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Millions of U.S. households struggle for sufficient electricity, heat, and cooling. But few poverty researchers have studied the psychological toll of energy insecurity.

Robbin Taylor picked up a bottle of corn oil, its contents completely solidified. "I don’t know what temperature vegetable oil freezes at," she told an interviewer from WBUR in February 2015. (The answer: 12 degrees F.) "And that was in the kitchen near the stove"—what should have been the warmest place in her house.

Taylor was living with her daughter and granddaughter in Dorchester, the Boston neighborhood with the city’s highest concentration of poverty. Taylor had been unemployed for more than a year. With no means to refill the basement oil tank, she and her family paced the house just to stay warm. The cold—average temps in Boston in February bottom out at around 20 degrees—made her delirious, Taylor said: "You kinda lose yourself in it, sort of become a hermit. It’s just like the three of us, three women struggling.”

Taylor and her family fall under a pattern sociologists term “energy insecurity.” An estimated 16 million U.S. households face this hardship, unable to afford electricity and stay warm or cool enough. Energy costs are known to have an outsize economic impact on the poor: It’s been estimated that the bottom 20 percent of U.S. earners spend roughly 10 percent of their monthly income on electricity, which is more than seven times the share of income paid by the top 20 percent.

But the physiological, behavioral, and psychological effects of what it’s like to struggle for sufficient household energy aren’t as well recognized by poverty researchers. This expense and experience has largely been ignored, to the detriment of families dealing with this crisis every day,” says Diana Hernandez, a professor of socio-medical sciences at Columbia University’s Mailman School of Public Health.

Hernandez is among the few researchers out there examining the ways household utilities can be a critical determinant of hardship and health. Published earlier this month in Social Science & Medicine, her latest study focuses on 72 families living in Dorchester and struggling to keep their homes heated, cooled, and lit. Recruited from neighborhood health centers, the vast majority were single mothers of color, and all of them reported living deep below the federal poverty level, with a median annual income of $30,000. Most received housing subsidies.

Through interviews, Hernandez detailed the many-pronged effects of energy insecurity—especially how it’s related to asthma attacks, chronic anxiety, and depression. “Stress. It adds stress,” said one parent quoted in the study. “It's silly sometimes, but I think like, ‘Geez. My lights are gonna shut off.’ Even though I know they won't but even if I'm behind a few days a week I worry.”

Rising utility costs can disrupt family structures, too, forcing families to uproot from house to house. That can be psychologically traumatic for children and parents alike. “My bills started raising up and raising up… So, I sent my kids to their aunt’s house ‘cause I didn’t want them in the house since you can’t cook or give them a bath or nothing,” said one mom. “I didn’t want them there. And then I went through my depression thing.”

Renters, Hernandez found, were in some ways at the biggest disadvantage, since landlords who don’t pay energy bills often have little incentive to update old building heating systems or provide efficient appliances. Another participant expressed her frustration about that imbalance this way:

I want Boston Gas to come out here so they can look at the boiler for themselves 'cause the first [inspector], when I first got my energy report he told me it looked like I was heating the whole of Boston. Then I get the next [inspector's] report and his report is just as bad as the first man's report. What don't they understand? Don't go after me. Go after the landlord 'cause I can only afford to give you $200 a month and that's all I can give you.

Even for low-income families that don’t have to pay directly for energy—either because they live in public housing, or because it’s included in their rent—Hernandez found that energy insecurity can crop up in other ways. Affordable housing can come with trade-offs, including outdated insulation, drafty doors and windows, poor ventilation, holes and cracks in the walls, and malfunctioning heating and cooling systems.  And when faced with a host of monthly bills and a tight housing market, consistent warmth or cooling was often the last necessity to get paid for. “A lot of participants prioritized housing and food because they are such basic, basic human needs,” Hernandez says. “There was a little more play with respect to how people negotiated energy.”

Indeed, families in her study developed many methods to resolve energy insufficiencies, using space heaters, ovens, or tons of extra layers to keep warm. Some went without proper refrigeration during shut-offs, relying on tubs of ice. Others leveraged medical conditions to their advantage. “I had my son's doctor fax a letter to [the utility company] saying they can't turn off my lights because he's on an asthma machine and he needs it,” said one parent. “So that's the only reason my lights stayed on.” These parents demonstrated a lot of flexibility and resourcefulness in the face of this hardship, Hernandez notes. But many of these solutions are themselves health hazards: candles used for illumination contribute to fatal house fires in poverty-stricken areas, as do unattended space heaters, open ovens, and other dangerous work-arounds. In the summer, heat-related illness and death disproportionately affect low-income households that lack access to air-conditioning.

What would really help struggling families? Hernandez suggests employing an energy rating system for all kind of properties, like the kind that exists throughout Europe. That would help both renters and owners be more aware of costs they might face before putting down a deposit. More consistent support for federal programs that assist with bill-paying and insulation would also help, as would stronger state laws mandating affordable utility rates and preventing shut-offs. Stronger housing codes could also compel landlords to keep structures updated, as can city-led appliance rebate programs.

Conversations about energy policy often revolve around efficiency for the environment’s sake. But Hernandez hopes her emerging research advances another narrative, focusing on the human toll when families are forced to make sacrifices to meet basic energy needs. Hungry parents and kids can turn to food pantries and SNAP benefits. “But the equivalent for energy doesn’t exist at the same scale,” she says.

Taylor discovered that fact first-hand when tried to find charitable assistance to heat her home. "After a while you just feel like you’re begging," she said. "I think I went to nine places and then I told my daughter, 'I just can’t do it anymore.'"

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