2025 Reports

Powering Up for Health: Policy Solutions for Energy Insecurity in New York City

Hernández, Diana; Lane, Kathryn; Smith, Caleb; Do, Vivian; Yuan, Ariel; Smalls-Mantey, Lauren; Daouda, Misbath; Bozzi, Laura; Olson, Carolyn

Energy insecurity—the inability to adequately meet basic household energy needs—affects more than a quarter (28%) of New York City residents. While energy cost burden, a function of energy cost, consumption, and household income, is one important way to measure difficulty meeting energy needs, energy insecurity encompasses more than economic hardship. It is worsened by physical living conditions and expressed through coping behaviors to contain costs and maintain comfort. Residents in un-weatherized homes or relying on energy-inefficient appliances use more energy and pay more to meet their everyday energy needs. Meanwhile, people who are energy insecure may seek to reduce their energy cost burden by severely restricting their energy use, a coping strategy that can put their health and safety at risk.

Energy insecurity adversely impacts health, increasing the odds of mental strain, respiratory conditions, cardiovascular health issues and limiting the use of electronic medical devices. The distribution and health effects of energy insecurity are inequitable, felt most by low-income households, households with children, households where someone uses electric medical equipment, people of color, recent immigrants, and renters. As extreme weather becomes more frequent and intense, the cost of living and utility bills rise, and energy and building heating systems transition to cleaner and potentially more expensive sources, energy insecurity will likely worsen and become more inequitable without active intervention.

While responsibility for the energy sector spans federal, state and local authorities, imminent threats to the energy safety net benefits that support energy affordability and infrastructure to enable a clean and just energy transition at the federal level, make state and local leadership even more critical to achieving universal access to life-sustaining energy. In this report, we outline policy options to address energy insecurity based on public health evidence from recent research conducted in NYC. While policies and programs often intersect across the core domains of energy insecurity—economic, physical, and coping—we present them separately, discussing evidence-based and health-promoting policy options within these primary areas of focus.

As a multifaceted issue that encompasses utility bills, housing quality, thermal comfort, access to safety net supports and public health, multiple interventions are needed to address energy insecurity and allow for equitable participation in the clean energy transition. Interventions are most likely to be successful, if coupled with efforts to address energy affordability upstream through utility rate design. We close with recommendations for standardized tracking of energy insecurity in relation to health and integrating screening into clinical care and public health surveillance efforts. Addressing energy insecurity through a holistic lens—rather than through siloed housing, health, or energy programs—allows for coordinated strategies that recognize how temperature regulation, affordability, and social protection intersect. A comprehensive approach can therefore yield more durable solutions, improving not only household energy affordability and housing quality but also health equity and climate resilience.