Diana Hernández

Energy Burden and the Need for Integrated Low-Income Housing and Energy Policy

Using detailed sociological and public health qualitative interview data, we demonstrate that energy poverty is more pervasive, and results in a greater energy burden for low-income tenants, than many policymakers would assume. This is due in part to a lack of funding, policy non-coordination, and a lack of understanding of the social and economic benefits of energy conservation, energy education, and flexible utility billing policies. Examining LIHEAP, weatherization, utility, and housing assistance policies, we suggest that a coordinated, regional approach to home energy and housing policy that integrates programs in each area will provide a more coherent policy solution.

Understanding ‘energy insecurity’ and why it matters to health

Energy insecurity is a multi-dimensional construct that describes the interplay between physical conditions of housing, household energy expenditures and energy-related coping strategies. The present study uses an adapted grounded theory approach based on in-depth interviews with 72 low-income families to advance the concept of energy insecurity. Study results illustrate the layered components of energy insecurity by providing rich and nuanced narratives of the lived experiences of affected households. Defined as an inability to adequately meet basic household energy needs, this paper outlines the key dimensions of energy insecurity-economic, physical and behavioral- and related adverse environmental, health and social consequences. By thoroughly examining this understudied phenomenon, this article serves to raise awareness of an increasingly relevant issue that merits more attention in research and policy.

Affording Housing at the Expense of Health Exploring the Housing and Neighborhood Strategies of Poor Families

Low-income families often simultaneously encounter housing and neighborhood problems pertaining to safety, affordability, and quality issues that necessitate strategies to maximize limited budgets and ensure safety. Such constrained decisions regarding inadequate housing and poor neighborhood conditions, however, may themselves create or exacerbate health risks. Building on the survival strategies literature, this article offers rich and detailed accounts of coping and management strategies on the part of vulnerable families facing housing and neighborhood hardships. The findings are based on in-depth interviews with 72 respondents and ethnographic observations in an urban community. The results illustrate how low-income women avoid neighborhood danger by relegating family life to the home environment, thereby increasing exposure to health risks such as stress, depression, and asthma. The discussion focuses on public health literature linking housing and health and proposes the use of legal strategies and community engagement as resources to complement current approaches to housing and neighborhood problems.

Energy Insecurity among Families with Children

The National Center for Children in Poverty (NCCP) is dedicated to promoting the economic security, health, and well-being of America’s low-income families and children. Using research to inform policy and practice, NCCP seeks to advance family-oriented solutions and the strategic use of public resources at the state and national levels to ensure positive outcomes for the next generation. Founded in 1989 as a division of the Mailman School of Public Health at Columbia University, NCCP is a nonpartisan, public interest research organization.

Youth perspectives on the intersections of violence, gender, and hip-hop

Youth’s perceptions of violence within their social environments can provide relevant insights into the gender-based interpersonal violence epidemic in inner-city communities. To explore this issue, we examined two sets of narratives with young men and women, aged 15 to 21, involved in hip-hop culture in New York City. In the analysis, we reveal youth accounts of street and interpersonal violence, examining the interconnections with gender and hip-hop culture. Our findings suggest that youth involved in hip-hop culture vary in the comprehensiveness of their definitions of violence and viewed violence as entertainment or as a way to gain or maintain respect. Moreover, many respondents described episodes of interpersonal violence but failed to classify the behavior as violent, which suggests that dialogue with youth is needed to deconstruct diverse cultural understandings and more effectively address violence among youth. We recommend using hip-hop as a tool for reform in the process.

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

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.

Exploring Kinship and Social Support in Women With Criminal Justice Backgrounds

Women’s incarceration has broad social impacts because of the unique caregiving roles that women occupy in their families and communities. In this study, we used qualitative interviews to examine kinship and social support among 30 women who had been recently released from incarceration in either a New York State prison or Rikers Island, New York City’s main jail complex. Qualitative findings suggest that women relied heavily on biological and extended family members for support. Kin relationships described were with other women (i.e., mothers, grandmothers, and female friends/peers), older female relatives were commonly described as caregivers, and caregiving was a key aspect of social support (both provided by and given to participants). Relationships with God were also important. Findings from this study contribute to our understanding of kin relationships and social support in women who have been incarcerated.

Public health entrepreneurs: training the next generation of public health innovators.

©2014 Association of Schools and Programs of Public Health “Funny how I just spent two years learning public health and now I’m throwing myself into the business entrepreneurship world. I have an idea for a technology start-up with aims to revolutionize the way cancer survivors, patients, and their loved ones connect with each other online and offline. It ties in with the ability to self-organize into neighborhood support groups around common interests or activities and not just diagnosis. In the meantime, I’m looking for work that can pay my living expenses while I form this idea, start testing the concept, and look for funding from big, scary venture capitalists. :) There’s no reason why public health can only be a government, academic, or nonprofit thing (though they make excellent partners). For my idea, a great amount of flexibility, creativity, and room for innovation is key.”

Residual Inequity: Assessing the Unintended Consequences of New York City’s Clean Heat Transition

Energy policies and public health are intimately intertwined. In New York City, a series of policies, known as the Clean Heat Program (CHP), were designed to reduce air pollution by banning residual diesel fuel oils, #6 in 2015 and #4 by 2030. This measure is expected to yield environmental and public health benefits over time. While there is near-universal compliance with the #6 ban, a substantial number of buildings still use #4. In this paper, geographic analysis and qualitative interviews with stakeholders were used to interrogate the CHP’s policy implementation in Northern Manhattan and the Bronx. A total of 1724 (53%) of all residential residual fuel burning buildings are located in this region. Stakeholders reflected mostly on the need for the program, and overall reactions to its execution. Major findings include that government partnerships with non-governmental organizations were effectively employed. However, weaknesses with the policy were also identified, including missed opportunities for more rapid transitions away from residual fuels, unsuccessful outreach efforts, cost-prohibitive conversion opportunities, and (the perception of) a volatile energy market for clean fuels. Ultimately, this analysis serves as a case study of a unique and innovative urban policy initiative to improve air quality and, consequently, public health.

When “the Cure” Is the Risk: Understanding How Substance Use Affects HIV and HCV in a Layered Risk Environment in San Juan, Puerto Rico

Background. Substance use, particularly injection drug use, continues to fuel the HIV/HCV (hepatitis C virus) epidemics in San Juan, Puerto Rico (PR). Aim. This article examines individual and sociostructural factors that affect HIV/HCV risk among people who use drugs (PWUD) living with or at risk for HIV/HCV in San Juan, PR. Findings were used to inform a community-level intervention to enhance HIV care access and retention for this population. Method. A rapid ethnographic assessment in collaboration with a community-based organization was conducted. Data collection took place between June and December 2013 and included field observations, 49 unstructured interviews with PWUD, and 19 key informant interviews with community stakeholders. Fieldnotes, photographs, and interview transcripts were analyzed for recurrent themes and to address the intervention-planning needs. Study results are presented as fieldnote excerpts, direct quotes from interviews, and photographs. Results. Findings suggest that PWUD in PR face myriad challenges that affect HIV/HCV risk and hinder linkage to and retention in care. Results describe a layered risk environment where PWUD encounter many barriers to prevention, care, and treatment such as transience, social isolation, stigma, limited housing options, and inadequate medical and substance use disorder treatment services. Discussion. These observed circumstances provide an empirical basis for the development and evaluation of comprehensive interventions that may serve to reduce barriers to care and link individuals to other supportive services. Conclusion. New approaches and comprehensive interventions are needed to break the structures that perpetuate risk and lack of engagement and retention in HIV care and substance use disorder treatment in San Juan.