Cold homes and children’s health
How smart data could protect our most vulnerable
Our Director, Joe Cuddeford, speaks to Dr Olivia Swann about her research into cold homes and children’s respiratory health.
Acute respiratory infections are the leading cause of hospital admissions for preschool children in the UK. Yet despite the scale of the problem, we don’t know how many of these cases could be prevented by improving the conditions children grow up in – particularly the problem of cold, damp homes.
In Scotland, where half of homes have low energy efficiency, a pioneering research project is seeking answers. Dr Olivia (Livvy) Swann, a paediatrician and data scientist, is leading a groundbreaking investigation into the connection between underheated homes and respiratory infections in preschool children.
“Children are like canaries in a coal mine,” Livvy explains. “Their respiratory systems are still developing, and they spend significant time at home during these crucial early years.”
It’s something Livvy has seen firsthand. “We were seeing the same children coming back to hospital with respiratory infections again and again – and their parents were telling us that they couldn’t afford to heat their homes. And we knew we were sending them back to the same home situations.”
Bridging medicine and data science
Livvy’s career began in paediatric infectious diseases, with stints overseas in Malawi and a PhD in cerebral malaria. But it was a different kind of health crisis – one closer to home – that prompted a new direction.
During the long days of the pandemic, Livvy taught herself to code. “If you’d told me ten years ago that I was going to be a data scientist, I would have just laughed,” she says. “But it’s becoming a bit of a superpower. As a clinician, to be able to formulate a question – like, why are these kids getting sick? – straight to analysing the data that might answer it.”
That mix of frontline insight and technical expertise now powers the Homes, Heat and Healthy Kids Study, an ambitious five-year project funded by the Wellcome Trust and hosted at the University of Edinburgh. It links up health, housing, energy and financial data to explore the risks posed by cold homes – and how to fix them without unintended consequences.
From retrofits to respiratory risk
While insulating homes to improve energy efficiency is essential, Livvy’s research asks a crucial question: could some upgrades be making things worse?
“We’ve had parents tell us their child’s breathing got worse after the house was insulated,” she says. “And when you look at the science, there are some early studies that indicate some interventions trap air pollutants – mould, smoke and viruses. So you end up with less ventilation and more indoor risk.”
That’s why Livvy’s study is looking not just at whether homes are warm but how they’re being made warm – and which measures might help or harm children’s health.
The power of smart data
To answer these questions, Livvy is combining traditional health and administrative data with new sources of smart data. Thanks to advances in administrative data research, it’s now possible to link healthcare data to individual properties in Scotland. Livvy layers this with financial transaction data from the Smart Data Foundry, prepayment smart meter data from Ofgem, Smart DCC and UrbanTide, and sensor data on humidity and mould risk from social housing provider Switchee.
“We’re linking together datasets that have never been combined before,” she explains.
The study will produce a powerful dataset to analyse links between household conditions and respiratory illness. It’s complex, but it’s building a much clearer picture of which kids are most at risk.
“I’ve had huge support from the Smart Data Foundry, the Smart DCC and Switchee. There is so much goodwill for projects where you can show the benefit of using data in a responsible way.”
Smart Data Research UK is funding the Smart Data Foundry to deliver a new Financial Data Service to support more researchers to access these types of data.
From silos to solutions
I ask about the challenges of working with such a wide range of datasets, and Livvy takes a deep breath. “Bringing all the different threads together – that’s going to be the majority of the work for the next year or two,” she says. “Because there are so many differences in how the data is structured and displayed. But don’t worry, I’ve got plenty of ideas.”
She’s had early success linking smart meter-derived fuel poverty scores to hospital admissions in the Lothian area using local DataLoch data for pilot analyses. The full national dataset – drawing from health records, housing data, and energy use – is still being assembled via Scotland’s National Safe Haven.
“It’s a mountain of paperwork, and it’s not going to be quick,” she admits. But Livvy is clear that the effort is worth it – not just for her project, but for future researchers. “We’re trying to make sure no one else has to repeat the groundwork we’ve done. The datasets we’ve fought to access – we’re ingesting them in ways that make them reusable. And our code will be open source so that anyone can learn from it.”
Livvy continues, “We have had an incredible amount of interest in the study and enormous goodwill from so many areas. We recently held a stakeholder event to explore the problem. I thought there might be 20 people and some sandwiches, but it turned into 130 people from over 50 organisations!”
Involving the public
One of the striking things about Livvy’s approach is the importance she places on involving the public in how their data is used. In fact, for Livvy, working with the public has been one of the most rewarding aspects of the study so far.
“In clinical research, we often have patient and public involvement groups. They can be a bit hit and miss,” she says. “If you’re not careful, you get the same people coming to the same groups.”
Determined to involve the ‘hard to reach and easy to ignore’, Livvy has built an advisory group of families with lived experience of the issues she’s studying.
One father, Andrew, shared his story:
“I am a single dad with a little girl suffering with asthma. Scotland is very cold, and I am struggling to heat up my home with the high fuel and energy prices.
“Last winter was horrible. I still have fuel debt that I need to pay during the summer, and by the time I finish paying the debt, the winter and the cold will arrive. I have been in this situation for two and a half years. It’s hitting me physically and mentally, and it’s keeping me up at night. I have to use food banks.
“I don’t mind sharing my data as long as it is shared anonymously. Being part of the study gives me comfort, knowing I am not alone. It has given me more confidence to speak out about my situation.”
The advisory group hasn’t just been consulted – they’ve helped shape the design of the study and co-created materials like an animated explainer video and powerful personal videos. The members of the group have also gained formal qualifications in Community Leadership for their involvement and expertise.
Transforming lives through smart data
The evidence generated by this study will be made available to policymakers in health, housing, energy and climate. Livvy’s goal is to provide concrete, quantitative answers to key questions. How much would childhood respiratory illness fall if homes were properly heated? Which retrofit measures are safest? What’s the cost of inaction?
“With children, if we don’t get it right early on, it sets you up for life,” Livvy says. “We know, for example, that babies living in cold homes grow less well because their bodies have to work harder to stay warm, using up energy that would normally help them develop and grow. That’s just so sad – it really gets me.”
At Smart Data Research UK, this is exactly the kind of research we aim to enable – where responsible use of data directly contributes to solving pressing societal challenges. Livvy’s pioneering work shows what happens when smart data is combined with clinical expertise and meaningful public involvement: practical solutions that make a real difference in people’s lives.
Ultimately, this is about giving kids a better chance – and making sure they don’t grow up in homes that make them sick. And thanks to data-driven research, we won’t have to guess – we can act.
