The impact of household energy poverty on the mental health of parents of young children

A Systematic Review of the Impact of Energy Insecurity on Mental Health During the COVID-19 Pandemic

Energy is an increasingly important social and public health concern. It is essential for good health and a prerequisite for basic needs in the household. Public health emergencies like COVID-19 have been known to be associated with mental health crises such as increased levels of loneliness, depression, and anxiety. A systematic search of the PubMed, Semantic Scholar, and ScienceDirect databases was conducted. After duplicate removal, title, abstract, and content screening, retrieval, and quality assessment, 11 studies met the criteria for this systematic review of articles. This study highlighted that the COVID-19 pandemic created a mental health crisis associated with various factors, particularly energy insecurity. The social implications for this study show that it is important for individuals and the public health community to recognize the impact that energy insecurity has on the population more specifically recognizing how energy insecurity affects mental health. Public health measures should focus on getting direct help to households that are struggling to keep the home at a safe temperature and pay their energy bills.

Household energy poverty and trajectories of emotional and behavioural difficulties in children and adolescents: findings from two prospective cohort studies

PURPOSE

The aim of this study is to examine the association between household energy poverty (EP) and trajectories of emotional and behavioural difficulties during childhood.

METHODS

The Growing up in Ireland study is two nationally representative prospective cohorts of children. The Infant Cohort (n = 11,134) were recruited at age 9 months (9 m) and followed up at 3, 5, 7 and 9 years (y). The Child Cohort (n = 8,538) were recruited at age 9 y and followed up at 13 y and 17/18 y. EP was a composite of two relative measures of EP. Emotional and behavioural difficulties were repeatedly measured using the strengths and difficulties questionnaire (SDQ). Linear spline multilevel models were used, adjusted for confounders to examine the association between (1) EP (9 m or 3 y) and trajectories of emotional and behavioural difficulties from 3 to 9 y in the Infant Cohort and (2) EP at 9 y and the same trajectories from 9 to 18 y in the Child Cohort.

RESULTS

In adjusted analyses, EP at 9 m or 3 y of age was associated with higher total difficulties score at 3 y (0.66, 95% CI 0.41, 0.91) and 5 y (0.77, 95% CI 0.48, 1.05) but not at 7 y or 9 y. EP at 9 y was associated with higher total difficulties score at 9 y (1.73, 95% CI 1.28, 2.18), with this difference reducing over time leading to 0.68 (95% CI 0.19, 1.17) at 17/18 y.

CONCLUSIONS

Our study demonstrates a potential association between early life EP and emotional and behavioural difficulties that may be transient and attenuate over time during childhood. Further studies are required to replicate these findings and to better understand if these associations are causal.

Poverty trajectories and child and mother well-being outcomes in Ireland: findings from an Irish prospective cohort

BACKGROUND

Poverty is associated with poor outcomes, yet exposure to distinct poverty trajectories in early childhood is not well understood.

OBJECTIVE

To understand the prevalence of different trajectories of household poverty and their association with mid-childhood and mother indicators of physical health and psychopathology in Ireland.

METHODS

We used a nationally representative, prospective cohort (Growing Up in Ireland-Infant Cohort). Household poverty included lowest third income decile, subjective poverty and material deprivation when children were aged 9 months, and 3, 5, 9 years. We used group-based multitrajectory cluster modelling to classify trajectories of poverty. Using multivariable logistic regression, adjusted with separate child and mother confounders, we assessed the association of poverty trajectories from 9 months to 9 years with child outcomes (overweight, any longstanding illness and psychopathology) at age 9 years and the same poverty trajectories over the same 9-year period with mother outcomes (overweight, any longstanding illness and depression).

RESULTS

Of 11 134 participants, 4 trajectories were identified: never in poverty (43.1%), material/subjective>monetary poverty (16.1%), monetary>material poverty (25.6%) and persistent poverty (15.2%). Children in persistent poverty compared with those in never in poverty experienced higher odds of being overweight at 9 years (adjusted OR (aOR) 1.70, 95% CI 1.34, 2.16), having a longstanding illness (aOR 1.51, 95% CI 1.20, 1.91), and psychopathology (aOR 2.06, 95% CI 1.42, 2.99). The outcomes for primary parents (99.7% were mothers) were as follows: having higher odds of being overweight (aOR 1.49, 95% CI 1.16, 1.92), having a longstanding illness (aOR 2.13, 95% CI 1.63, 2.79), and depression (aOR 3.54, 95% CI 2.54, 4.94).

CONCLUSIONS

Any poverty trajectory was associated with poorer psychopathology and physical well-being in late childhood for children and their mothers in Ireland.

Energy poverty: an overlooked determinant of health and climate resilience in Canada

OBJECTIVE

Despite Canada being an important energy producer, not all Canadians can access or afford adequate levels of energy services at home to meet their needs, maintain healthy indoor temperatures, and live a decent life-a situation known as energy poverty. Depending on the measure, 6-19% of Canadian households face energy poverty. Health risks associated with energy poverty are documented in countries with milder climates. This study explores, for the first time in the Canadian context, the association between energy poverty and health.

METHODS

Cross-sectional data are from the 2018 Canadian Housing Survey. Analyses are conducted on a sample weighted to represent 14 million Canadian households. The associations between expenditure-based and self-reported measures of energy poverty and self-rated general and mental health were assessed using logistic regression models, adjusted for potential confounding variables.

RESULTS

The odds of rating one's general (OR: 1.48; 95%CI: 1.29, 1.70) and mental (OR: 1.21; 1.04, 1.41) health as poor are significantly higher for Canadian adults in households with a high share of energy expenditure to income. The likelihood of poor general and mental health was significantly higher for those dissatisfied with the energy efficiency of their dwelling, and with their ability to maintain a comfortable temperature both in the winter and in the summer.

CONCLUSION

Exposure to energy poverty is associated with significantly increased likelihood of poor general and mental health. Given the high proportion of Canadian households facing energy poverty, with demonstrated implications for population health, tackling energy poverty is essential for an equitable energy transition and for climate resilience.

Period poverty and mental health in a representative sample of young women in Barcelona, Spain

BACKGROUND

The intersection between poverty and mental health is clear. Period poverty, understood as the lack of access to menstrual products, has been gaining attention especially among low and middle-income countries as an overlooked aspect of gendered poverty. Less is known about the incidence of period poverty in high-income countries and its association with mental health. The purpose of this study is to examine this association in a representative sample of young women living in an urban setting in southern Europe.

METHODS

This is a cross-sectional study. Data were obtained from a representative survey of individuals aged 15 to 34 in the city of Barcelona (Spain), with a sample group of 647 young women. Subjects were selected through a systematic stratified random sampling method. A proportional quota sampling was used. The information was registered using CAPI data collection method. Period poverty was measured by a combination of three questions about the lack of access or misuse of menstrual products for economic reasons. The GHQ-12 was used to measure the risk of poor mental health. The analysis was carried out using multivariable logistic regression.

RESULTS

From our sample, 15.3% of young women reported having experienced period poverty. Higher odds of poor mental health were estimated for women facing period poverty (AOR = 1.85 p < 0.05). This effect is statistically significant after controlling by their income status and level of deprivation. Young women living in poorer households have a higher probability of poor mental health than those living in high-income households (AOR = 0.47 p < 0.05). Finally, material deprivation was associated to an increased risk of poor mental health among young women reporting period poverty (AOR = 2.59 p < 0.01).

CONCLUSION

We found that a considerable number of young women living in an urban setting in a high-income country cannot afford menstrual products, and this may have an impact on their mental wellbeing. The relationship between period poverty and respondents' mental health is significant when controlling for factors known to confer an increased risk of poor mental health. If confirmed by further research, the public health burden of poor mental health in young women could be reduced by policy-level interventions to improve access to menstrual products.

How do energy prices and climate shocks affect human health? Insights from BRICS

The presented work analyzes the energy prices, climate shock, and health deprivation nexus in the BRICS economies for the period 1995-2020. Panel ARDL-PMG technique is used to reveal the underexplored linkages. The long-run estimates of energy prices are observed to be negatively significant to the health expenditure and life expectancy model, whereas, positively significant to the climate change model. These findings suggest that energy prices significantly reduce health expenditures and life expectancy and, thus, increase the death rate in the BRICS economies. The long-run country-wise estimate of energy prices is found negatively significant in case of Brazil, India, China, and South Africa. Alongside, the group-wise significance of CO2 emissions is discovered to be negatively, positively, and insignificant in the cases of life expectancy, death rate, and health expenditure models, respectively. Besides, country-wise long-run estimate of CO2 emissions witnesses negative significance for Russia, India, China, and South Africa.

A comprehensive urban programme to reduce energy poverty and its effects on health and wellbeing of citizens in six European countries: study protocol of a controlled trial

BACKGROUND

Nearly 11% of the European population is affected by energy poverty. Energy poverty is defined by the European Commission (2016) as the inability to afford basic energy services to guarantee a decent standard of living. Energy poverty is considered a complex, multidimensional problem that affects environment, housing, urban development, and health. Living in energy poverty conditions is associated with poorer human health and wellbeing. Hence, the WELLBASED intervention programme aims to design, implement and evaluate a comprehensive urban programme, based on the social-ecological model, to reduce energy poverty and its effects on the citizens' health and wellbeing in six European urban study sites: Valencia, Spain; Heerlen, The Netherlands; Leeds, United Kingdom; Edirne, Turkey; Obuda, Hungary, and; Jelgava, Latvia.

METHODS

A controlled trial is performed. A total of 875 participants are recruited (125-177 per study site) to receive the WELLBASED intervention programme for 12 months (intervention condition) and 875 participants act as controls (control condition). Data will be collected with a baseline measurement at inclusion (T0), and follow-up measurements after 6 months (T1), 12 months (T2), and 18 months (T3). In both study arms, effects of the WELLBASED intervention programme are measured: health-related quality of life (HR-QoL), mental health, frailty in older adults, self-perceived health, chronic conditions, and care utilization. At the same time points, household expenditure on energy and energy consumption are obtained. In the intervention arm, health-monitoring data (i.e. peak flow, oxygen saturation, blood pressure, and heart rate) are obtained monthly and sleep quality with a three-month interval. Household data with regard to temperature, humidity and air quality are collected near real-time by home sensors. Qualitative interviews are conducted in each study site to evaluate the impacts of the WELLBASED intervention programme and to help explain findings.

DISCUSSION

The WELLBASED intervention programme will provide new insights into the effectiveness of a comprehensive urban programme to tackle energy poverty and its effects on health and wellbeing across Europe. Hence, this study can contribute to European-wide replicable solutions for policy-makers and city practitioners to alleviate energy poverty.

TRIAL REGISTRATION

ISRCTN registry number is ISRCTN14905838 . Date of registration is 15/02/2022.

Indoor Environmental Quality and Consumption Patterns before and during the COVID-19 Lockdown in Twelve Social Dwellings in Madrid, Spain

This article analyses the situation that prevailed in 12 dwellings located on the outskirts of Madrid during Spain’s state of emergency. How did 24/7 occupation affect the quality of indoor air and power consumption patterns? The mixed method used (surveys and instrumental monitoring) pragmatically detected the variation in consumption, comfort and indoor air quality patterns before and during the COVID-19 pandemic. The characteristics initially in place and household predisposition had a conclusive effect on such variations. The starting conditions, including household composition, habits and the way daily activities were performed, differed widely, logically affecting power consumption: 8/12 case studies increase occupancy density by more than 25 percent; 11/12 improve thermal comfort; 10/12 improve air quality but not necessarily translate in a sufficient ventilation practices; air quality was lower in the bedrooms on the whole; only 4/12 case studies use the potential of passive measures; only one household adopted energy savings strategies; 10/12 case studies increase electric power consumption but none of the dwellings was fitted with a renewable power generation system. The conclusion drawn is that, despite starting conditions differing widely, household composition, habits (including performance of daily activities performance) and power consumption also played an active role in the end result. This approach allowed to integrate qualitative and quantitative findings on indoor environmental quality (IEQ), energy use and households’ behavior. The objective data on the energy situation of the case studies not only is useful for the study, but also for potential enrollment in energy rehabilitation programs, such as the European Regional Development Fund (ERDF).

Psychospiritual care for parents during the COVID-19 pandemic

In a recent article, energy poverty increases the likelihood of depression in parents. The authors responded that this situation must be given attention because parental well-being can influence child development and outcomes. With this, we propose, in this paper, that an avenue that can be done is by providing a psychospiritual care for parents especially during the COVID-19 pandemic in which anxieties among family members arise.

The Association of Energy Poverty with Health and Wellbeing in Children in a Mediterranean City

Children have been identified as being particularly vulnerable to energy poverty (EP), but little empirical research has addressed the effect of EP on children’s health and wellbeing, especially in southern Europe. In this work we aimed to provide an in-depth description of the distribution of EP by sociodemographic, socioeconomic and housing characteristics, as well as to analyse the association between EP and health and wellbeing in children in Barcelona. We performed a cross-sectional study using data from the Barcelona Health Survey for 2016 (n = 481 children under 15 years). We analysed the association between EP and health outcomes through prevalence differences and prevalence ratios (PR) and their 95% confidence interval (CI), using Poisson regression models with robust variance. In Barcelona, 10.6% of children were living in EP and large inequalities were found by sociodemographic, socioeconomic and housing characteristics. EP was strongly associated with poor health in children (PR (95% CI): 7.70 (2.86, 20.72)). Living in EP was also associated with poor mental health (PR (95% CI): 2.46 (1.21, 4.99)) and with more cases of asthma (PR (95% CI): 4.19 (1.47, 11.90)) and overweight (PR (95% CI): 1.50 (1.05, 2.15)) in children. It is urgent to develop specific measures to avoid such serious and unfair health effects on children.

Behavior Patterns, Energy Consumption and Comfort during COVID-19 Lockdown Related to Home Features, Socioeconomic Factors and Energy Poverty in Madrid

During spring 2020, the world was shocked at the imminent global spread of SARS-CoV-2, resorting to measures such as domestic confinement. This meant the reconfiguration of life in an unusual space; the home. However, not all households experienced it in the same way; many of them were vulnerable. A general increase in energy consumption and discomfort in many cases, led these families to suffer the ravages of confinement. This study analyzes the energy and comfort situation for the Madrid (Spain) population, according to the configuration of the homes, the characteristics of the dwellings, the vulnerability index by district, and energy poverty (measured with the 10% threshold of energy expenditure of home incomes). The results show a greater exposure, in confinement, of vulnerable and energy-poor households to scenarios of discomfort in the home, to which they could not respond, while energy consumption inevitably increased. Driven by need, energy-poor homes applied certain saving strategies, mainly resorting to thermal adaptation with clothing. This study shows the risk these households experienced in the face of an extreme situation, and invites reflection on preventive and containment measures that aim to avoid harming the disadvantaged in the future; harm that would also entail serious consequences on the health of their cohabitants.