Health Benefits of Energy Efficiency. Ellen Tohn Tohn Environmental Strategies

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Health Benefits of Energy Efficiency Ellen Tohn Tohn Environmental Strategies www.tohnenvironmental.com

Allergies and asthma triggers are common 9% of the US Population has Asthma- 1 in 11 56% Atopic (Allergic) ~20% of the US Population have Environmental Allergies 25% Allergic to Dust Mites 25% Allergic To Mold 25% Allergic To Pollen 25% Allergic To Pets From: www.aafa.org 25% of Asthmatics Have a smoker in the home 75% of Urban homes Have mouse Allergen in the dust 25-60% of asthmatics in urban areas allergic to roaches

24% households concerned about home risks 24% Challenges and Opportunities in Creating Healthy Homes: Helping Consumers Make Informed Decisions http://www.jchs.harvard.edu/sites/jchs.harvard.edu/files/healthy_homes_wolfson_la_jeunesse.pdf

84% 66% think energy-efficient homes are healthier homes. are at least somewhat concerned about indoor air quality. Source: Energy Pulse 2014 Gain a sustainable advantage 2017 Shelton Communication Group, Inc. ALL RIGHTS RESERVED. Source: Eco Pulse 2015 Gain a sustainable advantage 2017 Shelton Communication Group, Inc. ALL RIGHTS RESERVED.

New reports https://energy.gov/eere/buildings/downloads/home-rx-healthbenefits-home-performance-review-current-evidence https://e4thefuture.org/wp- content/uploads/2016/11/occupant-health-benefits- Residential-EE.pdf

DOE & E4TheFuture reports investigated health benefits Goal: Investigate impact of home performance measures on resident health. To build the case for contractors and advocates so they can: Educate clients Educate current funders (utilities, DOE) Educate medical community 300 studies reviewed, 40 studies included More studies of lower income single family homes

Rx for Child Health: Lower Fuel Bills Young children receiving fuel assistance are healthier than their peers who do not get fuel assistance Healthier babies - 20% less likely to be underweight for age or length Reduced hospital stays in colder months - 30% less likely to require admission after visiting emergency room. Source: Frank et al, Heat or Eat, Pediatrics, 2006

Energy efficiency can reduce health risks Insulation Air Sealing Heating System Upgrades Ventilation Vent Dryers Efficient Cooking Appliances Warmer drier air, improved indoor temperatures & relative humidity Less moisture, mold, particulates, pollutants, combustion byproducts, allergens Lower bills, better comfort Fewer heat or cold related deaths Less hypertension, heart disease Fewer asthma symptoms, respiratory risks, COPD Fewer heart disease risks Fewer cancer risks due to radon, formaldehyde, other sources Less stress, better mental health Reduced hospital and medical visits

Energy efficiency can improve health

National weatherization evaluation shows healthier outcomes Survey Question Pre-WX Post-Wx Change How often home too drafty (1= all the time, 4 = never) 2.86 3.60*** 26% How infested is home with cockroaches, other insects, spiders (1=extremely infested, 5=not infested at all) 4.19 4.37*** 4% How infested is home with mice (1=extremely infested, 5=not infested at all) Frequent mildew odor or musty smell (1=yes, 0=no) How often have observed standing water in home (1= never, 5=always) Have seen mold in home (1=yes, 0=no) 4.61 4.73* 3%.30.21*** -9% 1.60 1.44** -10%.28.19** -9%

Energy efficiency improves reported health outcomes Better Health 30% to 40% Worse Health 37% to 26% Source: Wilson J, Dixon SL, Jacobs DE, Breysse J, Akoto J, Tohn E, Isaacson M, Evens A, Hernandez J (2014). Watts-to-Wellbeing: does residential energy conservation improve health? Energy Efficiency, 7(1), 151.

Weatherization Plus Highline Communities, King County, WA STUDY GROUP: WEATHERIZATION PLUS COMMUNITY HEALTH WORKER COMPARISON GROUP: COMMUNITY HEALTH WORKER ONLY

Weatherization Plus Health work Standard weatherization + 61% new bath fans - most with timer 61% carpets removed 26% vapor barriers in crawl space 24% kitchen range fans Other measures as needed $4200/apartments (11) $6300/duplex or homes (23) E d u c a i o n o n l y Wx+ Education Source: Breysse J, Dixon S, Gregory J, Philby M, Jacobs DE, Krieger J. (2014). Effect of weatherization combined with community health worker in-home education on asthma control. American Journal of Public Health, 104(1), 57.

Weatherization Plus Health: Reduced moisture/mold 0% -5% -10% -15% -20% -25% -30% -35% -40% -45% -50% -28% -29% -37% -47% Mold Moisture

Asthma better controlled for children 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 71% 1 Year Baseline for both groups: 0% 48% 23% Added Benefit

HRVs/ERVs can improve asthma symptoms Installation of HRV/ERVs associated with fewer asthma respiratory symptoms 3 studies all controlled trials with at-risk children or children with asthma Studies also observed improvements in CO 2, VOCs, and airborne mold

ASHRAE 62.2 exhaust ventilation can improve environmental conditions Fewer headaches among children in 62.2 2010 vs. 1989 homes Homes in both groups had lower CO 2 and formaldehyde 62.2 2010 homes had some declines in radon in first floor

Typical One Touch Partners Health Lead Asthma Visiting Nurses Smoking Cessation Housing Government Rehab Habitat for Humanity Rebuilding Together Community Programs Energy Weatherization Utility Programs Home Performance

VT WAP families have health risks

Families want health insurance information Response Chart Percentage Count Yes 44.0% 435 No 55.8% 552 Yes and older than 60 years, refer to Area Agency on Aging 0.2% 2 Total Responses 989

Wx replaced smoke & CO alarms in 40% homes Response Chart Percentage Count no working smoke detector or detector > 10 years old no working carbon monoxide alarm or > 5 years old non working smoke detector will be replaced by Weatherization non working carbon monoxide alarm will be replaced by Weatherization 8.2% 102 10.1% 126 39.6% 494 42.0% 524 exposed electrical wiring 3.8% 47 stairs or porch without adequate railings 4.1% 51 windows or doors don't open for exit 3.8% 47 Other, please specify... 6.2% 77 no safety risks mentioned or observed by home visitor 44.3% 553 Total Responses 1247 21

VT One Touch 1 in 4 homes/families (300) needed a referral Response Chart Percentage Count Yes, will specify 24.0% 301 Yes, but family declined referral 1.3% 16 No referral needed 74.7% 937 Total Responses 1254 22

Most Common One Touch Referrals 70% 60% 50% 40% 30% 20% 10% 0% Statewide Burlington 23

One Touch is up and running in 6 12 months One Touch Program (8-12 months) Kick Off Meetings Engage Partners Develop Tools & Pilot (1-4 months) Develop Check up Forms, Electronic Referral & Outcome Measures Engage Partners Pilot Test Refine Tools & Expand Reach (5-12 months) Modify Tools & Approach Partner Adoption Sign Compact/MOU