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.

Residential energy efficiency interventions are complex social and construction programmes that may benefit health, yet the interactions between the material improvements, health and health-related outcomes, and householder responses are not well understood. While indoor winter warmth and householder satisfaction have been identified as the key mediators for physiological, mental and social health outcomes, this paper explores how programme contexts may have influenced the outcomes. This review revealed that common target populations were low income households, children and the elderly.

A guide with these contents

• Sustainable and accessible ways to keep cool
• Key messages
• How does heat affect the body?
• Doesn’t air conditioning solve the problem?
• How can electric fans help?
• When shouldn’t electric fans be used?
• What if it’s too hot to use a fan or there is no power?
• How can buildings help keep people cool without the need for air conditioning?
• What should governments, employers, services and communities do to promote
• ‘fan-first’ cooling?
• Sources