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.

The review of policies being implemented in China, the EU, India and the US presented in this report has also identified some key challenges that we must address if we are going to realize the mitigation potential of the building sector. Chief among these is the need to improve our monitoring of the impact that our policies are having. Lack of measured and verifiable data on the influence of policies on building energy performance currently hampers our ability to assess and continuously improve their effectiveness.