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 provides a review of research that addresses the relationship between indoor temperatures and health outcomes, taking into consideration studies that focus heat or cold exposure within the household context. It aims to extend previous research by considering both indoor temperatures from existing housing, and empirical studies that focus on energy efficiency measures and subsequent health impacts. To achieve this aim, a literature review was undertaken, combining engineering and health databases.

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.