As part of the Energy Poverty Advisory Hub’s (EPAH) thematic series on equity and vulnerability, this third article explores how energy poverty intersects with health and wellbeing. As the previous articles highlighted, addressing energy poverty requires an equity-based approach that recognises the diversity of vulnerable groups and the intersecting forms of disadvantage, economic, social, and environmental, that shape people’s lives. Building on these foundations, this article draws on evidence from the Horizon 2020 WELLBASED project to show how energy poverty is also a profound public health challenge, demanding integrated and just responses at all policy levels.
Energy Poverty as a Public Health Challenge
Energy poverty is not only a social or economic issue, it is a major public health concern. When households cannot afford adequate energy for heating, cooling, and ventilation, their living environments become unhealthy. Cold, damp, and poorly ventilated homes lead to respiratory diseases such as asthma and bronchitis, aggravate cardiovascular conditions, and worsen musculoskeletal pain in older adults. Beyond physical health, the constant worry about high energy bills and poor home comfort triggers stress, anxiety, and depression, and even disrupts sleep and nutrition.
These conditions are more than individual problems; they form part of a broader pattern of social and health inequality. Low-income families, older people, children, and marginalized groups are disproportionately affected, as they are more likely to live in inadequate housing and have limited capacity to improve their situation. Thus, energy poverty deepens existing vulnerabilities, widening the gap in health and wellbeing across populations.
WELLBASED: Understanding and Addressing Health Implications
The Horizon 2020 WELLBASED project was designed precisely to understand and act upon this complex relationship between energy, health, and vulnerability. By combining social, economic, and environmental perspectives, WELLBASED developed and tested Urban Programmes (WUPs), which are integrated, community-level intervention models that address energy poverty as a determinant of health through targeted household support, behavioural and financial guidance, and coordinated social and health services, in six European cities: Valencia (Spain), Heerlen (Netherlands), Edirne (Turkey), Jelgava (Latvia), Obuda (Hungary), and Leeds (England).
These programmes were built on the Social Ecological Model of Health Determinants (Dahlgren and Whitehead, 1991), which recognizes that health is shaped not only by individual choices but also by community networks, living conditions, and broader socio-economic contexts. Accordingly, WELLBASED interventions acted on several levels, from promoting energy-efficient behaviours and community support networks to improving living conditions and informing policy measures that address energy poverty systemically.
Through this approach, the project was able to identify, describe, and measure how energy poverty impacts physical and mental health, generating robust quantitative and qualitative evidence that reveal both the scale of the problem and the mechanisms through which it operates.
From Health Impact to Vulnerability
The health consequences of energy poverty illustrate a powerful connection between material deprivation and human vulnerability. Data from WELLBASED clearly show that people living in energy poverty are in poorer health and wellbeing than the general population. Around 80% of participants had one or more chronic health conditions, double the European average, and nearly half suffered from three or more. Mental health problems were also prevalent, with 30–40% reporting anxiety, stress, or depression.
Qualitative findings add a human dimension to these numbers. Across all six pilot cities, participants described the daily reality of living in cold or overheated homes, how damp exacerbated respiratory problems in children, how extreme temperatures worsened chronic pain, and how fatigue and poor sleep reduced their capacity to work or care for others. Many felt trapped and powerless, unable to change their circumstances, a feeling that reinforces social isolation and stigma.
Energy poverty, therefore, is a multifaceted form of vulnerability, rooted in structural inequalities but expressed through personal experiences of discomfort, ill health, and exclusion. It affects not only how people live, but how they feel about themselves and their place in society.
However, the relationship between health and energy poverty is not one-directional. As Middlemiss et al. (2023) argue, the causal link works both ways. On the one hand, inadequate heating, cooling, or ventilation can directly harm physical and mental health. On the other, poor health can itself increase the risk of energy poverty, for example when disability or chronic illness limits income or increases energy needs. This creates a vicious cycle, where poor health and energy deprivation reinforce each other over time, a pattern clearly observed in the WELLBASED pilot cities. Breaking this cycle requires policies that address both sides simultaneously: ensuring healthy homes and supporting those whose health conditions make them more vulnerable to energy poverty.
From Evidence to Equitable Action
WELLBASED did not stop at diagnosis; it moved toward real, equitable action. The findings guided municipalities, policymakers, and local stakeholders in designing interventions that integrate health, energy, and social equity. For example, WELLBASED’s deliverable Policy Recommendations – Interventions describes concrete measures such as socio-health energy audits, distribution of energy-efficiency kits, group training on energy & health, and home retrofitting for vulnerable households. These interventions were paired with community empowerment activities and awareness-raising campaigns to build resilience and improve living conditions. Importantly, the project emphasized that tackling energy poverty requires multilevel and holistic action. Quick fixes or isolated initiatives may offer temporary relief but fail to address the structural roots of inequality. By adopting a socioecological and rights-based perspective, recognizing access to energy as a fundamental human right, WELLBASED reframed the issue from one of charity to one of justice and entitlement.
The project’s legacy lies in its demonstration that energy, health, and wellbeing are inseparable. Addressing energy poverty means not only improving comfort at home but also restoring dignity, health equity, and social cohesion across Europe.
The project developed a series of documents providing recommendations for decision-makers, synthesising the main lessons learned across the six pilot cities and outlining key approaches to better integrate health, equity, and energy considerations into policies addressing energy poverty. Drawing from the evidence generated by WELLBASED, the documents highlight the importance of strengthening local capacities, improving housing conditions and access to affordable energy, enhancing cooperation between health, social, and energy services, and embedding health-related indicators into monitoring frameworks. Together, these insights illustrate how a holistic and equity-driven approach can help break the cycle between energy poverty and poor health and support more effective strategies at local and European levels.
As Europe strives for a just energy transition, health equity must be at its core. The WELLBASED experience shows that tackling energy poverty is a public health imperative and a matter of social justice. By integrating energy, health, and equity perspectives, we can ensure that no one’s wellbeing is compromised by the cold, the heat, or by the cost of their energy.
Victoria Pellicer, Valencia Clima i Energia Foundation, Valencia City Council
Elena Rocher, Valencia Innovation Capital Foundation, Valencia City Council
Details
- Publication date
- 17 December 2025