Heat or eat? America’s poor face an inhumane, impossible choice this winter.

Inflation now is at the highest rate in 13 years and is a real concern for all Americans. Housing, food, furniture and many other goods are more expensive. The cost of another, more invisible commodity – home heating – is also projected to rise, even as much as 50%, in the coming months. The burdens of reduced buying power across so many facets of daily life is especially hard on low-income households. This winter, the poor will likely face an unconscionable choice: heat or eat. 

The cost of home heating is expected to increase substantially across the board. Natural gas will increase 30% to $746, heating oil will increase 43% to $1,734 and electricity will increase 6% to $1,268. Paying so much more for warmth will cripple many already economically challenged households.  

The problem is that poor households were barely able to afford winter heating bills before this price surge. Many were getting by on forbearance. With added pressures, it won’t just be a cold winter, it could be deadly without government intervention. 

Winter is the most expensive season

Nearly 1 in 3 households in the United States are energy insecure, according to a 2015 report, meaning that they are unable to adequately meet household energy needs. Energy insecurity is driven by lack of money and worsened by poor energy efficiency; the more inefficient, the more expensive it is to heat one’s home.

The poor and people of color are more likely to live in energy-inefficient homes, despite lower energy consumption overall. Extreme energy conservation is a coping strategy used by the poor along with turning to ovens, stoves or space heaters as supplemental heating sources. 

As an academic researcher, I have interviewed hundreds of low- and moderate-income people who were unable to meet their energy needs. I visited their homes and met them in energy assistance offices around the USA. The women and men I interacted with did not have the privilege to take energy for granted. Some lived without heat because their furnace was no longer functional and they did not have the means to replace it. More common, these families faced exceedingly high bills that were impossible to afford on meager wages. Many had received disconnection notices and made promises they couldn’t keep to pay down their debts with utility companies. The winter was often the most expensive season. 

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To live without sufficient heat is to suffer in private. Family members wear coats and extra layers of clothing at home. They are bound to their beds and sofas where blankets and quilts provide warmth without added expense. They live out of one room in the house to concentrate the heat and contain the costs. Visitors are unwelcome. 

Risk dying at home

The global energy crisis of the 1970s and '80s spurred what is known today as the Low Income Home Energy Assistance Program. LIHEAP provides payment assistance for income-eligible households and delivers emergency relief when households face a disconnection threat, shut off or at risk of lacking fuel. 

This program is a critical lifeline for poor families, yet few actually receive help. Depending on the year, only about 1 in 5 eligible households obtain energy assistance benefits. Instead, a recent paper shows that many forgo food or medicine.

Despite receiving energy assistance annually for the past 20 years, a woman I interviewed in New York City, described a harrowing but not uncommon daily struggle for thermal comfort. Her winter ritual involved boiling pots of water and turning on a space heater in the living room where she spent her days and nights. As an elderly person who used her oil-based heating sparingly, she risked freezing pipes and dying at home. She would not be the first.

More than 19,000 Americans have died of cold-related causes since 1979, many of them elderly. Excess winter deaths are a real threat when the cost of heating rises.

My research has shown that energy insecurity is associated with poor sleep quality, mental strain and respiratory illness. Others have found that cold stress is connected to cardiovascular risks and declines in neurological function. 

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Many households that are energy insecure are also food insecure. And like energy, food prices are on the rise, 4.6% higher than a year ago. 

On the bright side, households that receive energy assistance are less likely to be undernourished. The takeaway here is that government assistance can protect against these twin hardships.

As Congress battles out the infrastructure bill and Democrats fight to enhance the social safety net, policymakers must remember that the poor can little afford the risks of an impossibly cold winter. As heating costs rise, emphasis on improving efficiency and expanding energy assistance are time-sensitive and life-preserving matters. 

Diana Hernández is an associate professor of Sociomedical Sciences at Columbia University’s Mailman School of Public Health and a visiting scholar at the Russell Sage Foundation, where she is writing a book on energy insecurity entitled, "Powerless: The People’s Struggle for Energy in America."