompted an investigation that found alarming indications of the effect of cold on the elderly poor, who were found to be suffering hypothermia inside their homes

The study, entitled “Cold and Lonely,” examined the cases of 217 hypothermic patients at three Alfred Health hospitals in south-eastern Melbourne, Victoria’s capital, between July 2009 and September 2016.

These hospitals serve a population of about 700,000 people, about a sixth of the city’s population, so the data gives only a partial view of the extent of the underlying social crisis.

Hypothermia patients found indoors accounted for 78 percent of hospital presentations, with elderly socially-isolated people over-represented. Of these, 65 percent were on pensions and 42 percent lived alone. Moreover, 87 percent of hypothermic elderly patients were found indoors.

Exposure-related hypothermia—being found outdoors when the maximum temperature was less than 20 degrees C—accounted for 22 percent of the hospital presentations. It was significantly associated with lower age and alcohol or drug-induced intoxication.

Inpatient deaths also were significantly higher among indoor patients compared to exposure patients (16 percent against 2 percent respectively). Body temperatures recorded in the emergency departments ranged from 23.9 to 36.4 degrees C.

Dr Michelle Ananda-Rajah, one of the study’s authors, told the WSWS: “It was quite an unexpected finding. We didn’t expect the majority of people to be found indoors… The patients who were found indoors had an eight times higher rate of dying than those found outdoors.

“People vulnerable to hypothermia were especially the elderly, even inside their own homes. Their homes were not adequately heated. They were socially isolated. We defined social isolation as living alone, having very few social supports around them, no friends or family, nothing documented in their medical history…

“We found the trend was patients who lived alone had worse outcomes. Their mortality was higher. This is not a medical problem; this is a social problem... Poverty, social isolation, inability to pay heating bills are probably factors behind this observation.”

The results point to an often-hidden social crisis—the avoidance or under-consumption of heating by people who must ration their energy use so they can pay their electricity and gas bills. Power prices increased by an average of 12 percent in Victoria each year between 2006 and 2016, the same period covered by the “Cold and Lonely” study.

The Labor Party bears particular responsibility for this social blight. It has been in office in the state since 2014, presiding over the public health and housing systems.

A Victorian Council of Social Services (VCOSS) survey, “Battling On—Persistent Energy Hardship,” published in 2018, found that in 2014–2016, 1.8 percent of Victorian households (45,000 households) were persistently unable to heat their homes. Another 3.6 percent were temporarily unable to do so. Nationally, 1.6 percent were persistently unable to heat their homes.

Of those unable to heat their homes, half did not report persistent payment difficulty. They paid energy bills on time by restricting or foregoing heating. Households with persistent heating inability had especially low incomes—half were in the lowest 20 percent of incomes. Also, 60.4 percent of these households included at least one person with a long-term health condition or disability.

An earlier VCOSS study, entitled “Power Struggles. Everyday battles to stay connected,” published in 2017, said: “People make significant sacrifices to pay energy bills. This can include restricting or entirely foregoing heating or cooling … or going without lighting.”

People renting are more likely to have persistent energy hardship. Brotherhood of St Lawrence research showed that the largest cohort of households unable to heat their homes (37 percent) were private tenants.

The VCOSS study pointed out: “Under current laws, landlords are able to lease structurally unsound homes with no or inadequate insulation, old and inefficient heating (if heating is provided at all), a lack of proper ventilation and aged, expensive hot water systems.”

The study included case studies of participants living in draughty homes who use no heating in winter due to energy costs. Others went to bed early in cold weather.

One elderly male pensioner, living alone, did not replace his gas heater after it broke down. He told interviewers: “I bite the bullet… if it’s cold, I’ll put a jumper on.” If he still felt cold, he went to bed early.

A number of elderly people gave similar accounts to the WSWS.

Brian, 83, lives alone in his own home, which is in need of repair, but repairs are too expensive. He recently lost his part-pension. “Six years ago I didn’t have to worry about money the way I do now,” he said. He closed down his gas account and relies on electricity. Asked how he heats his home in cold weather, he replied: “I use the electric blanket.”

Brian suffered a heart attack three years ago, so must live close to a hospital. “I do need to be warm, because of that,” he said.

John, 76, a pensioner, lives alone in a public housing flat. There is a heater, but it doesn’t give out much heat. “I don’t put the heater on at all,” he explained. “I wear a lot of clothes. I have a big thick doona and I take a hot water bottle to bed.

“The hot water in the flat is paid for by the housing commission. I don’t use much gas. Electricity is $78 for one bill... I would like the windows to be double glazed the way they are in Europe. That keeps in the heat.”

Enrico, 75, a pensioner, lives in a rented two-bedroom house with his daughter, who is also a pensioner. He worked in the building industry for 50 years, but lost his life savings in a swindle. “Now I pay $330 a week rent,” he said. “I can’t find anything cheaper. If you’re a pensioner, they won’t give you a chance.

“I use heating only when necessary, if I’m desperate, because it costs so much money. If I’m really cold, I only put the heater on for half an hour, not even an hour. I have a lumbar problem in the spine. I stuffed up my back working in the building industry. I’m in pain 24 hours a day.”

Aged 66, Fay lives in a public housing flat, which she says is “pretty cold. It is quite draughty. The balcony door has dropped and there is a gap.”

Fay is angry about her power bills because no matter how low her usage, she still has to pay the supply charge, which is often much greater than the usage. “I complain nearly every bill. My last two gas bills were astronomical. I had a gas bill of $56.30, and my actual usage was $1.83. Once a month I put complaints on their site.

“When I’m cold I just go to bed early and use a hot water bottle. I have a little fan heater in the kitchen. My heater in the lounge was not on once... The supply charge, it’s killing me. I try and budget. I put x amount to pay it each fortnight, so I don’t have bill shock. You shouldn’t have to live like this.”

The “Cold and Lonely” report has uncovered a glaring social problem of fuel poverty affecting older people that, if compounded by poor health, can have serious outcomes for those affected. It adds to studies conducted globally showing a direct connection between intensifying social inequality and poor health under capitalism.

The author also recommends:

Studies reveal stark health divide in Australia
[6 July 2017]

The “disease” of social inequality sends thousands to a premature death
[25 September 2017]

Contribute to the fight for socialism in 2020

2019 has been a year of mass social upheaval. We need you to help the WSWS and ICFI make 2020 the year of international socialist revival. We must expand our work and our influence in the international working class. If you agree, donate today. Thank you.