CHARLOTTE, N.C. — During the heat dome that blanketed much of the Southeast in June, Stacey Freeman used window units to cool her poorly insulated mobile home in Fayetteville, N.C. The 44-year-old mom relied on space heaters during the winter.

In each cases, her energy bills bumped into tons of of dollars a month.

“Sometimes I have to choose whether to pay the electric bill,” Freeman said, “or pay all the rent, buy food, or not let my son play sports?”

As a regional field organizer for PowerUp NC, Freeman’s job is to help people properly weatherize their homes, especially in the Sandhills region where she lives and works and where poverty and rising temperatures make residents vulnerable to the health effects of climate change.

But Freeman’s income is just too high to afford the services she helps others obtain through her grassroots initiative for sustainability, clean energy and environmental justice.

Like a growing variety of Americans, Freeman is battling what is named energy povertyincluding the inability to pay utility bills for heating or cooling the home. Households that spend greater than 6% Some researchers suggest that around 20% of their income from electricity bills goes to the energy poor.

Energy poverty can increase exposure to extreme heat or cold, which increases the risk of respiratory problems, heart problems, allergies, kidney disease and other health problems. And that burden falls disproportionately on households in communities of color, which experience it at a rate 60% higher than in white communities.

Public health and environmental experts say that as climate change continues to drive extreme weather, greater policy efforts are needed to help vulnerable communities, especially during heatwaves.

“Energy poverty is just one example of how climate change can exacerbate existing inequities in our communities,” said Summer Tonizzo, spokeswoman for the North Carolina Department of Health and Human Services.

Extreme heat is the leading explanation for weather-related deaths in the U.S., and the risk increases as temperatures rise. Last yr, 2,302 people died in the U.S. died of heat-related causeswhich is a 44% increase compared to 2021. In one week in early July this yr, extreme heat killed at the very least 28 people, according to The Washington Postbased on reports from government officials, health workers and local media reports.

Yet 1 in 7 households spends about 14% of their income on energy, according to RMI, an energy and sustainability think tank. Nationally 16% of households lives in energy poverty, according to an evaluation co-authored by Noah Kittner, an assistant professor of public health at the University of North Carolina at Chapel Hill.

“Old, inefficient buildings and heating systems force people to supplement their energy needs in ways that increase costs,” Kittner said.

Pregnant women, people with heart or lung disease, young children, older people, and people who work or exercise outdoors are most vulnerable to heat-related health problems. High temperatures have also been linked to mental health problems, equivalent to suicide and severe depression.

Location is one other risk factor. For example, in the historically black community in Raleigh often called Method, temperatures might be 10 to 20 degrees warmer than nearby areas with more vegetation and less development, said La’Meshia Whittington, an environmental justice and clean energy advocate. Interstate 440 runs through Method, and the city stores shuttle buses there, often with their engines running.

“That creates a lot of pollution that heats the area,” Whittington said. “There’s no ground to absorb the heat. Instead, it bounces off the shingles, the roofs, the sidewalks, and creates a furnace.”

Method residents often complain of chronic headaches and respiratory problems, she added.

While rural areas tend to have cooler temperatures than nearby urban areas because they’ve less asphalt and more trees, they often lack resources like health care facilities and cooling centers. Substandard housing and higher poverty rates contribute to high rates of heat-related illnesses.

As Ashley Ward, director of the Heat Policy Innovation Hub at Duke University, puts it, energy poverty “is about burdens piling up without any means of addressing them at the individual level.”

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In many parts of the country, extreme heat is a comparatively latest problem. Policymakers have historically focused on the risks posed by lower temperatures.

The federal low-income home energy assistance program, established greater than 4 a long time ago, has a funding formula that favors states with a chilly climate over those experiencing extreme heat, according to a Georgetown University study. Florida, Georgia, Arizona, Texas and Nevada have the lowest proportional allocations of federal funds, while North Dakota, South Dakota and Nebraska have the highest.

North Carolina relies heavily on private donors and local nonprofits like PowerUp to provide fans and air conditioners during the summer, but the state doesn’t subsidize energy bills.

On extremely hot days, Freeman and her colleagues at PowerUp NC work with state health officials to direct vulnerable people to cooling centers.

On a private level, staying cool this summer meant sending my son to a free, open-air recreation center as a substitute of paying for him to play in a sports league.

“We do things that don’t cost anything,” she said. “We’re just trying to keep up with the electric bill.”

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