In an era of U.S. energy abundance, the persistently high energy bills paid by low-income households is troubling. After decades of weatherization and bill-payment programs, low-income households still spend a higher percent of their income on electricity and gas bills than any other income group. Their energy burden is not declining, and it remains persistently high in particular geographies such as the South, rural America, and minority communities.

This paper reviews empirical data from evaluations of the influence of residential energy efficiency retrofits on indoor environmental quality conditions and self-reported thermal comfort and health. Data were extracted from 36 studies described in 44 papers plus two reports. Nearly all reviewed studies were performed in Europe or United States. Most studies evaluated retrofits of homes with low-income occupants. Indoor radon and formaldehyde concentrations tended to increase after retrofits that did not add whole-house mechanical ventilation.

Co-benefits rarely enter quantitative decision-support frameworks, often because the methodologies for their integration are lacking or not known. This review fills in this gap by providing comprehensive methodological guidance on the quantification of co-impacts and their integration into climate-related decision making based on the literature. The article first clarifies the confusion in the literature about related terms and makes a proposal for a more consistent terminological framework, then emphasizes the importance of working in a multiple-objective–multiple-impact framework.