Energy insecurity and health

At 9:02 p.m. on Monday, Oct. 29, my 8-year-old son came barreling up our basement stairs, screaming, "What happened?"

Our electricity had shut off due to Hurricane Sandy, as it had for hundreds of thousands along the East Coast. We were prepared with candles, flashlights, and a spontaneous game of charades played out in our living room.

But this event occurs in thousands of homes in Philadelphia without hurricane winds or fallen trees. Children emerge from basements citywide with the same fear and confusion as my son's, but games do not spontaneously occur. The reality of family hardships leaves many in the dark, in the cold, and in danger.

Energy insecurity occurs when a family lacks consistent access to enough of the kinds of energy needed for a healthy and safe life in a particular region.

In a large study at St. Christopher's Hospital for Children's emergency room, 31 percent of families surveyed had energy insecurity. Many also had housing and food insecurity, echoing the fact that the First Congressional District around St. Christopher's is the third-most-impoverished for children in the nation.

Energy insecurity is understandable when one considers the Home Energy Affordability Gap, which is the difference between affordable (6 percent of gross household income) and actual energy bills.

In the United States, the energy gap has risen 168 percent from 2002 to 2011. In Pennsylvania, the gap jumped more than 250 percent during the same period, with the average household in Philadelphia sustaining over $2,000 a year in shortfalls.

The poorer you are, the harder the home energy burden (bill as percentage of household income) falls on you, and the more likely your household will have to make tough choices that could affect your children's health.

As gasoline prices keep threatening $4 a gallon, the energy choices families must make are becoming more extreme.

Imagine if your electricity or gas were shut off. What would you do to keep warm, take care of perishable foods, help with your child's homework, give a nebulizer treatment to an asthmatic?

What if your energy source were cut off for a week or longer? What does energy insecurity do long-term to children's health?

The human body has developed to function best in an environment that is neither too cold nor too hot. Adults can tolerate fluctuations in temperatures better than children. The younger the children, the more they absorb and react to these fluctuations, by shivering more, overheating, and increasing stress hormones that affect their ability to fight infections, develop brain connections, and grow.

Numerous studies have shown the harmful medical effects of energy insecurity on children. Mothers of these children are more likely to consider their offspring in poor or fair health. Children in these households are more likely to be hospitalized and underweight, a sign of inadequate health.

These children are also at risk for developmental delays as their rapidly developing brains are exposed to the toxic effects of temperature instability, food insecurity, and stress hormones.

For special populations, temperature fluctuations are even more destructive.

Cold-sensitive conditions such as asthma and eczema are worsened by colder weather. Children with sickle-cell disease have more severe pain crises, some life-threatening. Infants are more likely to have apnea, pauses in their breathing that can cause babies to turn blue.

Energy insecurity doesn't exist in isolation; it often coexists with lacks of food and housing, leading an already stressed household to make choices such as "heat or eat," or sharing their home with friends and family.

Children in energy-insecure homes are also more likely to die. Die of carbon monoxide poisoning from space heaters. Die of fires as families use their stoves to heat their homes. Die of falls from windows as families let in cool night air on hot summer days, lacking electricity for a fan or air conditioner to keep everyone comfortable.

A 2002 study found that 24 percent of fatal home fires occurred in homes where the power was shut off.

How can we help?

Although funding for the Low Income Home Energy Assistance Program (LIHEAP) meets the needs of only a quarter of eligible families, energy-insecure households can apply at https://www.humanservices.state.pa.us/Compass.Web/CMHOM.aspx or by calling the LIHEAP hotline at 1-800-692-7462.

Help advocates for the poor increase LIHEAP funding (www.supportliheap.org).

Refer families to the Community Legal Services Energy Unit to help with utility disputes and questions at www.clsphila.org or 215-981-3746.

Go to http://cap4kids.org/Philadelphia for a listing of utility programs and energy-saving ideas.

As some children in our city of plenty ask their parents, "Why can't we have heat?" and "Why don't we have a refrigerator to store our medicines?", these parents respond not with talk of hurricanes, but with a hopeless look: "Because we can't afford it." Temperatures are dropping. So is the health of our children.