A Lunch and Learn Session Hosted by the Irving Institute's Energy Justice Clinic
When Dr. Diana Hernández speaks about energy insecurity, she is not talking about a single utility bill or an isolated hardship. She is talking about whether a family can stay warm through a winter storm, whether an elderly person can run an air conditioner during a heat wave, whether a household managing chronic illness can power the medical equipment it depends on.
Energy, in her framing, is not a convenience. It is the resource that underpins much of daily life—and the consequences of losing access to it are rarely contained to one area. As she put it, energy insecurity is intertwined with food insecurity, chronic illness, and economic instability: "People live with energy insecurity and many other things." When access to energy is unreliable or unaffordable, those burdens compound one another in ways that a single metric or policy response can struggle to capture.
As Associate Professor of Sociomedical Sciences at Columbia University's Mailman School of Public Health, Dr. Hernández has spent her career documenting those consequences and building the research foundation for a field she helped define. On May 14, more than 30 students, faculty, staff, and community members gathered for a lunch and learn session hosted by the Energy Justice Clinic at Dartmouth College, where Dr. Sarah Kelly introduced Dr. Hernández as "one of the leading voices in the country on energy insecurity as a public health issue." The conversation covered research, federal policy, and public health—and drew on insights from her recently published book, Powerless: The People's Struggle for Energy, which examines how limited access to affordable, reliable energy shapes daily life for low-income households across the country.
Dr. Hernández's entry into energy research began in urban settings, where she encountered problems that lacked clear documentation or a defined body of literature.
"I learned that there was a set of issues that were not well documented," she recalled. "I wrote a paper that was foundational to the field—one of the first to define energy insecurity." Working in Boston's Dorchester neighborhood with the Medical Legal Partnership at Boston Medical Center and then in a series of projects in New York City with organizations like WE ACT for Environmental Justice and the Association for Energy Affordability, Hernández examined how low-income households navigated unaffordable utility bills, inadequate housing, and the consequences of losing heat or power.
Over time, her colleagues pushed her to think more broadly. What about rural communities? What about post-disaster contexts? Hurricane impacts in Puerto Rico forced her to reckon with a dimension of energy insecurity she had not fully accounted for: grid failure.
"It was first a housing issue," she explained. "Then it expanded to an infrastructure issue in post-disaster contexts." That evolution led to her new book, which draws on firsthand accounts to examine how limited access to affordable, reliable energy shapes daily life for low-income households across the country.
"People don't consider New York City as representative of the nation," she noted. "I needed to take nationally accessible data and anchor it in human narratives." The result reflects her conviction that numbers alone cannot fully capture the lived experience of energy insecurity—and that understanding the problem at a national scale requires personal accounts as well.
Central to Dr. Hernández's work is the relationship between energy insecurity and health. The connection is well-supported by her research and runs in more than one direction.
"It's not uncommon to have a set of health outcomes associated with energy insecurity," she said, pointing to links with food insecurity and chronic illness. But the relationship is not one-directional. "Energy insecurity correlates to health challenges, and health challenges drive energy insecurity. It goes both ways."
Households managing chronic illness may face greater financial pressure, making them more vulnerable to disconnection or at greater risk when exercising dangerous coping behaviors such as forgoing food or medication to pay a utility bill.
One institution that has moved to address this connection directly is Boston Medical Center (BMC), where Dr. Hernández conducted her dissertation research. BMC has developed what she described as a "solar energy prescription model"—a program that provides solar credits to patients as part of their care.
"Boston Medical Center has been at the cutting edge," she said. "They've also invested in resilient power infrastructure so they can operate during a disaster and serve as a hub for energy access."
She noted, however, that such models remain uncommon. "What is lacking is screening. There is not enough screening that leads to referrals to programs and relief." The public health system has been slow to integrate energy insecurity into routine assessment, even as evidence of its health consequences continues to grow. Data infrastructure presents a related challenge: the Residential Energy Consumption Survey, one of the primary tools for tracking energy insecurity nationally, is conducted only every four to five years, leaving policymakers and researchers working with information that may not reflect current conditions.
Any serious examination of energy insecurity in the United States must engage with the Low-Income Home Energy Assistance Program—LIHEAP—the federal program that has served as the nation's primary energy safety net for nearly half a century.
Its origins trace to a specific moment of national crisis. In the 1970s, OPEC's restrictions on heating fuel triggered widespread hardship and prompted a federal response that eventually became LIHEAP. That program, Dr. Hernández noted, also set the country on a broader policy path toward energy efficiency, weatherization investment, and bill assistance.
"For the last 50 years, LIHEAP has helped avert energy crises at the household level, but it has not kept up with current energy realities—which include a heating planet and rising energy costs," she said.
In the current political environment, where programs like the Supplemental Nutritional Assistance Program (SNAP) and the Affordable Care Act (ACA) have faced significant funding threats, LIHEAP has shown a degree of staying power. "SNAP benefits and the ACA have seen huge cuts. LIHEAP and weatherization have not." That durability is partly a function of LIHEAP's framing as a critical stopgap with a smaller price tag, which has historically attracted bipartisan support.
But durability is not the same as adequacy. LIHEAP is administered as a block grant, with federal allocations to states determined by heating and cooling degree days and income eligibility at the population level. States then develop their own distribution plans, meaning that whether an eligible household receives assistance can depend significantly on geography and state-level priorities.
The program's design also reflects its origins. "LIHEAP is overly focused on heating," Dr. Hernández said. "That goes to its origin—it was about heating fuels." As climate change produces more frequent and severe heat events, the program's cooling assistance component has not kept pace with growing need. And because LIHEAP typically activates only when a household is at imminent risk of losing service via a shutoff, it is structured around crisis intervention rather than prevention.
"It operates more like an ER," she said. "People must go to the edge to be helped."
The program's reach tells its own story. Only 17 percent of eligible households receive LIHEAP benefits—a significant gap compared to SNAP, which reaches approximately 82 percent of eligible households. Application barriers are higher, funding pools are smaller, and the system is oriented toward acute need rather than sustained support.
What is needed, Dr. Hernández argued, is a more integrated approach. "We need to couple weatherization, energy assistance, and rate reform." She pointed to the potential of stacking benefits and capital to fund efficiency upgrades, developing tiered rate structures that reflect household income, and building public health-inspired surveillance systems capable of identifying at-risk households before they reach crisis.
A question running through much of Dr. Hernández's work is whether access to energy should be understood as a human right—and what it would mean in practice to treat it as one.
"How do you ensure access to energy? A rights-based framing?" she said, acknowledging the political complexity. "It is an enabler of other established rights. Still, there is pushback."
The evidence, she suggested, strengthens the case. "Now, we have evidence that energy insecurity is consequential for health and survival. Health has consistently been a compelling lever for policy change."
The scale of the problem gives the question particular weight. Approximately 3 percent of the U.S. population experiences utility disconnection in any given year—millions of people losing access to a resource that supports their ability to stay warm, stay cool, prepare food, and manage their health. Globally, approximately one billion people lack access to energy entirely.
"That's a moral question," Dr. Hernández said. "Should we be turning utilities off? This is a public service."
Disconnection reform is one component of the SPARKED Action Framework she outlined—a comprehensive vision that also includes Screening, Participation in energy decision-making, Affordability, Robust social and energy safety nets, Knowledge and energy literacy, Efficiency and Clean Energy Access and Disconnection Reform. The framework reflects her view that energy insecurity is too complex and too consequential to be addressed through any single policy lever. "Complex problems need comprehensive solutions," she said. "It's not enough to do weatherization or have bill assistance. Energy insecurity needs a comprehensive approach and holistic set of solutions."
The Irving Institute's Energy Justice Clinic convenes researchers, practitioners, and community members to advance energy justice scholarship. Dr. Hernández's book, Powerless: The People's Struggle for Energy, is available now.
