Health and care leaders in Cumbria are warning that older people are facing one of the toughest and potentially most deadly winters on record.
The soaring cost-of-living crisis means this winter poses a serious threat to elderly people, who already struggle to afford to heat their homes.
Every year, between 300 and 500 older Cumbrians die because of problems like this.
Colin Cox, Cumbria’s Director of Public Health, said: "The cost-of-living crisis has overtaken Covid-19 as the major public health threat over the coming months.
"Difficulty in heating houses leads directly to increased lung and heart health problems and contributes to the higher rate of hospitalisations and deaths that we see over the winter, so I’m particularly worried about what might happen this year.
"Winter is always a particularly difficult time for many people, including those who are older and on lower incomes, and this year is likely to be exceptionally so."
Cumbria Community Foundation's (CCF) Winter Warmth Appeal launched in Cumbria this month with the aim of raising £500,000 to help older people turn on their heating.
Mr Cox added: “I very much welcome the Winter Warmth Appeal as something that could really help Cumbria’s most vulnerable people in what looks set to be the hardest winter for many years."
Last year generous Cumbrian individuals and businesses donated a record £222,819 to the Winter Warmth Appeal, helping 1,751 older Cumbrians keep warm.
CCF Chief Executive Andy Beeforth said: "Every year many vulnerable Cumbrians have to choose between heating and eating.
"But this winter could see many more in serious difficulty because of the huge rises in the cost of energy happening at the same time as spiralling food costs.
"It is a perfect storm of difficulty facing older Cumbrians with limited means.
"I would ask everyone who is able, to please make a donation to the Winter Warmth Appeal, whether large or small.
"The money goes directly in grants to help elderly Cumbrians to turn on their heating during the coldest weather."
Cumbria Community Foundation has run the appeal every year since it was launched in 2010, raising more than £1m. This year the CCF has set a higher target of £500,000.
Any donations made before Friday 9 December will be doubled with match funding.
Rosemary Armstrong, 78, from Stanwix in Carlisle, says a winter warmth grant made winter more bearable last year.
"The bungalow gets very, very cold," she said.
"I have to sit with my feet up in the evening because they turn to blocks of ice. My circulation is not as good as it was."
Rosemary says she has cut down on food due to rising costs.
"I have lost a stone and a half which I probably needed to do. I just don’t eat as many treats and puddings anymore.
"The winter warmth grant makes a big difference in not worrying so much about my bills and being able to keep warm."
The Winter Warmth Appeal last year also proved vital for Peter Charters, 73, who lives in Grange-over-Sands in a rented two-bedroom flat.
A winter warmth grant meant he could keep his storage heaters on during the coldest weather.
"It was getting quite cold," said Peter who suffers from Chronic Obstructive Pulmonary Disease and diabetes.
"I had to get the blankets out. I used to wrap myself up in a duvet.
"I’m quite vulnerable. I can’t get out for exercise now because of the COPD, if I walk any distance I get out of breath.
"I am very grateful to people who have donated to the Winter Warmth Appeal.
"If they have the means to be able to donate, I am more than grateful, especially for people like myself who don’t have a very high income and you are stuck in that situation."
Matthew Taylor meets Tom Bowness from Penton
Tom Bowness, 80, from Penton near Newcastleton fears receiving his oil heating bill as winter approaches.
In the last 12 months, the price of the oil he uses to heat his rural home has doubled, causing him to live in just one room in his house to save money.
Tom has recently received a grant of £200 from the CCF's Winter Warmth fund.
The fund is open to anyone aged 60 or over who meets eligibility criteria with regard to their income.
Want a quick and expert briefing on the biggest news stories? Listen to our latest podcasts to find out What You Need To know...