Exploring the Housing and Household Energy Pathways to Stress: A Mixed Methods Study

Diana Hernández,Douglas Phillips,Eva Siegel

doi:10.3390/ijerph13090916

Diana Hernández, Douglas Phillips + Show 1 more

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https://doi.org/10.3390/ijerph13090916

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Abstract

Chronic stress, known to contribute to negative physical and mental health outcomes, is closely associated with broader issues of material hardship, poor neighborhood conditions, residential instability, and inadequate housing conditions. However, few studies have comprehensively explored pathways to stress in a low-income housing environment. A mixed-methods pilot study investigated the concept of energy insecurity by looking at the impacts of weatherization and energy efficiency interventions on low-income households in the South Bronx neighborhood of New York City. In-depth interviews were conducted with 20 low-income heads of household; participants also completed health, housing and budget assessments. Physical deficiencies, economic hardship, and health issues all interacted to directly and indirectly produce living conditions that contribute to chronic stress. Households with higher stress reported more health problems. Poor quality housing led to coping responses that increased expenses, which in turn increased stress around housing and energy affordability. This study provides further support for the connections between both health and the built environment and between low socio-economic status populations and net negative health outcomes. Energy insecurity is an important contributor to chronic stress in low-income households, and isolating pathways to stress where there is potential for interventions is important for future policy and housing-based strategies.

Highlights

Living in pervasive poverty is closely linked to chronic stress for low-income populations [1,2,3].On average, low-income populations suffer from poorer physical and mental health [4], and chronic stress has been identified as a mediating factor between low socio-economic status (SES) and negative health outcomes [5]
Previous research based on the present study examined the impacts of energy efficiency upgrades and showed that improvements in thermal comfort, enhanced health and safety and lower energy expenses were achieved but larger housing issues persisted in spite of benefits [25]
We describe the various pathways to stress among low-income householders that may contribute to net negative health outcomes observed in low SES populations

Summary

Introduction

Living in pervasive poverty is closely linked to chronic stress for low-income populations [1,2,3].On average, low-income populations suffer from poorer physical and mental health [4], and chronic stress has been identified as a mediating factor between low socio-economic status (SES) and negative health outcomes [5]. The effects of chronic stress on physical and mental health have been mechanistically elucidated through the concept of allostatic load, defined as “the cost of chronic exposure to fluctuating or heightened neural or neuroendocrine response resulting from repeated or chronic environmental challenge that an individual reacts to as being stressful” [6]. This chronic exposure to hormonal stress response causes the body to be more susceptible to adverse health events [7]. Children living under conditions of prolonged adversity and chronic poverty are at greater risk of exposure to hormonal stress response and of experiencing toxic stress, manifested as disruptions of the brain’s architecture and other systems during sensitive developmental periods [9,10]

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