How Energy-Efficiency Upgrades Can Improve Your Health

Yves here. Lambert underwent a big project to boost the energy efficiency of his 100+ year old house in Maine. Despite being very solidly built in many ways, it really leaked heat through the attic. And even before the recent oil and gas price spikes, the cost of heating fuel is a big item for many cold-climate homeowners. Here we learn the payoff is bigger than just lowering the cost of temperature control.

By Bridgett Ennis, co-founder of ChavoBart Digital Media (CBDM), an audio and video production firm with a focus on scientific and environmental media. CBDM contributes original reporting, audio production, and distribution to the Climate Connections radio program and podcast. Originally published at Yale Climate Connections
An energy-efficient home offers more than just lower utility bills and a smaller carbon footprint.

It can also provide a healthier environment for the people who live there.

That’s according to Kevin Kennedy, the environmental health program director at Children’s Mercy Hospital in Kansas City, Missouri.

High moisture levels and dust or other allergens cause poor indoor air quality, Kennedy says. Weatherizing a home or making other energy-efficiency upgrades can help.

Making those improvements can even reduce the number of visits a patient needs to make to the doctor or emergency department – or the amount of medication that asthma patients must take to manage their condition.

Children’s Mercy Hospital’s Healthy Homes Program performs environmental health assessments in people’s homes. Staff members then make recommendations for addressing health hazards.

Yale Climate Connections spoke to Kennedy about how energy-efficiency upgrades and weatherization programs can lead to positive health outcomes.

This interview has been lightly edited and condensed for clarity.

Yale Climate Connections: How does improving the environmental conditions of a home affect the health of patients suffering from respiratory diseases?

Kevin Kennedy: When you are able to assess the environment and identify specific types of environmental conditions and then make changes to improve the indoor environment, then you see a reduction in [healthcare] utilization. And that translates into dollars, because they’re not going to the hospital, they’re not having to go to the emergency department.

Families have contacted us to tell us that they’ve just seen a dramatic change in how often their child needs asthma medicines, how much better they feel. They’re able to play sports again.

YCC: What services do you offer through the Children’s Mercy Environmental Health Program?

Kennedy: When we go into the home of a client, one person focuses on health education and talking to the family about general behaviors and how they manage their home, cleaning activities, maintenance. And a second person is looking more specifically at the building, the systems that support the building, the contents of the rooms and of all the different aspects of how that building is designed, built, operated, and maintained.

Listen: Living in energy-efficient homes can improve people’s health


  1. Larry Carlson

    “Lambert underwent a big project to boost the energy efficiency of his 100+ year old house in Maine.”

    If you have the time, it might be interesting to see what this entailed. I’m considering something similar, and it looks like the key items would be:
    1) Attic sealing and insulation
    2) 4” foam insulation under siding and window replacement
    3) Basement insulation (inside walls – outside walls and under slab is better, but not practical for a retrofit)
    4) Given the tighter building envelope, an air exchanger might be needed

    1. drumlin woodchuckles

      I also think a detailed description of every step taken might be valuable for the readers and worth an article in and of itself . . . . if Lambert decides to do so.

    2. Lambert Strether

      > what this entailed

      Parts of the house are 100 years old; others are from the 40s (I think). The house is quite large.

      The project took several years.

      1) Fill in the attic, first.

      2) Insulated windows (eliminating the rattling wood frames)

      3) I did a lot of sealing around doors, interior and exterior (stuff I could buy at the hardware store). I also created a routine of covering the windows with plastic wrap in the winter (even the insulated ones). I also piled garbage bags of raked leaves around the exposed part of the basement walls. Both these last measures were really helpful, both for the perception of heat and drafts.

      After a pause I found another vendor who started by doing a blower door test; the house still pinned the meter (!);

      4) On top of the attic fill, pink stuff (nothing on the roof because we want the attic cool).

      5) Basement and large crawlspace foamed (can’t say it was 4″ but I whatever the standard was, it was that). Plastic on the floor of the crawlspace.

      The house is not tight enough to require an air exchanger, but it did pass the blower door test.

      In addition, since one object was to save on fuel, I installed a new (and efficient) natural gas furnace to replace a monstrous old oil burner.

      It was quite a project!

      1. drumlin woodchuckles

        Bags of fall leaves! . . .

        When my youngest brother and his fiance’ at the time lived in a trailer on a rancher’s property east of Aurora , Colorado; the rancher was kind enough to stack a whole bunch of hay bales up against the windward side of the trailer over the winter, lending quite a bit of insulation right there.

      2. Daveb

        We had extra atic insulation blown in. I chose cellulose as it creates more of an air barrier than fibreglass.
        Tightening up air leakage can make a huge difference to heating and comfort. As noted below it does risk the interior air quality. One doesn’t want it too tight without air exchange tech.

        1. drumlin woodchuckles

          The more on-site renewable energy one can harvest to heat the house with, the less tight the house has to be.

          Or am I wrong?

  2. Cristobal

    As an old house nut I would discourage window replacement. Rehabilitate the old wooden sash (strip if requiered). Rehang and fit with weatherstrip. Install storm windows. Energy effeciency can be achieved without destroying the character of the house. You’ll be glad you did.

    1. Adam1

      I’d say this article is bordering on misleading because air exchange is not a “might be needed”. Given your list of energy improvement tasks it would be critical to include it.

      ALL BUILDINGS need to be properly ventilated. Without sufficient ventilation you’ll risk a buildup of mold supporting moisture and other environmental contaminates that you’ll have to live with and breath. In the old days construction practices kept the typical weather elements out (rain & snow), but were leaky enough that the buildings usually vented themselves quite well, including letting heat (or cooling) escape.

      If you REALLY tighten up a home you need to add mechanical ventilation or you will be creating an environmental nightmare for yourself. I state this because even if you hire a company to do the work there are far too many out there that know how to make a building/rehab really tight and energy efficient structures, but are not necessarily skilled or knowledgeable about the importance of ventilation. And given it’ll likely take years for the worst building environmental issues to become so overwhelming and for anyone to connect the dots to bad health it’s produced an environment where bad/poorly equipped companies just keep on going.

      My boss lives in a home built within the last 10 or so years and she’s complained year in and year out about her family being cursed with illness. When I asked her if the home has a home ventilation system she had no idea. I’ve told her she need to have the home evaluated because if there was insufficient ventilation occurring it could be the cause of her families recurring health issues. That was right before covid so unfortunately I’m not sure she got one done.

      1. pete

        These were my thoughts as well. It can be especially bad when people break things like florescent lights.

        Also this seems to be a health benefit only to people who are really sensitive to outside issues. For normal people I don’t see a real health risk to outside exposure.

      2. drumlin woodchuckles

        The good thing is that such technology exists and is by now a mature technology in Scandinavia and Hokkaido.

        Here is a bunch of images that ” air to air heat exchange” called up. Some are relevant. Some may have interesting URLs for url diving.;_ylt=A0geK9fGCLZi7SYAt4FXNyoA;_ylc=X1MDMjc2NjY3OQRfcgMyBGZyA3NmcARmcjIDc2ItdG9wBGdwcmlkA0xvN2c0UG40UVJPbldtNk8xdGp3d0EEbl9yc2x0AzAEbl9zdWdnAzEEb3JpZ2luA3NlYXJjaC55YWhvby5jb20EcG9zAzAEcHFzdHIDBHBxc3RybAMwBHFzdHJsAzQxBHF1ZXJ5A2hvdXNlaG9sZCUyMGFpciUyMHRvJTIwYWlyJTIwaGVhdCUyMGV4Y2hhbmdlciUyMGltYWdlBHRfc3RtcAMxNjU2MDk2OTc4?p=household+air+to+air+heat+exchanger+image&fr2=sb-top&fr=sfp

  3. Lexx

    When we put solar panels up on our roof, folks stopped to talk to us about them, and mused how they might improve their own energy efficiency. We told every one of them, ‘first, get an energy audit… and follow every one of their suggestions.’ An audit here is or was free. Let them test the airflow and tell you where your house is leaking heat, then plug the holes as time and money allow.

    It was a comprehensive list of suggestions; it took us a few years* to complete it.


    1. Louis Fyne

      many utilities offer free, or very discounted, energy audits as part of their energy efficiency programs.

      tend not to be well advertised, and buried in their website

    1. drumlin woodchuckles

      And there may still be a multi-year window before the Lords of Utility think of buying laws persecuting self-contained deep battery 12-volt DC systems from off of peoples’ own personal roofs. And if one finds one is creating more power than one “needs”, one can do things like setting up a very big basement chest freezer to deep-freeze hundreds of chill packs for keeping a fridge cool with, for example. Or enclosed “space heatering” a thousand pound pile of rocks in the basement for yielding heat for the house with. Or etc.

      Power not bought from the utility equals coal, gas and oil not bought by the utility from the Lords of Fossil.

      1. tomk

        In a 70’s era solar home near me they tried to store and distribute heat with a basement rock pile.. You need to make sure they’re really clean and dry to avoid real unpleasantness. My sense is that water storage is easier.

    2. juno mas

      Please, Mamma, don’t let your readers be Cowboys!

      Anthing electrical, even 12V systems, can create heat or sparks that start fires, if not properly fused. Do Not Do It Without Professional Supervision. It doesn’t take a genius to be a licensed electrician, but if you don’t want your car or home to spontaneously ignite one day, use one to do electrical work.

      The problem with using 12v DC power in the home is the wiring needs to be of a wire gauge large enough to cover longer distance than anticipated in a automobile/van. And the wire coating needs to be protected from impacts and corrosion.

      If you want to use solar power in a stand-alone battery bank system it’s better to wire the solar panels (12v) in series to get 24v or 36v power output. The higher voltage output can be run longer distances in smaller gauge wire. A battery bank can similarly be arranged to match this voltage. Then buy a sine wave inverter that takes the battery power and converts (90% eff.) to conventional alternate current (110v AC). Then use standard appliances that are UL approved.

      Since we’re talking about homes, here’s my version:

  4. converger

    This interview is misleading.

    If your house is warmer and dryer, moisture is less likely to accumulate inside and on your walls, so less mold. This is true. But it is disingenuous to say that and just call it a day. It’s not that simple.

    When your house is leaking heat or cold, it is also moving fresh air through the house. When you reduce ventilation, toxics in building materials and virus loads go way up, oxygen levels go down. This is very bad, partly because most houses built in the last 50 years have lots of toxics in their building materials, partly COVID. A Corsi box might help mitigate virus and particulate loads, but does little to fix toxics in building materials.

    We’ve gotten really good at making buildings tight. We remain really, really bad at building healthy houses and office buildings that get enough fresh air or pay attention to toxic offgassing. I can show you studies about the glory of mechanical technical fixes. The reality is that very few architects, engineers, builders, or regulators prioritize getting healthy indoor air right, let alone Jackpot ready.

    Speaking as someone who has spent a considerable part of their professional career pushing hard on more energy efficiency in buildings, I’ve become less convinced that fixating on energy efficiency while ignoring ventilation was ever the right answer.

    1. drumlin woodchuckles

      Do you have any thoughts or information to offer on air-to-air heat exchangers for super-tight houses so that air may again flow while preserving some of the indoor-climate-control energy efficiency?

      1. converger

        Air to air heat exchangers are the standard technological fix. They work OK. They’ve been around for a long time. I think there’s definitely a place for them in climate zones that tend to run really hot and/or really cold. Like superinsulation and ultra-tight sealing, I think they are silly in places with low heating and/or cooling loads where opening a couple of well-placed windows is usually the superior choice.

        One problem I have with any solution that requires a 100% reliable mechanical solution to make a building livable: you really want where you live to be OK with or without an always-on technology fix.

        Three other, related issues with the cookie cutter active air to air heat exchangers that are probably going to get installed if you go this route (in many places, you don’t get a choice): not enough air exchange to mitigate problems, not enough attention paid to building material toxics, and not an even enough ventilation flow through the house to make sure that everywhere gets enough fresh air.

        All of these are fixable, if designers and builders and code officials are paying attention. They rarely are. Think about the office buildings and stores you go to that just don’t feel very good to be in. Think about the pervasive, gaping under-ventilation issues that COVID has revealed. That’s the problem. When we were just focused on saving energy, we weren’t paying nearly enough attention to healthy indoor habitat.

        1. drumlin woodchuckles

          I wonder if there is ( or could be) any such thing as a non-power-driven air-to-air heat exchanger, at least for winter in cold climates.

          If between very intelligent passive design or retrofitting to begin with combined with renewable-energy-driven supplemental heating, would it be possible to heat the air inside the house enough to where it would fight to escape? And have it pass through a cross-current air-to-air heat exchange type system which would suck in cold outside air just as fast as the hot inside air fights to rise out of the house? And the incoming cold air, pulled in by the suction of the hot air rising out, could take some of the outgoing hot air’s heat back into itself as it comes in?

          I bet Steve Baer could design such a thing.

  5. scott s.

    Yet there is a push to higher density housing. It would seem that high density just makes it more difficult to achieve some of these indoor air quality measures.

  6. ghiggler

    I’m more worried about air quality than air temperature.

    We tend to leave windows open, and wear more or less accordingly. That said, our house is pretty tight, but not to today’s highest standards – I made sure of that.

    Furnace goes on when average daytime temperature is around 60 or less. Big south-facing window helps here as it lets the low winter sun deep into the house; so do roasting, stewing and baking. There’s a roof vent air intake next to the furnace which I feel gives adequate air exchange in the winter.

    Air conditioning goes on when daytime highs are above 80 for over 6 hours. Summer is for grilling outside and salad from the garden. This is when the house is tightest, but the windows will generally be open at night, both for air exchange and cooling.

    If and when the furnace dies, I’ll go the heat pump route with regenerative heating and cooling to maintain air exchange.

    Obviously, if allergens from outside are an issue, this won’t work for you and the energy-efficiency for health trope will. But maintain air exchange anyway – just filter it well and make sure it includes regenerative heating and cooling – the heat transfer between incoming and outgoing air that BillS refers to.

  7. Taurus

    I see people feel strongly about ventilation and this is good.

    You also have to realize that retrofitting a 100-year old house in Maine to not leak air is not the same as new-build all-closed cell insulation house in 2022. The struggle there is to simply limit the rate of air-exchange, not to make the place air-tight.

    I have worked on and off for about 10 years on a 1890 vintage house in New Hampshire and speak from experience on this. We managed to cut fuel consumption to 25% of what it was when we moved in. This includes various kinds of insulation, window replacement on parts of it and upgrading the boiler. There is still more I can do but old age sneaks up on you.

    After all this work and all this labor and expense, I have to tell you that my house will never be the house that gets heated because my dog is chasing a ball around the kitchen :)

    Rule of thumb: insulation is the best energy efficiency investment you can make in an old house – dollar for dollar.

    1. juno mas

      Well, the first best energy efficiency investment is reducing air infiltration/exfiltration. But that takes lotsa time and effort, so most folks go first with insulation. Then slowly work on the infil/exfil (doors, windows, foundation sill plates, building wrap, etc.).

  8. Brooklin Bridge

    If I had the money and time (and the town wasn’t raising my property taxes every year to un-afordable rates), the first thing I would do is get a HERS rater (or someone with equivalent knowledge and equipment) to come over with the blower door equipment and anything else they are currently using such as infrared imagery. I would want a rater with both extensive building experience (as in construction and repair) and 10 years or so in the field of energy conservation and specifically the analysis of older homes. I would be less interested in the actual rating (something banks and insurance companies are focused on) than in the advice of the rater as to where to start out for the biggest bang for my buck and then what to do and then what and so on. Such an individual would pick up on such seemingly little things as a thermostat near a heat source such as a fire place or wood burning stove and would prioritize them into a schedule I could follow with an eye to always getting the greatest reduction in heat/cool loss for the least money and with ventilation and other such concerns being part of the overall solution.

    The only problem with this specific tack – particularly for me, a privacy nut – is that HERS raters, while using much of their equipment and software responsible for a good deal of the analysis, also record the information in a central database or at least that was the state of affairs when I took the HERS rating course. They maintain that they keep the data secure, but as they are closely related to banks and insurance companies, I’m skeptical.

    Other than that, the advantage of such an individual is the experience and ability to address a complex problem with many different parts that is very similar, but also just different enough in each case -old homes particularly- to warrant such an analysis. It’s hard to imagine all the little “gotchas” that can baffle an otherwise effective effort at reducing energy loss.

    1. drumlin woodchuckles

      I am just an old analog refugee in this new digital world. I would assume that people who go into a non-glamorous field like HERS rating are probably basically honest people. So I would assume that they and maybe even their central database sincerely try to keep data private and sincerely think that they do.

      One thing I have learned from reading NaCap down the years ( as well as hearing news of hack after hack after hack as well as the field of data brokering ) is that . . . . if it is digital, it is not private. No amount of encryption or law or anything else is going to change that. If you are “digital”, you have put yourself in the Global Goldfish Bowl under the Global Microscope. Too bad, so sad. Live with it. I know if I ever get a HERS audit done, I will have to just live with it. Same as I have to live with the fact of zero privacy for every other digital thing that I do.

      If you want to keep any part of your life private, keep it analog. That’s my purely tinfoil advice.

      1. Brooklin Bridge

        It’s the software that stores the results of the test(s) in a central repository. The HERS raters (providers) themselves have nothing to do with that process other than entering the data.

        HERS is owned and run (standards set) by RESNET (Residential Energy Services Network) and I don’t have good info on the make up but I’m sure it is closely related to the mortgage industry.

        As to the raters or providers themselves (who are HERS members), from the instructor I had (a Maine builder of long experience and a real belief and skill in tightening up older houses) I got the impression that the industry has moved on from idealistic home builders trouble shooting energy leaks to business types, generally very competent, where the focus on profitability is principal from the start or dominates as time goes by.

  9. Clark Landwehr

    Increasing energy efficiency causes an INCREASE in energy consumption and carbon emissions. This is the history of energy conversion for thousands of years. Wood-burning antiquity (5% efficiency) consumed far less energy than our civilization with its 70% efficient gas turbines.

  10. AlexisS

    Ditto on the anti-tight-house side…

    Bad air is worse than putting on another sweater.

    Old houses, especially 100 or 200+ years old, have building systems that were meant to breathe. Besides bad air, you can cause a lot of rot by making it too tight. Sometimes I see people spray insulation in their attics (in my historic town) and I wanna throw up. Yeah they’re gonna have a nice tight space and they’re gonna be warmer for a few years, maybe 10 maybe 20, and then the roof is going to leak (because roofs always leak eventually) and they won’t have any way to know where the leak is, because everything is covered, and the foam is going to hold moisture against the 200 year old wood, and it’s going to rot out.

    So the embodied energy of the 200 year old piece of wood is just down the tubes, and there’s nothing like it anymore. There’s no wood that will last 200 years now, most of it won’t even last 20.

    Especially heinous are replacement windows. Double glazed windows are only about 2% more efficient than a single glazed window plus a storm window. And the single glazed window is a totally modular system. You break one of the panes of glass, you replace it. But double or even triple glazed windows are a complete joke, a scam. They might last 20 years, if you’re lucky (but look at how long the warrantees are). As soon as the seal between the layers of glass fails, you’re left with the insulating value of a single glazed window. And you can’t replace part of it, you have to rip out the whole thing, the frame and everything, and start all over again.

    Can anybody really try to tell me that that’s more efficient than keeping and repairing what you already have? The concept of “embodied energy” is really important here. The most energy efficient house is the one that already exists. You have to think of the whole process, what does it take to build, what does it take to destroy. What gets recycled? What goes to landfill?

    I’m not saying that there’s nothing that can be done to make old houses warmer and use less heating oil, but it’s really important to consider what’s there, why it’s there, and what are going to be the results of changing it. A historic preservation carpenter of my acquaintance did a little study. He redid several windows, insulating around one of them, and that’s the one that was rotted out five years later.

Comments are closed.