Improving air quality and comfort in buildings through energy efficiency can lead to better health.
E4TheFuture initiatives have helped to advance understanding of energy efficiency’s benefits for human health and opportunities for integrated energy-plus-health programs in homes, particularly related to asthma and other respiratory diseases. See Overcoming Weatherization Barriers for our toolkit to address health and safety obstacles that can hinder energy retrofits, focused on low-income populations.
A range of efforts advances the energy/health connection. We encourage people to apply an equity and justice lens, when exploring resources.
Four areas serve as starting points:
- Research on Health Benefits of Energy Efficiency
- Energy-Plus-Health Program Models and Guidance
- Resources for Energy-Plus-Health Policies
- Health Benefits in Cost-Effectiveness Screening
1. Research on Health Benefits of Energy Efficiency
Integrated energy and health programs have been shown to improve occupant health as well as decrease energy use. See examples of research and studies below.
Occupant Health Benefits of Residential Energy Efficiency (White Paper, 2016)
Home Rx: The Health Benefits of Home Performance (Report, U.S. Dept. of Energy, 2016)
ACEEE‘s research includes:
- Protecting the Health of Vulnerable Populations with In-Home Energy Efficiency: A Survey of Methods for Demonstrating Health Outcomes (Oct. 2019)
- The Value of Energy Efficiency as a Public Health and Climate Mitigation Strategy (June 2019)
- The air quality-related health benefits of energy efficiency in the United States (Mar. 2019)
- Cost-Effectiveness Tests: Overview of State Approaches to Account for Health and Environmental Benefits of Energy Efficiency (Dec. 2018)
- Saving Energy, Saving Lives: The Health Impacts of Avoiding Power Plant Pollution with Energy Efficiency (Feb. 2018)
ACEEE focuses on both indoor and outdoor air quality in their work. Their Bridging Health & Energy Efficiency working group discusses research on health and energy efficiency programs, practice and policies. See also ACEEE’s Health & Environment page.
2. Energy Plus Health Program Models and Guidance
Various resources provide guidance and tools for coordinating and administering integrated energy-plus-health programs, as well as information on existing programs including pilot efforts.
Energy-Plus-Health Playbook (2019) and blog by E4TheFuture and Ellen Tohn, Orchestrating a Better Outcome: New Playbook Offers Guidance on “Energy-Plus-Health” Programs.
The Playbook outlines three program tiers with increasing levels of health and energy integration. It illuminates key case studies and considerations for program design and/or development, and offers tips for navigating health industry partnerships. Tools and resources help users implement integrated programs.
Download slides: Using the Energy-Plus-Health Playbook (2019).
Download slides: US DOE Better Buildings Residential Network – Health and Energy Efficiency Are Trending (Peer Exchange Call, 10/24/19)
Braiding Energy and Health Funding for In-Home Programs: Federal Funding Opportunities, (Research Report, ACEEE, 2020) identifies six sources of health-related federal funding that could be used to support residential energy efficiency programs. Such an integrated approach can yield environmental, economic, and health benefits, particularly for vulnerable communities.
Making Health Count: Monetizing the Health Benefits of In-Home Services Delivered by Energy Efficiency Programs, (Research Report, ACEEE, 2020) shows that by targeting common health risks — asthma, falls, and exposure to extreme heat or cold — existing weatherization programs could save almost $3 billion in avoided harms over ten years. Among the first to quantify these potential savings, this study introduces a tool to customize calculations for specific programs.
Capitalizing on the Health Impacts of Improving Housing Conditions, by Michael McKnight and Ruth Ann Norton, is a chapter in The Practical Playbook II: Building Multisector Partnerships That Work (2019) that shares the Green and Healthy Homes Initiative’s experiences and best practices for integrated energy-plus-health program coordination.
The Next Nexus: Exemplary Programs that Save Energy and Improve Health (Research Report, ACEEE, March 2018) and The New Leaders of the Pack: ACEEE’s Fourth National Review of Exemplary Energy Efficiency Programs (Research Report, ACEEE, 2019) provide overviews of key health and energy efficiency programs, methodologies, results, and conclusions.
The Asthma and Health Benefits of Connecting with Weatherization and Energy Efficiency Programs (Regional Asthma Management & Prevention, RAMP Digest) cites key considerations and resources for integrated programs.
Washington State’s Weatherization Plus Health Program Resources page lists their integrated program materials and other publications that they have developed or found useful.
3. Resources for Energy and Health Policies
Several jurisdictions have enacted policies that recognize the value of the energy/health connection and provide sustained funding to support advancement and help overcome barriers to progress.
Some states are integrating health and energy efficiency programs, to improve outcomes for human health in addition to saving energy. Because health and efficiency projects cross sectors, initiatives are frequently collaborative among departments or organizations.
Examples of policy support for such integration include:
- Gubernatorial Executive Order establishing “Health in All Policies” Task Force (CA EO S-04-10; VT EO 07-15)
- Gubernatorial Executive Order to incorporate “Health Across All Policies” for state agencies facilitating health and energy department collaboration (NY EO 190)
- Legislation relating to “Healthy Housing” (WA HB1720-2015)
- Legislation establishing a “Healthy transportation compact” (MA General Laws I.II.6C.33)
- Mayoral Executive Order establishing “Office of Sustainability and Citywide Sustainability Policy” (Denver EO 123), which encompasses health and energy sustainability
- Mayoral Executive Order: Sustainable DC Transformation Order (DC 2013-209) from Sustainable DC.
- County Ordinance implementing inter-branch collaboration on the countywide strategic plan (King County, WA Ordinance 16948)
- A City Ordinance establishing “Health in All Policies” as a strategy for a California city (Richmond Ordinance 07-14 N.S.) that resulted in a city resolution to adopt a framework for “Health in All Policies.”
- A County Health Department Health Equity Initiative (Multnomah, OR)
The above list is a sample of relevant policies and is not meant to be exhaustive or kept current. Find more information on Health in All Policies in this 2017 report by the National Association of County and City Health Officials.
Funding for Energy Plus Health Programs
Sustained funding is a necessary component of a successful energy plus health program. Because such programs are multi-sectoral projects, program funding varies significantly. Examples include:
- Medicaid and MCO reimbursement for Home-Based Asthma Services (e.g., in MO)
- State legislation for home health funds (CT)
- State legislation for housing health and safety funds (WA)
- Hospital Community Benefits
- Optimal Energy’s CHEE presentation overview of using medical funding for home health
- One Touch and Weatherization funding (VT)
4. Health Benefits in Cost-Effectiveness Screening
States vary in whether — and the extent to which — they account for public and occupant health impacts of energy efficiency investments when conducting benefit-cost analyses of efficiency programs. You can learn about where and how states account for these health impacts via the National Efficiency Screening Project’s Database of Screening Practices (DSP). The National Standard Practice Manual provides guidance on how states can determine whether accounting for health impacts is relevant to their state.
Refer to Research on Health Benefits of Energy Efficiency (section 1 above) to view studies that may help support accounting for health impacts.
See also ACEEE resources in “Other Publications” in section 2 above.
The US EPA offers tools to assist states and communities in quantifying the health and environmental impacts of energy efficiency (and renewables). The guide Public Health Benefits per kWh of Energy Efficiency and Renewable Energy (2019) discusses quantification of public health benefits at a local and state level. See their report Quantifying the Multiple Benefits of Energy Efficiency and Renewable Energy: A Guide for State and Local Governments (EPA, 2018) and visit the State and Local Energy and Environment Program website.
Home Performance Contractor Training
Healthy Housing Principles Certificate – BPI essential certification and resources.
Incorporating Health into Energy Efficiency Program Design (ACEEE, 2021) compilation of relevant resources.
Product Evaluation and Healthy Building Information from buildingclean.org
Notable Blogs/Case Studies
How well are we tracking the health impacts of energy efficiency programs? (Sara Hayes, ACEEE)
Orchestrating a Better Outcome: New Playbook Offers Guidance on “Energy-Plus-Health” Programs (Julie Michals and Ellen Tohn)