TY - ICOMM T1 - Achieving Health and Social Equity through Housing: Understanding the Impact of Non Energy Benefits in the United States Y1 - 2020 A1 - Ruth Ann Norton A1 - Brendan Wade Brown A1 - Catherine Lee A1 - Kiki Malomo-Paris A1 - Jamal Lewis KW - Energy efficiency AB - This report identifies and explores how home-based energy efficiency measures, weatherization and healthy home upgrades can confer non-energy benefits at the individual and community level, effectively address social determinants of health, and drive significant savings by improving economic, health and environmental outcomes for residents of affordable housing. PB - Energy Efficiency for All UR - https://assets.ctfassets.net/ntcn17ss1ow9/2CMLkZBwlL3n37tfwNfqWS/e5dc2cfc9d74f6a39b5149f922707583/AchievingHealth_SocialEquity_final-lo_0.pdf ER - TY - JOUR T1 - Incorporating injury prevention into energy weatherization programs JF - Journal of public health management and practice Y1 - 2020 A1 - Tohn, Ellen A1 - Jonathan Wilson A1 - Van Oss, Tracy A1 - Gurecka, Michael KW - Energy efficiency KW - healthy homes KW - injury prevention KW - weatherization AB - Clients receiving weatherization/energy services with an added injury prevention home assessment with modifications/repairs experienced a decline in falls and thus fall-related costs. Interventions in 35 homes were associated with significant reductions in falls from baseline to 6 months postintervention (from 94% to 9%; P < .001) and falls with calls for assistance (from 23% to 3%; P < .02). The decline in falls with calls for assistance in the intervention group was significant when adjusted for a comparison group effect (P = .07). At a median cost of $2058 per home, the addition of an injury prevention component led by an occupational therapist offers the potential to avoid expensive fall-related medical costs (lift assistance, hospital transport and admission, long-term care). Integration of injury prevention into weatherization work, which targets lower-income seniors with high energy use, offers potential to reduce costly hospitalizations and poor health outcomes. PB - LWW VL - 26 ER - TY - ICOMM T1 - Making Health Count Y1 - 2020 A1 - Sara Hayes A1 - Cassandra Kubes A1 - Christine Gerbode KW - Energy efficiency AB - KEY TAKEAWAYS • Energy efficiency programs bring both energy savings and the potential for substantial health benefits to participating households. • The large existing network of in-home energy efficiency programs could be modified to include measures that promote better health outcomes for program participants. • If existing weatherization programs targeted four common health risks—asthma, falls, and exposure to extreme heat or cold—they could save more than $228 million due to avoided health harms. Those savings could reach $2.9 billion over 10 years. • Monetized estimates of the health benefits of interventions can be leveraged to enable programmatic changes, help to build partnerships between the energy efficiency and health sectors and attract additional funding for in-home efficiency programs. PB - ACEEE UR - https://www.aceee.org/sites/default/files/pdfs/h2001.pdf ER - TY - JOUR T1 - Energy efficiency as energy justice: addressing racial inequities through investments in people and places JF - Energy Efficiency Y1 - 2019 A1 - Jamal Lewis A1 - Diana Hernández A1 - Arline T. Geronimus KW - African Americans KW - Energy burden KW - Energy efficiency KW - Energy insecurity KW - Energy justice KW - Racial justice KW - Restorative justice KW - weatherization AB - Structural racism in the form of racial residential segregation and the series of laws, policies, and practices that continue to reinforce it have robbed generations of African Americans of socioeconomic opportunity, wealth accumulation, safe, secure or energy efficient housing, and full societal inclusion. Research indicates that African Americans are more likely to live in older, energy-inefficient homes with structural deficiencies, outdated appliances, and faulty energy systems. These conditions lead to a disproportionate burden of energy insecurity, defined as Bthe inability to adequately meet household energy needs^ among African Americans across the economic spectrum. This, in turn, generates increased costs and decreased comfort, conditions closely linked to adverse physical and mental health outcomes. Persistent income inequality, wealth gaps, and entrenched racial residential segregation have disenfranchised African Americans and reduced their ability to escape this pernicious cycle. Weatherization, which is the practice of protecting a building’s interior from the elements while enhancing its energy efficiency and reducing costs, could be a catalyst for reducing the disproportionate energy burden affecting low-income individuals and ultimately improve health and social outcomes among African Americans. We argue for investing in policies that provide energy efficiency and weatherization assistance—and not only energy bill assistance—to provide a long-term and equitable solution to energy insecurity that is also a critical step toward restorative justice. PB - Springer ER - TY - ICOMM T1 - Energy-Plus-Health Playbook Y1 - 2019 A1 - Laura Capps A1 - Liz Curry A1 - Emily Levin KW - Energy efficiency AB - As the energy efficiency industry faces disruptive market changes, program administrators (PAs) seek new strategies for reaching and engaging low- and middle-income customers. In parallel, the health industry is undergoing structural changes to make the transition from a feefor-service reimbursement system to payment models that are increasingly tied to outcomes. Many health care providers treating patients with chronic respiratory illnesses such as asthma and chronic obstructive pulmonary disorder (COPD) are testing new approaches that include inhome assessment of patients’ housing conditions. Energy efficiency PAs have the technical knowledge and trained workforce to conduct the in-home assessments and upgrades needed to address substandard housing conditions that affect health. The transformations taking place for both industries create new program design opportunities that target a shared barrier: unhealthy and substandard housing conditions that cause high energy burdens and compromise household health. By leveraging each other’s resources, customer access, workforce, and policy frameworks, the energy and health industries can achieve mutually beneficial outcomes. New collaborations nationwide are addressing these challenges by coordinating energy efficiency and health resources. This Playbook is designed to help energy efficiency PAs develop or expand healthy home programming, referred to as Energy-Plus-Health programs. Integrated Energy-Plus-Health programs offer PAs the opportunity to: • Reach more customers and provide more extensive services, • Increase participation in weatherization and residential retrofit programs, • Improve the quality of life of low-income households and communities, • Improve health outcomes and reduce health care utilization rates and costs, and • Unlock new health-related funding streams to leverage utility ratepayer dollars for improved program outcomes. This Playbook starts off in Section 1 by describing how the document is organized, with the intent to make this a user-friendly, easy-to-follow guidebook that walks the reader through key concepts, steps, and options for developing and implementing Energy-Plus-Health programs. PB - veic UR - https://www.veic.org/Media/default/documents/resources/manuals/energy-plus-health-playbook.pdf ER - TY - JOUR T1 - Energy Efficiency as a Tool for Preservation of Affordable Rental Housing: Evaluation of the Efficiency Emphasis in the MacArthur Foundation's Window of Opportunity Initiative Y1 - 2018 A1 - Heather L. Schwartz A1 - Aimee E. Curtright A1 - Ogletree, Cordaye A1 - Thornton, Elizabeth A1 - Jonsson, Lisa KW - Energy efficiency AB - In response to the predicted potential loss of nearly a million affordable rental homes in the United States, the MacArthur Foundation in 2000 launched a large philanthropic initiative called Window of Opportunity (WOO) to preserve privately owned affordable rental housing. By 2011, the foundation had learned from its WOO recipients and affiliates that improvements in energy efficiency (EE) could enable residential building energy costs to be lowered, improving cash flow and, by extension, the viability of multifamily affordable rental housing. As a consequence, the foundation decided to invest in energy efficiency. From 2012 to 2015, the MacArthur Foundation awarded 39 grants and loans totaling $27.5 million to promote the energy efficiency of multifamily affordable rental housing. Awardees for these grants and loans spanned the real estate, energy, and environmental sectors. This evaluation confirms that there have been marked increases nationally since 2010 in investments in the energy efficiency of multifamily rental housing, including in the subset that is affordable. Interviews, grantee accomplishments, and two case studies indicate that, of the seven desired outcomes the foundation outlined for Window of Opportunity-Energy Efficiency (WOO-EE), the initiative's greatest contributions were to help improve cross-sector collaboration and to increase awareness of EE as a preservation tool for affordable multifamily rental housing. WOO-EE activities had a smaller positive influence on three more of the outcomes, had no appreciable influence on one of them, and had an unknown influence on another. PB - RAND Corporation UR - https://www.rand.org/pubs/research_reports/RR2293.html ER - TY - JOUR T1 - How Citizen Potawatomi Nation utilizes energy efficiency and renewable energy to address its high energy burden JF - The Electricity Journal Y1 - 2018 A1 - Sandra K. Begay KW - Energy efficiency KW - Geothermal KW - Housing development KW - Indian energy KW - Tribal housing AB - Tribal lands comprise 2% of the United States but contain 5% of the potential renewable resources totaling over 14 billion MWh of energy generation potential. A vast majority of this potential has been undeveloped. Challenges such as difficulty accessing capital, securing interconnection and power purchase agreements, and persistent poverty have hindered energy development. The Citizen Potawatomi Nation is recognized for utilizing energy efficiency and renewable energy to address its high energy burden. VL - 31 UR - http://www.sciencedirect.com/science/article/pii/S1040619018301908 ER - TY - JOUR T1 - Impacts of energy-efficiency investments on internal conditions in low-income households JF - Building Research & Information Y1 - 2018 A1 - Poortinga, Wouter A1 - Jiang, Shiyu A1 - Grey, Charlotte A1 - Tweed, Chris KW - Energy efficiency KW - Housing KW - humidity measurements KW - monitoring KW - public health KW - public policy KW - retrofit KW - temperature measurements AB - Living in cold conditions poses a risk to health, in particular to low-income, fuel-poor households. Improving the energy efficiency of the housing stock may bring multiple positive health gains through improved indoor temperatures and reduced fuel consumption. This study used a multilevel interrupted time-series approach to evaluate a policy-led energy-performance investment programme. Long-term monitoring data were collected for intervention and control households at baseline (n = 99) and follow-up (n = 88), creating a dataset with 15,771 data points for a series of daily-averaged hydrothermal outcome variables. The study found that the intervention raised indoor air temperature by on average 0.84 K as compared with control households, thereby bringing the majority of indoor temperature measurements within the ‘healthy’ comfort zone of 18–24°C, while average daily gas usage dropped by 37%. External wall insulation was the most effective measure to increase indoor air temperature. The greatest increases were found in the evening and at night, in the bedroom, and in British steel-framed buildings. No evidence was found that the intervention substantially increased indoor relative humidity levels when accompanied by mechanical ventilation. The study concludes that the multilevel interrupted time-series approach offers a useful model for evaluating housing improvement programmes. PB - Taylor & Francis VL - 46 ER - TY - JOUR T1 - New domain for promoting energy efficiency: Energy Flexible Building Cluster JF - Sustainable cities and society Y1 - 2018 A1 - Vigna, Ilaria A1 - Roberta Pernetti A1 - Wilmer Pasut A1 - Roberto Lollini KW - Building cluster KW - Energy efficiency KW - Energy flexibility KW - Indicators KW - Smart readiness indicator AB - The ongoing energy system shift—from traditional centralized fossil fuel based to decentralized renewable energy sources based—requires a strengthened control of energy matching. Smart buildings represent the latest step in building energy evolution and perform as active participants in the cluster/energy infrastructure scale, becoming energy prosumers. In this framework, the IEA EBC Annex 67 introduces the concept of ‘Energy Flexible Building’, defined as a building able to manage its demand and generation in accordance with local climate conditions, user needs and grid requirements. Currently, there is no insight into how much flexibility a building may offer, and this study aims to overview the theoretical approaches and existing indicators to evaluate the Energy Flexibility of building clusters. The focus on cluster scale allows for the exploitation of the variation in energy consumption patterns between different types of buildings and the coordination of load shifting for the improvement of renewable energy use. The reviewed indicators can contribute to the definition of the Smart Readiness Indicator, introduced in the European Commission proposal for the EPBD revision, in order to test a building’s technological readiness to adapt to the needs of the occupants and the energy environment, as well as to operate more efficiently. PB - Elsevier VL - 38 ER - TY - JOUR T1 - The intersection of energy and justice: Modeling the spatial, racial/ethnic and socioeconomic patterns of urban residential heating consumption and efficiency in Detroit, Michigan JF - Energy and Buildings Y1 - 2017 A1 - Dominic J. Bednar A1 - Tony Gerard Reames A1 - Gregory A. Keoleian KW - Energy consumption KW - Energy efficiency KW - Energy justice KW - Fuel poverty KW - Residential buildings KW - Space heating KW - Spatial analysis AB - Residential energy conservation and efficiency programs are strategic interventions to reduce consumption and increase affordability. However, the inability to identify and distinguish between high energy consumers and highly energy inefficient households has led to ineffective program targeting. Additionally, little is known about the spatial, racial and socioeconomic patterns of urban residential energy consumption and efficiency. Publicly available data from the U.S. Energy Information Administration and the U.S. Census Bureau are used with bottom-up modeling and small-area estimation techniques to predict mean annual heating consumption and energy use intensity (EUI), an energy efficiency proxy, at the census block group level in Detroit (Wayne County), Michigan. Using geographic information systems, results illustrate spatial disparities in energy consumption and EUI. Bivariate analysis show no statistical relationship between race/ethnicity and energy consumption; however, EUI is correlated with racial/ethnic makeup; percent White (−0.28), African American (0.24) and Hispanic (0.16). Income and housing tenure reveal inverse relationships with consumption and efficiency. Though areas with higher median incomes and homeownership exhibited higher consumption (0.28 and 0.56, respectively), they had lower EUIs (−0.48 and −0.38, respectively). This study provides evidence supporting approaches for conservation and energy efficiency program targeting that recognizes the significance of race, ethnicity, place and class. VL - 143 UR - http://www.sciencedirect.com/science/article/pii/S0378778817308435 ER - TY - ICOMM T1 - Saving Lives through Energy Efficiency: Valuing the Health- and Safety-Related Benefits of Weatherization in Low-Income Homes Y1 - 2017 A1 - Christopher Chan A1 - Greg Clendenning A1 - Beth Hawkins A1 - Erin Rose A1 - Bruce Tonn KW - Energy efficiency AB - “Non-energy benefits” (NEBs) – such as improved comfort, health, safety, and productivity – are an important, yet often difficult to measure, component of determining and recognizing the full, “real” value of the country’s energy efficiency (EE) programs. A comprehensive, integrative study was conducted to reexamine and quantify the health and safety-related NEBs of the single-family lowincome (LI) weatherization program in Massachusetts (MA), which include reduced asthma, thermal stress, home fire, and carbon monoxide (CO) poisoning; reduced losses in work income; reduced use of short-term predatory loans; and increased home productivity. This study employed the methodology developed in a 2015 U.S. Department of Energy (DOE) study of its Weatherization Assistance Program (WAP). Applying the occupant survey data and methodology of the well-designed and large-scope national WAP study, which had passed review by a national expert panel, along with a robust set of secondary medical and wage data resulted in a much improved quantification of these NEBs. Although not all the occupant survey findings are statistically significant, supplemental evidence from the literature and previous study sufficiently supports their application. The study produced NEB values that are substantially higher and considered more robust than their previous counterparts, which is due primarily to the study’s ability to better detect, quantify, and monetize improvements in health status and mortality from weatherization. In particular, the value of the avoided lives lost from exposure to dangerously cold or hot temperatures and unsafe heating equipment, while subject to considerable uncertainty, is substantial. The total value of the health-related NEBs is $769 per weatherized home annually and $172 without including the avoided death benefit. PB - 2017 International Energy Program Evaluation Conference CY - Baltimore, MD UR - http://www.nmrgroupinc.com/wp-content/uploads/2019/01/Gregs-paper.pdf ER - TY - JOUR T1 - Lifting the high energy burden in America’s largest cities: How energy efficiency can improve low income and underserved communities Y1 - 2016 A1 - Drehobl, Ariel A1 - Ross, Lauren KW - Energy efficiency AB - This report provides a snapshot of energy burdens in cities across the US. We focus on the high home energy burdens faced by select groups in major metropolitan areas. Years of analysis by the firm of Fisher Sheehan & Colton determined that low-income households pay proportionally more than the average household for energy costs. Our analysis builds on this research as we take a closer look at energy burden in specific household groups. In the first half of this report, we analyze data from the US Census Bureau’s 2011 and 2013 American Housing Survey to determine energy burden values for 48 of the largest US cities and specific households within each city. In the second half of the report, we discuss strategies for alleviating high energy burdens, with a focus on policies and programs to increase the impact of energy efficiency initiatives in these communities. UR - https://assets.ctfassets.net/ntcn17ss1ow9/1UEmqh5l59cFaHMqVwHqMy/1ee1833cbf370839dbbdf6989ef8b8b4/Lifting_the_High_Energy_Burden_0.pdf ER - TY - JOUR T1 - Targeting energy justice: Exploring spatial, racial/ethnic and socioeconomic disparities in urban residential heating energy efficiency JF - Energy Policy Y1 - 2016 A1 - Tony Gerard Reames KW - Energy efficiency KW - Energy justice KW - Fuel poverty KW - Residential heating KW - Spatial analysis AB - Fuel poverty, the inability of households to afford adequate energy services, such as heating, is a major energy justice concern. Increasing residential energy efficiency is a strategic fuel poverty intervention. However, the absence of easily accessible household energy data impedes effective targeting of energy efficiency programs. This paper uses publicly available data, bottom-up modeling and small-area estimation techniques to predict the mean census block group residential heating energy use intensity (EUI), an energy efficiency proxy, in Kansas City, Missouri. Results mapped using geographic information systems (GIS) and statistical analysis, show disparities in the relationship between heating EUI and spatial, racial/ethnic, and socioeconomic block group characteristics. Block groups with lower median incomes, a greater percentage of households below poverty, a greater percentage of racial/ethnic minority headed-households, and a larger percentage of adults with less than a high school education were, on average, less energy efficient (higher EUIs). Results also imply that racial segregation, which continues to influence urban housing choices, exposes Black and Hispanic households to increased fuel poverty vulnerability. Lastly, the spatial concentration and demographics of vulnerable block groups suggest proactive, area- and community-based targeting of energy efficiency assistance programs may be more effective than existing self-referral approaches. VL - 97 UR - http://www.sciencedirect.com/science/article/pii/S0301421516304098 ER - TY - JOUR T1 - The impact of household energy efficiency measures on health: A meta-analysis JF - Energy Policy Y1 - 2014 A1 - Christopher D. Maidment A1 - Christopher R. Jones A1 - Thomas L. Webb A1 - Abigail Hathway A1 - Jan M. Gilbertson KW - Energy efficiency KW - Health KW - Housing improvements KW - Meta-analysis KW - Wellbeing AB - It is widely accepted that interventions designed to promote household energy efficiency, like insulation, central heating and double glazing, can help to reduce cold-related illnesses and associated stress by making it easier for residents to keep their homes warm. However, these interventions may also have a detrimental effect on health. For example, the materials used or lower ventilation rates could result in poorer indoor air quality. The present research sought to systematically quantify the impact of household energy efficiency measures on health and wellbeing. Thirty-six studies, involving more than 33,000 participants were meta-analysed. Effect sizes (d) ranged from −0.43 (a negative impact on health) to 1.41 (a substantial positive impact on health), with an overall sample-weighted average effect size (d+) of 0.08. On average, therefore, household energy efficiency interventions led to a small but significant improvement in the health of residents. The findings are discussed in the context of the health improvements experienced by different groups of participants and the study design factors that influence health outcomes. The need for future studies to investigate the long term health benefits of interventions designed to promote household energy efficiency is identified. PB - Elsevier VL - 65 ER - TY - JOUR T1 - Watts-to-Wellbeing: does residential energy conservation improve health? JF - Energy Efficiency Y1 - 2014 A1 - Jonathan Wilson A1 - Sherry L. Dixon A1 - David E. Jacobs A1 - Jill Breysse A1 - Judith Y. Akoto A1 - Tohn, Ellen A1 - Isaacson, Margorie A1 - Evens, Anne A1 - Hernandez, Yianice KW - Energy efficiency AB - Residential energy conservation has been increasing in number of houses treated, frequency, and scope, but few studies have examined whether modern energy conservation measures improve the health status of the occupants. We measured self-reported general, respiratory, cardiovascular, and mental health via structured telephone interviews using an adaptation of the National Health Interview Survey at baseline and follow-up in 2009–2012 [n = 248 households in Boston, Chicago, and New York City (248 adults and 75 children)]. Housing included buildings with one to three units (n = 106 units) located in Boston and buildings with >3 units/building (n = 142) located in Chicago and New York. The energy conservation typically included insulation, heating equipment, and ventilation improvements. Adult respondents reported a 0.29-point improvement in the mean general health score (1 = excellent, 2 = very good, 3 = good, 4 = fair, 5 = poor) (3.07 to 2.78, p < 0.001). Sinusitis, hypertension, overweight, and reduced use of asthma medication during asthma attacks showed 5 %, 14 %, 11 %, and 20 % differentials between improvement and worsening (p = 0.038, p < 0.001, p < 0.001, and p = 0.077, respectively). Forty-two adult respondents reported doctor-diagnosed asthma at baseline. Two measures of asthma severity worsened (days with problems sleeping—differential between improvement and worsening −28 %, p = 0.009; and frequency of symptoms such as cough, wheezing, and shortness of breath—differential between improvement and worsening −26 %, p = 0.031). Nitrogen dioxide, carbon monoxide, and carbon dioxide were low and showed no significant changes from baseline to follow-up in 41 housing units. This study found that residential energy conservation work conducted by trained professionals that balances energy efficiency and indoor environmental quality improves general health, sinusitis, and reduced asthma medication. Further research is needed to understand asthma-related outcomes. VL - 7 SN - 1570-6478 UR - https://doi.org/10.1007/s12053-013-9216-8 IS - 1 ER - TY - JOUR T1 - Energy efficiency, housing, equity and health JF - International Journal of Public Health Y1 - 2013 A1 - Braubach, Matthias A1 - Ferrand, Arnaud KW - Energy efficiency VL - 58 SN - 1661-8564 UR - https://doi.org/10.1007/s00038-012-0441-2 IS - 3 ER - TY - JOUR T1 - A randomised trial of home energy efficiency improvement in the homes of elderly COPD patients JF - European Respiratory Journal Y1 - 2010 A1 - L. M. Osman A1 - J. G. Ayres A1 - Garden, C. A1 - Reglitz, K. A1 - Lyon, J. A1 - J. G. Douglas KW - Energy efficiency AB - A randomised trial of 178 patients in Aberdeen, UK with a previous hospital admission for chronic obstructive pulmonary disease (COPD) was carried out in order to determine whether improving home energy efficiency improves health-related quality of life in COPD patients. 118 patients were randomised and 60 agreed to monitoring only. Energy efficiency upgrading was carried out in 42% of homes randomised to intervention. Independent energy efficiency action was taken by 15% of control participants and 18% in the monitoring group. The main outcome measures were respiratory and general health status, home energy efficiency and hospital admissions. Intention-to-treat analysis found no difference in outcomes between the two groups. In 45 patients, who had energy efficiency action independent of original randomisation, there were significant improvements in respiratory symptom scores (adjusted mean 9.0, 95% CI 2.5–15.5), decreases in estimated annual fuel costs (-£65.3, 95% CI -£31.9– -£98.7) and improved home energy efficiency rating (1.1, 95% CI 0–1.4). COPD patients are unlikely to take up home energy efficiency upgrading, if offered. Secondary “pragmatic” analysis suggests that those who do take action may achieve clinically significant improvement in respiratory health, which is not associated with an increase in indoor warmth. PB - European Respiratory Society VL - 35 UR - https://erj.ersjournals.com/content/35/2/303 ER - TY - JOUR T1 - The effects on health of a publicly funded domestic heating programme: a prospective controlled study JF - Journal of Epidemiology & Community Health Y1 - 2009 A1 - Walker, J A1 - Mitchell, R A1 - Petticrew, M A1 - Platt, S KW - Energy efficiency AB - Objective: To assess the effect of a publicly funded domestic heating programme on self-reported health.Design, setting and participants: A prospective controlled study of 1281 households in Scotland receiving new central heating under a publicly funded initiative, and 1084 comparison households not receiving new heating. The main outcome measures were self-reported diagnosis of asthma, bronchitis, eczema, nasal allergy, heart disease, circulatory problems or high blood pressure; number of primary care encounters and hospital contacts in the past year; and SF-36 Health Survey scores.Results: Usable data were obtained from 61.4% of 3849 respondents originally recruited. Heating recipients reported higher scores on the SF-36 Physical Functioning scale (difference 2.51; 95% CI 0.67 to 4.37) and General Health scale (difference 2.57; 95% CI 0.90 to 4.34). They were less likely to report having received a first diagnosis of heart disease (OR 0.69; 95% CI 0.52 to 0.91) or high blood pressure (OR 0.77; 95% CI 0.61 to 0.97), but the groups did not differ significantly in use of primary care or hospital services.Conclusions: Provision of central heating was associated with significant positive effects on general health and physical functioning; however, effect sizes were small. Evidence of a reduced risk of first diagnosis with heart disease or high blood pressure must be interpreted with caution, due to the self-reported nature of the outcomes, the limited time period and the failure to detect any difference in health service use. PB - BMJ Publishing Group Ltd VL - 63 ER - TY - JOUR T1 - Effect of insulating existing houses on health inequality: cluster randomised study in the community JF - BMJ Y1 - 2007 A1 - Howden-Chapman, Philippa A1 - Matheson, Anna A1 - Crane, Julian A1 - Viggers, Helen A1 - Cunningham, Malcolm A1 - Blakely, Tony A1 - Cunningham, Chris A1 - Woodward, Alistair A1 - Saville-Smith, Kay A1 - O’Dea, Des A1 - Kennedy, Martin A1 - Baker, Michael A1 - Waipara, Nick A1 - Chapman, Ralph A1 - Davie, Gabrielle KW - Energy efficiency AB - Objective To determine whether insulating existing houses increases indoor temperatures and improves occupants’ health and wellbeing.Design Community based, cluster, single blinded randomised study.Setting Seven low income communities in New Zealand.Participants 1350 households containing 4407 participants.Intervention Installation of a standard retrofit insulation package.Main outcome measures Indoor temperature and relative humidity, energy consumption, self reported health, wheezing, days off school and work, visits to general practitioners, and admissions to hospital.Results Insulation was associated with a small increase in bedroom temperatures during the winter (0.5°C) and decreased relative humidity (-2.3%), despite energy consumption in insulated houses being 81% of that in uninsulated houses. Bedroom temperatures were below 10°C for 1.7 fewer hours each day in insulated homes than in uninsulated ones. These changes were associated with reduced odds in the insulated homes of fair or poor self rated health (adjusted odds ratio 0.50, 95% confidence interval 0.38 to 0.68), self reports of wheezing in the past three months (0.57, 0.47 to 0.70), self reports of children taking a day off school (0.49, 0.31 to 0.80), and self reports of adults taking a day off work (0.62, 0.46 to 0.83). Visits to general practitioners were less often reported by occupants of insulated homes (0.73, 0.62 to 0.87). Hospital admissions for respiratory conditions were also reduced (0.53, 0.22 to 1.29), but this reduction was not statistically significant (P=0.16).Conclusion Insulating existing houses led to a significantly warmer, drier indoor environment and resulted in improved self rated health, self reported wheezing, days off school and work, and visits to general practitioners as well as a trend for fewer hospital admissions for respiratory conditions. PB - BMJ Publishing Group Ltd VL - 334 UR - https://www.bmj.com/content/334/7591/460 ER - TY - JOUR T1 - Monetary benefits of preventing childhood lead poisoning with lead-safewindow replacement JF - Environmental Research Y1 - 2007 A1 - Rick Nevin A1 - David E. Jacobs A1 - Michael Berg A1 - Jonathan Cohen KW - Climate change KW - Cost benefit analysis KW - Energy efficiency KW - Housing KW - lead poisoning AB - Previous estimates of childhood lead poisoning prevention benefits have quantified the present value of some health benefits, but not the costs of lead paint hazard control or the benefits associated with housing and energy markets. Because older housing with lead paint constitutes the main exposure source today in the US, we quantify health benefits, costs, market value benefits, energy savings, and net economic benefits of lead-safe window replacement (which includes paint stabilization and other measures). The benefit per resident child from improved lifetime earnings alone is $21,195 in pre-1940 housing and $8685 in 1940–59 housing (in 2005 dollars). Annual energy savings are $130–486 per housing unit, with or without young resident children, with an associated increase in housing market value of$5900–14,300 per housing unit, depending on home size and number of windows replaced. Net benefits are $4490–5,629 for each housing unit built before 1940, and $491–1629 for each unit built from 1940–1959, depending on home size and number of windows replaced.Lead-safe window replacement in all pre-1960 US housing would yield net benefits of at least $67 billion, which does not include many other benefits. These other benefits, which are shown in this paper, include avoided Attention Deficit Hyperactivity Disorder, other medical costs of childhood lead exposure, avoided special education, and reduced crime and juvenile delinquency in later life. In addition,such a window replacement effort would reduce peak demand for electricity, carbon emissions from power plants, and associated long-term costs of climate change. PB - Elsevier VL - 106 UR - https://www.sciencedirect.com/science/article/pii/S0013935107001909 IS - 3 ER -