A rapid review of the effectiveness and cost effectiveness of interventions that make homes warmer and cheaper to heat for households in fuel poverty in rural and remote areas

Abstract

The cost-of-living across the UK has been on the increase since the start of 2021. Living in a rural community is often associated with additional costs compared to those in urban areas. For example, people living in rural areas are not always connected to the gas grid, often using oil and liquid petroleum gas for heating that are more expensive and not subjected to energy price caps. Moreover, housing in rural areas is generally older, not as well insulated and less energy efficient than houses in urban locations, leading to increased risk of fuel poverty. Home energy advice, energy efficiency measures, and financial support all have the potential to mitigate fuel poverty. The aim of this rapid evidence review was to determine the effectiveness of interventions that make homes warmer and cheaper to heat for households in fuel poverty in rural and remote areas. Fourteen studies and eight sources of grey literature were included in the review. The included studies and grey literature were published between 2007 and 2022. There was some evidence of effectiveness for interventions such as energy efficiency home improvements / retrofitting, home improvements (including replacing lightbulbs and electric heaters, external insulation, heating systems, loft insulation installing central heating), Welsh Government Arbed (home improvement and energy efficiency measures) and Nest (home improvements and advice) interventions, provision of energy and home energy advice, and referral for support and/or insulation measures or home improvements. Interventions such as social energy subsidies might not be effective in reducing fuel poverty, and energy efficient social housing was a more efficient method of alleviating fuel poverty. However, the certainty of the evidence is very low, primarily due to the study design and poor quality of the included studies. Policy makers and funding bodies need to make further investments into research focusing on measures to alleviate fuel poverty, with particular focus on economic analysis. There is a need for high quality, well-developed randomised controlled trials to investigate the effectiveness and cost-effectiveness of energy efficiency measures and advice. Future research should investigate which interventions are the most effective in what types of housing in rural areas to help the targeting of interventions better.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

The Wales Centre For Evidence Based Care was funded for this work by the Health and Care Research Wales Evidence Centre, itself funded by Health and Care Research Wales on behalf of Welsh Government

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

All data produced in the present study are available upon reasonable request to the authors

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