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.

To address challenges associated with climate resilience, health and well-being in urban areas, current policy platforms are shifting their focus from ecosystem-based to nature-based solutions (NBS), broadly defined as solutions to societal challenges that are inspired and supported by nature. NBS result in the provision of co-benefits, such as the improvement of place attractiveness, of health and quality of life, and creation of green jobs.