Health experts release policy roadmap to alleviate the burden of high energy bills

Energy insecurity—the inability to adequately meet basic household energy needs—affects more than a quarter of New York City families, putting them at risk for worse health outcomes. A new policy brief, “Powering Up for Health: Policy Options to Address Energy Insecurity in New York City,” authored by public health experts from academia, government, and the nonprofit sector, outlines policy options for local and state governments to address energy insecurity and its related health risks. While federal support is critical, ongoing threats to the limited federal infrastructure to support energy affordability and social benefits make state and local leadership even more important.

Authors are affiliated with Columbia University Mailman School of Public Health, New York City Department of Mental Health & Hygiene, and WE ACT for Environmental Justice.

“As extreme weather becomes more frequent and intense, the cost of living and utility bills rise, and energy and building heating systems transition to cleaner and potentially more expensive sources, energy insecurity will likely worsen without active intervention,” says Diana Hernández, PhD, associate professor of sociomedical sciences and a co-author of the new paper. “Our paper highlights the key policy actions required to reduce energy insecurity now and to ensure that all households, especially those most vulnerable, can participate equitably in the clean-energy transition.”

“Energy insecurity is a threat to health, and it hurts marginalized communities the most,” says Acting Health Commissioner Michelle Morse, MD, MPH. “No New Yorker should have to choose between heating their home or putting food on their table. We know this dilemma need not exist — we hold the power to change it. That is what this policy roadmap shows us. By strengthening energy assistance, redesigning utility rates, building housing that centers health, and creating a more resilient energy system, we can protect public health and ensure reliable, affordable energy for all.”

Energy Insecurity in New York City

Policy proposals outlined in the new paper are based on public health research by Hernández and collaborators and funded by the Alfred P. Sloan Foundation and Vital Strategies. According to one study, New Yorkers who cannot pay their energy bills compensate by limiting their use of air conditioning, even when it was very hot outside, and going without heat in the cold season because of an inability to pay the bill. The distribution and health effects of energy insecurity are inequitable, felt most by low-income households, households with children, households where someone uses electric medical equipment, people of color, recent immigrants, and renters. The vast majority of New Yorkers who fall behind on utility payments or who have had a utility shutoff also have trouble paying their rent or mortgage, purchasing food, or seeking medical care.

Another study by the academic researchers found that energy-insecure New Yorkers were more likely to have breathing problems, mental health issues, and experience poor sleep. Inadequate heating and cooling can contribute to indoor air pollution, mold, and extreme temperatures, which can lead to or worsen asthma, pneumonia, and other chronic heart, lung, and metabolic diseases. Thermal discomfort and stress can trigger anxiety and depression and disrupt sleep, which is linked to a higher risk of high blood pressure and stroke. In extreme cases, an inability to control indoor temperatures can lead to hypothermia in cold weather or heat stress (including heatstroke and heat exhaustion) in hot weather, both of which can be life-threatening.

Policy proposals include the following, many of which are ongoing:

• Reform and expand New York’s energy safety net by bolstering the Home Energy Assistance Program (HEAP) to cover equipment and energy costs for both heating and cooling year-round and increase overall funding levels; enabling auto-enrollment in Expanded Energy Assistance Programs; and integrating energy assistance into public health insurance coverage, such as Medicaid and Medicare.
• Redesign utility rates to make energy more affordable for low- and moderate-income customers and provide avenues for utility debt prevention and arrearage management.
• Invest in weatherization and energy-efficient housing improvements, for example, by designating funding and incentives for landlords to repair or improve building envelopes and insulation without increasing rents.
• Strengthen and modernize the power grid to support electrification, make energy infrastructure more resilient in areas in need of improvement, prevent overloading, and reduce power outages, while also containing costs to consumers.
• Promote adoption of clean energy technology. Increase household participation in individual and community solar, and adoption of induction stoves.
• Adopt standardized tracking of energy insecurity in relation to health and integrate screening into clinical care.

“The evidence base on the impacts of energy insecurity on health is well-established and growing. Together, these findings point to the urgent need for coordinated, cross-sector action to address this social and environmental determinant of health and to protect the well-being of New Yorkers across the city,” the paper’s authors conclude.

A full list of authors is available in the policy brief.