The healthcare industry has the potential to be a strong ally in the effort to reduce the energy burdens of low-income households. Problems associated with high energy burdens often include adverse health effects. Insufficient heating and cooling systems and leaky homes can cause hypothermia and heat stress. Improper air filtration, cracked heat exchangers, and poor ventilation can exacerbate asthma and other respiratory problems for occupants (Batterman et al., 2012; Doll, Davison, and Painting, 2016). Air conditioning units can transmit bacteria and lead to increased infection rates. Additionally, medical conditions often require electricity for treatment and medicines, such as diabetics needing refrigeration for insulin and those with breathing-related complications needing electrically powered breathing assistance devices. If updates to infrastructure are too costly and energy burdens are too high, households can end up sacrificing their health in order to cope with their energy bills. This in turn can lead to higher healthcare costs that further exacerbate the expenditure burden of households and lead to chronic stress (Hernandez et al., 2016).
The physical and mental health benefits of energy-efficiency upgrades are well documented (Camprubi et al., 2016; Fabian et al., 2012, 2014; Frey et al., 2015; Leventis et al., 2017; Coombs et al., 2018; Tonn et al., 2018). Surveys and case studies of residents systematically 51 identify favorable health effects (Hernandez and Philips, 2015; Hernandez et al., 2016). Based on
the self-reports of public housing residents, Jacobs et al. (2015) found that green and healthy housing produced health benefits; specifically, there were reduced rates of hay fever, asthma, headaches, sinusitis, respiratory allergies, and angina. The latest WAP evaluation indicates that the value of the program’s health benefits are significant (Tonn et al., 2018).
Collaboration and co-funding across the energy and healthcare industries offer an opportunity for both industries – and the vulnerable populations they serve – to benefit. The healthcare industry, and in particular Medicaid and Medicare and those states with value-based healthcare, have a vested interest in supporting healthy homes for low-income households that reduce medical costs. The energy industry often cannot invest in energy-efficiency measures or install rooftop solar systems without first making structural and safety investments (Breysse et al., 2011). Cofunded programs can leverage the potential benefits to both sectors (Kravatz et al., 2018; Ulrich et al., 2018). By combining health and safety housing improvements with efficiency retrofits using established energy-efficiency programs, the cost-effectiveness of efficiency investments can be strengthened. Spillman et al. (2016) provides examples of state initiatives where Medicaid funding has been used to make improvements, some of which are also energy-efficiency
measures, and to educate residents about the health benefits of home energy upgrades. Healthy home measures include cleaning air conditioners and vents, improving HVAC systems, installing standalone air filters, plugging air leaks, and better insulation. By expanding the labor force of energy retrofit and public health professionals serving vulnerable populations, both stakeholder industries can improve (Dryden, et al., 2018).