How Limitations in Energy Burdens Compromise Health Interventions for COVID Outbreaks in Urban Settings

Low-income households have experienced increased energy burdens and inaccess to healthcare services during the COVID-19 pandemic, which has limited their ability to practice social distancing and stay-at-home orders. Here, we show that a households’ inability to adopt social distancing due to constraints in utility and healthcare expenditure drastically impacts the course of disease outbreak in five U.S. counties. Low-income households shoulder greater burdens of disease and death than other households, while functioning as a consistent source of exposure to higher income households. Health interventions combining social distancing and resource protection strategies (e.g., utility access and healthcare) were the most effective in limiting the spread of COVID-19. Additionally, resource protection strategies tailored to alleviate utilities and financial constraints for low-income households can protect the whole population. Current policies need to address the multidimensionality of energy burdens, housing environment, and public health. The findings also imply methods for future disaster management. Funding Information: C.-F. Chen, G. Bonilla, and H. Nelson are supported by the Engineering Research Center Program of the U.S. National Science Foundation (NSF) and the Department of Energy under NSF award EEC-1041877 and the CURENT Industry Partnership Program. Declaration of Interests: The authors have no financial or non-financial interests associated with the material in this manuscript.