Goxo egon: older adults coping with cold in a port municipality in the Basque Country

Background

Cold temperatures can have a significant impact on people with Non Communicable Diseases (NCDs). This participatory study aimed to understand the impact of cold on older adults with NCDs and psychosocial vulnerability and co-design recommendations.

Methods

Photovoice was used as a group-based participatory action research method. Participants were recruited from an area classified within the most socioeconomically deprived quintile according to the deprivation index. The area has an Atlantic climate, temperate and without dry season. The research team included 2 facilitators and 3 observers. 5 participants (4 women and 1 man) aged 64–76 all were born in Gipuzkoa and were home owners. 2 lived alone, 2 lived with an adult child, and 1 lived with extended family. They held five group discussion sessions at the Retirees’ Club (a municipally funded community centre) in Gipuzkoa, Spain.

Results

Four main themes emerged: 1) Cold features. They did not perceive cold as a risk to their health, but they did perceive dampness as a source of discomfort. 2) Neighbourhood urban design. Architecture that was not very functional for cold and rain; they highlighted the lack of covered outdoor spaces. 3) Housing. The importance of public investment to improve home insulation. 4) Living with the cold. Individual coping strategies to reduce the use of heating. Study limitations: during the weeks of fieldwork temperatures were unusually high, they were not able to recruit socioeconomically highly vulnerable individuals.

Conclusions

Cold was not identified as a major problem for the group as they had multiple policy and cultural adaptation mechanisms, both behavioural and technical. They did not identify weaknesses in this regard in the healthcare they receive.

Key messages

• Through participatory citizen-science methodologies, it is possible to contextualise the health impacts of cold and coping strategies in people with NCDs.

• Public investment programmes to improve home insulation are well perceived and should be strengthened as a key public health intervention in socioeconomically deprived settings.