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.

In 2009, the European Union adopted high-level goals for renewable energy, energy efficiency, and greenhouse gas reductions with targets set toward the year 2020. This was followed in 2012 by adoption of the Energy Efficiency Directive (EED) (2012/27/EU), which included as a major component a requirement for Member States to create Energy Efficiency Obligations Schemes (EEOSs) on energy companies or equivalent alternative measures, and those provisions have now been in effect for three years.