The impact of winter pressures on different population groups in Great Britain: 22 November to 18 December 2022

• Almost a quarter of adults (24%) reported they were occasionally, hardly ever, or never, able to keep comfortably warm in the past two weeks; respondents experiencing moderate-to-severe depressive symptoms (44%) and people using prepayment, or "top-up", meters for energy bills (41%) were more likely to report this.

• Around 1 in 7 (15%) adults were somewhat, or very, worried their food would run out before they had money to buy more in the past two weeks; Asian (26%) and "Other ethnic group" (46%) adults, and people with one or more dependent children (25%), were among those more likely to report this.

• Around 1 in 5 adults reported eating smaller portions (18%) and food past its use by date (18%); those experiencing moderate-to-severe depressive symptoms (35% and 33%, respectively), adults with diabetes (26% and 24%, respectively), and those with one or more dependent children (20% and 22%, respectively) were more likely to report both.

• Over two thirds (70%) of those who ran out food in the past two weeks, and couldn't afford to buy more, also reported being occasionally, hardly ever, or never, able to keep comfortably warm.

• Around 1 in 5 (21%) adults reported they were waiting for a hospital appointment, test, or to start receiving medical treatment through the NHS; adults experiencing moderate-to-severe depressive symptoms (48%), and those with a disability (37%) were more likely to report the wait had a strong negative impact on their lives.

• Around 4 in 10 (39%) employed or self-employed adults who were waiting for NHS treatment reported that the wait had affected their work, including 26% saying they reduced their working hours and 7% went on long-term sick leave.

• Almost a quarter (23%) of adults who needed to see a GP in the past month reported not being able to get an appointment; adults who experienced moderate-to-severe depressive symptoms (30%) were more likely to report this.

This is the second in a series of publications reporting findings from our new Winter Survey. It provides an update to our Impact of winter pressures: December 2022 article, covering data from 22 November to 4 December 2022. This publication covers the period from 22 November to 18 December 2022, analysing a larger sample of adults. It highlights how different UK populations are being affected by current winter pressures.

In this article, we report particular estimates and differences between groups where these are statistically significant. In certain cases, differences between groups are not commented on, as wide, or overlapping, confidence intervals prevent us from knowing if these differences are statistically significant. Similarly, we may be unable to draw out existing differences between certain groups because of small sample sizes. See Section 9: Data sources and quality for more information.

We asked adults what actions they were taking because of the increases in the cost of living. Around half of adults reported spending less on food and essentials (45%). Around 1 in 6 (16%) said they were using more credit than usual. Around 3% said they were using support from charities, such as food banks, because of the increases in the cost of living.

Adults who were more likely to report spending less on food and essentials include those:

• experiencing moderate-to-severe depressive symptoms (63%)

• paying energy bills by prepayment ("top-up") (59%)

• renting (57%)

• living in the most deprived areas in England (54%)

• with one or more dependent children (52%)

For other actions adults were carrying out because of the increases in the cost of living, see our Impacts of the cost of living on behaviours and health dataset.

Around 1 in 7 (15%) adults reported doing much, or slightly, less physical activity because of increases in the cost of living. In contrast, around 1 in 10 (9%) reported doing much, or slightly, more physical activity.

Because of the increased cost of living:

• around 1% of adults reported smoking cigarettes (much or slightly) more, while 5% of adults reported smoking cigarettes (much or slightly) less

• around 3% of adults reported vaping more, while 2% of adults reported vaping less

• around 3% of adults reported drinking more alcohol, while 19% of adults reported drinking less alcohol

Of those who are currently paying for prescription medication, 1 in 14 (7%) reported they were taking less medication to save on prescription costs.

Food insecurity

Food insecurity is the inability of households to acquire enough food to lead a healthy life. We adapted three questions from the "Household Stage 1" module of the United States Department of Agriculture's (USDA) food security survey (PDF, 214KB). The aim was to understand the extent to which adults are worrying about food running out, and the proportion of people who report not being able to afford enough food or a balanced diet. Our survey found that:

• around 1 in 7 (15%) adults were somewhat (10%), or very (5%), worried their food would run out before they had money to buy more in the past two weeks; however, 66% of adults were somewhat unworried (7%), or not at all worried (59%)

• around 1 in 20 (5%) reported that their household had run out of food and could not afford to buy more in the past two weeks

• around 1 in 10 (11%) said they tend to (6%), or definitely (4%), disagree with the statement "my household can afford to eat a balanced diet", while 75% of adults said they tend to (27%), or definitely (48%), agree

Those who were more likely to be somewhat, or very, worried their food would run out before they had money to buy more in the past two weeks include adults:

• who were Asian (or Asian British) (26%) and of "Other ethnic group" (46%)

• experiencing moderate-to-severe depressive symptoms (37%)

• living in the most deprived areas in England (29%)

• with one or more dependent children (25%)

Those who were more likely to report running out food and being unable to buy more include adults:

• experiencing moderate-to-severe depressive symptoms (16%)

• living in the most deprived areas in England (13%)

• renting (11%)

• with one or more dependent children (8%)

Those who were more likely to definitely, or tend to, disagree that they were able to afford a balanced diet include adults:

• experiencing moderate-to-severe depressive symptoms (26%)

• who are very obese (24%)

• living in the most deprived areas in England (20%)

• who rent (20%)

Adults in the North East (64%) were also less likely to report being able to afford a balanced diet than adults in London (80%) and the South East (80%).

When adults were asked what they were doing to save money on food because of increases in the cost of living, around 1 in 5 reported eating smaller portions (18%) and eating food past its use by date (18%). Adults more likely to report both of these include those:

• experiencing moderate-to-severe depressive symptoms (35% and 33%, respectively)

• renting (27% and 20%, respectively)

• with diabetes (26% and 24%, respectively)

• with a health condition (22% and 20%, respectively)

• with one or more dependent children (20% and 22%, respectively)

Energy insecurity

Energy insecurity is the inability of a household to meet its basic energy needs, such as heating their homes and having a warm bath.

We asked adults how often they were able to keep comfortably warm in their homes in the past two weeks. Almost a quarter of adults (24%) reported they were occasionally, hardly ever, or never, able to keep comfortably warm (15% occasionally, 8% hardly ever, 2% never).

Adults who were more likely to report being occasionally, hardly ever, or never, able to keep comfortably warm in their home in the past two weeks include those:

• experiencing moderate-to-severe depressive symptoms (44%)

• paying energy bills by prepayment (41%)

• living in the most deprived areas in England (36%)

• renting (36%)

Adults at risk of cold-related illness (23%) were just as likely as those not at risk of cold-related illness (24%) to report they were occasionally, hardly ever, or never able to keep comfortably warm. At-risk adults include those with health conditions, such as asthma or cardiovascular diseases, that could be worsened by cold weather, as defined in Section 8: Glossary.

Around 6 in 10 (58%) adults who were somewhat, or very, worried their food would run out before they had money to buy more and 70% of those who ran out food in the past two weeks, were also occasionally, hardly ever, or never, able to keep comfortably warm at home.

Around 6 in 10 (60%) adults reported using less fuel, such as gas or electricity, in their home because of increases in the cost of living. When these adults were asked how they were using less fuel compared with the same time last year:

• more than 9 in 10 (95%) were using the heating less

• around 4 in 10 (43%) were using the tumble dryer less

• a similar proportion (42%) were using the washing machine less

• just under 4 in 10 (38%) were bathing or showering less

In particular, those who were:

• disabled (46% compared with 34% of non-disabled adults) and renting (48% compared with 33% of those who own their home) were more likely to report bathing or showering less

• disabled (39% compared with 27% of non-disabled adults), living in the most deprived areas in England (40% compared with 25% in the least deprived areas), renting (42% compared with 28% of those who own their home) and using prepayment meters (47% compared with 31% of adults using other methods) were more likely to report cooking less

• renting (14% compared with 4% of those who own their home) and using prepayment meters (22% compared with 7% of adults using other methods) were more likely to report not heating or reheating food until it's piping hot

We found that around 1 in 5 (21%) adults reported that they were waiting for a hospital appointment, test, or to start receiving medical treatment (henceforth NHS treatment) through the NHS. Of those waiting for an appointment, 67% reported that they had been waiting for up to 6 months. Around 10% reported that they had been waiting between 7 and 11 months, and 19% reported that they had been waiting for a year or longer.

Adults who were more likely to report waiting for NHS treatment include those:

• with a disability (41%)

• experiencing moderate-to-severe depressive symptoms (34%)

• at risk of cold-related illnesses (32%)

• economically inactive, because of retirement (28%) or other reasons (32%)

Of those waiting to start NHS treatment, around 3 in 10 (28%) adults reported that they were waiting for more than one health condition. Around 1 in 14 (7%) adults said that they were waiting for an initial consultation with a specialist, or a planned follow-up consultation. Meanwhile, 6% were waiting for diagnostic tests and 4% were waiting for surgery.

The impact of waiting for NHS treatment

More than 7 in 10 (72%) adults who reported waiting for NHS treatment also reported the wait had a negative impact on their life. Roughly 29% of adults said that the wait has had a strong negative impact on their life, while 43% reported it has had a slight negative impact.

Adults who were more likely to report that waiting for NHS treatment had a strong impact on their lives include those:

• experiencing moderate-to-severe depressive symptoms (48%)

• with a disability (37%)

• living in the most deprived areas in England (42%)

Figure 7 shows that adults who said that waiting for NHS treatment had a strong impact on their lives were most likely to report waiting had affected their well-being (71%). Other impacts included making their condition worse (56%), affecting their mobility (44%), and affecting their relationships (40%), among others.

Around 4 in 10 (39%) employed, or self-employed, adults reported that waiting for NHS treatment had affected their work. When asked in which ways their work had been affected by waiting for NHS treatment, employed or self-employed adults reported:   

• changing the tasks they do (42%)

• reducing their working hours (26%)

• not going for promotion or training opportunities (11%)

• going on long-term sick leave (7%)

We asked respondents about their experiences with accessing a GP. Around 4 in 10 (37%) said they needed to make an appointment in the past month. Of these adults, around a third (32%) reported it was easy, or very easy, to make an appointment, while over half (52%) reported it being difficult or very difficult.

Adults who were more likely to report it being difficult, or very difficult, were also more likely to:

• experience moderate-to-severe depressive symptoms (62%)

• also be on an NHS waiting list (59%)

When asked about their experience in their last attempt to make a GP appointment, adults reported:

• being offered only a telephone consultation when they wanted a face-to-face appointment (39%)

• waiting too long for a GP appointment (37%)

• difficulty contacting the GP practice (30%)

• not being able to get an appointment (23%)

Adults who had moderate-to-severe depressive symptoms were more likely to report not being able to get an appointment (30%). Adults on an NHS waiting list (17%) and disabled adults (16%) were more likely to report not being able to get an appointment with the GP they wanted to see.

We sought to understand the impact that the cost of living, NHS waiting lists, GP access and other pressures are having on the public's health and well-being. Adults were most likely to report that the following issues negatively affected their health or well-being in the past month:

• having to cut back on heating my home (34%)
• waiting too long for a GP appointment (23%)
• waiting too long for a hospital appointment or treatment (15%)
• having to cut back on gas or electricity to cook, or heat, meals (13%)

Moderate-to-severe depressive symptoms

We use the two-item version of the Patient Health Questionnaire (PHQ-2) (PDF, 131KB) to identify adults with depressive symptoms, to have a better understanding of the impact of winter pressures on these adults. Respondents were asked the following questions, and were presented with four response options ranging from 0 (not at all) to 3 (nearly every day):

• over the last two weeks, how often have you been bothered by having little interest or pleasure in doing things?

• over the last two weeks, how often have you been bothered by feeling down, depressed or hopeless?

A "depressive symptoms" score was then derived by summing both responses chosen, resulting in a score ranging from 0 to 6. A person's PHQ-2 score sits in one of two categories:

• No to mild symptoms: this refers to a PHQ-2 score of between 0 and 2 (inclusive)

• Moderate to severe symptoms: this refers to a PHQ-2 score of between 3 and 6 (inclusive)

If respondents answered "Don't know" or "Prefer not to say" to either of the questions, they are excluded from this analysis.

Disabled adult

To define disability in this publication, we refer to the "core" definition set out in the GSS harmonisation guidance. This identifies a "disabled adult" as a person who has a physical or mental health condition or illness that has lasted, or is expected to last, 12 months or more, and that this reduces their ability to carry out day-to-day activities.

Dependent children

A dependent child is any person aged 0 to 15 years in a household (whether in a family or not), or a person aged 16 to 18 years in full-time education and living in a family with their parent(s) or grandparent(s). It does not include any people aged 16 to 18 years who have a spouse, partner or child living in the household.

Highest qualification

Highest education level, as defined in this government page covering qualification levels, refers to the level of the highest qualification obtained by a respondent when they were initially surveyed by the Opinions and Lifestyle Survey (OPN). Qualifications have been grouped into the following groups for ease of analysis and communications:

• degree or equivalent: level 6 or higher qualification obtained anywhere

• below degree level: level 1 to 5 qualifications (including GCSEs, A Levels, or equivalent)

• other qualification: other qualification obtained in the UK not included in the other categories, or any qualification obtained outside the UK which is not a degree

• none: no formal qualifications

Economic activity

"Employed or self-employed" does not include people on government training schemes. The OPN does not ask whether a person is on a government training scheme, so caution should be taken when comparing these figures with other labour market sources.

At risk of cold-related illness

Exposure to cold temperatures can have negative impacts on people's health. People who are particularly at risk of cold-related illnesses include those:

• aged 65 years or older

• who are pregnant

• with a cardiovascular condition

• with a lung condition

• with a rheumatic condition

• with a mental health condition diagnosed by a doctor

• who have attended hospital because of a fall in the past three months

Given the higher cost of energy this winter, adults who use electrical medical equipment at home (for example, ventilators or humidifiers) are also included in this group.

This release contains data and indicators from a module being undertaken through the Office for National Statistics' (ONS) Opinions and Lifestyle Survey (OPN).

Breakdowns by age and sex, including confidence intervals for the estimates, are contained in our Impact of winter pressures on adults in Great Britain datasets. For information on confidence intervals, see our Uncertainty and how we measure it for our surveys article.

Where differences between different demographic groups are presented in this bulletin, or comparisons between estimates are made, associated confidence intervals should be used to assess the statistical significance of the differences. For information on statistical significance, see our Uncertainty and how we measure it for our surveys article.

Sampling and weighting

This analysis used a pooled dataset of two waves of the Winter Survey. In the first wave (period 22 November to 4 December 2022), we sampled 4,962 households. The responding sample for this period contained 2,524 individuals, representing a 51% response rate. In the second wave (period 7 to 18 December 2022), we sampled 4,935 households. The responding sample for this period contained 2,236 individuals, representing a 45% response rate. This sample was randomly selected from those who had previously completed the Labour Market Survey (LMS) or OPN.

Survey weights were applied to make estimates representative of the population (based on ONS population estimates). Further information on the survey design and quality can be found in our Opinions and Lifestyle Survey QMI.