Association by Age Groups Between Retrofitting Home Heating and Insulation and Subsequent Hospitalised Home Fall Rates: A Natural Experiment

Insulating homes has been shown to provide health benefits, but benefits for home safety have not been studied. The current study analyses hospitalised falls rates, making use of a large New Zealand cohort initially set up to study health benefits. This cohort consists of just under half a million people (n = 469,666; 53.3% female; mean age 35.7), half in an intervention group (n = 236,040; 53.6% female; mean age 36.2) who had their homes retrofitted with insulation early in the study period and half in a control group (n = 233,626; 52.9% female; mean age 35.3) with homes retrofitted later. We found that retrofitting programme was associated with changes in fall rates that varied in a non-linear way with age. Cubic splines were used to estimate a non-linear but continuous relationship between age and changes in fall rates. Although other research has indicated that home insulation and heating have a positive influence on older people’s wellbeing and ability to live independently, the current analysis indicated a safety benefit only for under-70-year-olds, not for older people; the population-wide change in fall hospitalisation rates associated with the programme estimated was null. The study highlights the importance of considering the benefits of home improvements, particularly for older people, in a holistic way that encompasses wellbeing as well as health and safety outcomes.