Indoor Temperature and Energy Insecurity: Implications for Prenatal Health Disparities in Extreme Heat Events

Abstract

Background: Extreme heat events are a major public health concern and are only expected to increase in intensity and severity as climate change continues to accelerate. Pregnant people are physiologically more vulnerable to the effects of extreme heat, and exposure can induce harm on both the pregnant person and the fetus.

Objectives: This commentary argues that there is a need for greater epidemiological research on indoor heat exposure and energy insecurity as potential drivers of maternal and child environmental health disparities.

Discussion: While there is substantial evidence linking ambient (outdoor) high temperature to pregnancy-related outcomes, there is a lack of epidemiological evidence to date on pregnant people's exposure to high indoor temperature and adverse maternal and/or child health outcomes. Energy insecurity is disproportionately experienced by people with low incomes and/or people of color, and indoor temperature may play a role in shaping socioeconomic and racial/ethnic disparities in maternal and child health in the United States. Further research is needed to understand the relationship between indoor heat exposure, energy insecurity, and pregnancy outcomes in both parents and children and to inform potential policies and practices to enhance resilience and reduce maternal/child health disparities. https://doi.org/10.1289/EHP13706.

Figure 1.

Conceptual framework on impact of energy insecurity on heat exposure and maternal and child health disparities. This schematic shows how structural inequities related to housing shape physical and economic energy insecurity, which, in turn, influence indoor heat exposure. Indoor and ambient heat exposure operate jointly to affect maternal and child health disparities.