Introduction
Method
Variable | Operationalization |
---|---|
Fuel poverty | |
LIHE and/or LILEK | |
Unfavorable indoor environment | |
Moisture, mold and/or inadequate ventilation | Combination of two questions from the regional module of the Health Survey about living environment, concerning the respondent’s housing quality in the past 12 months. Respondents are asked to indicate their agreement with the following two statements: “There are mold or moisture spots in my living or sleeping room” and “I think I can ventilate my house sufficiently.” When respondents agreed with the statement about mold or moisture spots and/or disagreed with the statement about sufficient ventilation of the house, this was considered as an unfavorable indoor environment. This resulted in a dichotomous variable: unfavorable indoor environment (no or yes) |
Demographic characteristics | |
Age | The Health Survey was enriched with data from Statistics Netherlands. Respondent’s age was measured in years, with reference date September 1, 2022. This resulted in a continuous variable |
Gender | The Health Survey was enriched by Statistics Netherlands with the respondent’s gender, resulting in a categorical variable: male or female |
Ownership | This variable originates from the Monitor Fuel Poverty [2]. This variable distinguishes between tenants of housing corporations, tenants of private landlords, and homeowners |
Educational level | Education is inquired in the Health Survey with one question: “What is your highest completed education (with diploma or certificate)?” Respondents can choose from eight answer options. Additionally, data were enriched by Statistics Netherlands with education level, after which both variables were combined to create a complete variable. This resulted in an ordinal variable: low educational level (lower secondary education, lower vocational education), middle educational level (higher secondary education, preuniversity education, intermediate vocational education), and high educational level (higher vocational education, university) |
Household with/with no children | This was inquired with the question: “Which persons do you currently live with?” Different and multiple answers are possible, resulting in different variables for household composition. For this research, we used a categorical variable with two categories: household with or with no children living at home |
Level of urbanity of residential municipality | The level of urbanity of the respondent’s residential municipality was added to the dataset based on the environmental address density of the municipality where the respondent resides. This resulted in an ordinal variable with five categories, ranging from extremely urban (1) to nonurban (5) |
Health measures | |
Score no mental health issues | This variable was measured with the MHI 5, an international standard for measuring mental health. The MHI 5 consists of five questions, relating to how one has felt in the past four weeks. There are six answer options, ranging from constantly to never, with a corresponding score ranging from 0 to 5. This score is multiplied by four, resulting in a sum score ranging from 0 (very unhealthy) to 100 (perfectly healthy). A score of 60 or higher indicates good mental health [19] |
Risk score for anxiety disorder or depression | This variable was measured with the Kessler-10, a screening instrument for psychological distress. The instrument was translated and validated in the Dutch population and consists of ten items, identifying whether a respondent felt nervous, tired, hopeless, restless, down, depressed, or worthless in the past four weeks [20]. Answer options are displayed on a five-point Likert scale, ranging from never to always. This resulted in a sum score ranging from 10 to 50 points, with a higher score indicating a higher risk of anxiety disorder or depression |
Stress | Stress was inquired with the following question: “Have you experienced stress in the past four weeks?”, with four answer options, ranging from no, (almost) not to yes, a lot of stress. This resulted in a dichotomous measure, distinguishing between respondents who experienced (a lot of) stress in the past weeks and respondents who had experienced no or little stress in the past four weeks |
Negative self-rated (perceived) health | This variable was measured with one subjective question: “How is your health in general?” There were five answer options, resulting in three categories. Self-rated health can be effectively measured using one item and provides a good impression of the subjective assessment someone gives to his or her health in general [21]. This resulted in an ordinal variable: experienced health is very good or good, experienced health is fair, and experienced health is poor or very poor. A higher score indicates a more negative (poorer) experienced health |
Physical limitations | This variable was measured by two questions: “Are you limited in your daily life because of health problems?” and “Has this limitation lasted for half a year or longer?” This resulted in an ordinal variable with three outcome categories: no, not limited at all or (severely) limited, but for less than half a year; limited in daily life for half a year or longer because of health problems; and severely limited in daily life for half a year or longer because of health problems |
Social capital | Social capital refers to the level of social cohesion in the neighborhood. This was measured using five different statements about interaction in the neighborhood. Respondents were asked to what extent they agree with these statements using five answer options, resulting in a sum score with a range from 5 to 25, where a higher score indicates a higher social capital |
Loneliness | Loneliness was measured with the De Jong Gierveld Loneliness Scale [22]. This scale consists of eleven items with three answer options, asking to what extent certain statements apply to the respondent (e.g., “I miss people around me” or “I miss a really good friend”). Answer options are yes, somewhat, and no, where yes and somewhat receive a score of 1 and no receives a score of 0, resulting in a sum score with a range from 0 to 11 |
Results
Variable | No fuel poverty (unweighted data) | Fuel poverty (unweighted data) | Total (unweighted data) | Total (weighted data) | |
---|---|---|---|---|---|
Fuel poverty (%, n) | 2.4% (384) | 3.5% (15,978) | |||
Unfavorable indoor environment (%, n) | 10.8% (1704) | 21.9% (84) | 11.0% (1788) | 12.8% (60,672) | |
Age (M, SD) | 59.8 (16.9) | 62.1 (17.2) | 59.9 (16.9) | 51.91 (18.57) | |
Gender (%, n) | Female | 51.7% (8179) | 61.7% (237) | 51.9% (8416) | 50.7% (233,389) |
Ownership (%, n) | Tenants of housing corporations | 14.7% (2321) | 61.2% (235) | 15.8% (2556) | 19.8% (91,070) |
Tenants of private Landlords | 4.8% (760) | 18.2% (70) | 5.1% (830) | 6.0% (27,457) | |
Homeowners | 80.5% (12,745) | 20.6% (79) | 79.1% (12,824) | 74.2% (341,454) | |
Educational level (%, n) | Low | 35.5% (5548) | 65.0% (245) | 35.7% (5793) | 30.5% (140,089) |
Middle | 32.3% (5049) | 23.9% (90) | 31.7% (5139) | 34.9% (160,594) | |
High | 32.2% (5032) | 11.1% (42) | 31.3% (5074) | 33.5% (154,203) | |
Household with children (%, n) | 24.4% (3823) | 16.7% (63) | 24% (3886) | 32.4% (153,790) | |
Level of urbanity of residential municipality (%, n) | 2 = highly urban | 50.9% (8048) | 52.2% (201) | 50.9% (8249) | 58.6% (269,462) |
3 = moderately urban | 4.2% (671) | 3.6% (14) | 4.2% (685) | 3.4% (15,531) | |
4 = low urban | 37.6% (5955) | 38.8% (149) | 37.7% (6104) | 35.5% (163,148) | |
5 = nonurban | 7.3% (1152) | 5.2% (20) | 7.2% (1172) | 2.6% (11,840) | |
No mental health issues (M, SD) | 0.78 (0.16) | 0.69 (0.29) | 0.78 (0.16) | 0.75 (0.17) | |
Risk of anxiety disorder or depression (M, SD) | 0.33 (0.13) | 0.41 (0.17) | 0.33 (0.13) | 0.35 (0.15) | |
Stress (M, SD) | 0.13 (0.33) | 0.20 (0.40) | 0.13 (0.34) | 0.18 (0.38) | |
Self-rated health (%, n) | Very good or good | 68.3% (10,781) | 42.0% (161) | 67.5% (10,942) | 68.6% (315,372) |
Fair | 26.5% (4181) | 43.3% (166) | 26.8% (4347) | 25.2% (115,796) | |
Poor or very poor | 5.2% (828) | 14.6% (56) | 5.5% (884) | 6.1% (28,012) | |
Physical limitations (%, n) | No limitations or (severe) limitations but for a period shorter than half a year | 66.0% (10,241) | 46.6% (173) | 64.2% (10,414) | 68.06% (323,144) |
Limitations but not severe for half a year or longer | 29.9% (4633) | 43.9% (163) | 29.6% (4796) | 26.43% (125,500) | |
Severe limitations for half a year or longer | 4.2% (646) | 9.4% (35) | 4.20% (681) | 4.19% (19,879) | |
Social capital (M, SD) | 20.32 (3.91) | 18.72 (4.47) | 20.29 (3.93) | 19.57 (4.05) | |
Loneliness (M, SD) | 3.09 (3.32) | 4.69 (3.81) | 3.13 (3.34) | 3.30 (3.45) |