Nearly half of US households couldn't reliably afford to heat, cool, or power their homes last year. For those who had to choose between paying for electricity and buying food or medicine, the mental health cost was steep: anxiety symptoms appeared in 39% of cases, depression in 32%. That's more than double the rate among households with stable energy access.
The connection emerged from analysis of Census Bureau data by researchers at Georgia Tech, published in JAMA Network Open. What makes this finding significant isn't just the numbers—it's what they reveal about a gap in how we understand household stability. We talk about food insecurity and housing insecurity as urgent public health issues. Energy insecurity barely registers in the conversation, even though it shapes whether you can safely heat your home, charge your medical devices, or sleep through the night without overheating.
"Being able to afford your home does not guarantee you can afford to safely heat, cool, or power it," says Michelle Graff, the assistant professor who led the research. The burden falls hardest on Black and Hispanic households, renters, and families dependent on electronic medical equipment—groups already navigating other forms of instability.
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The mechanism isn't mysterious. Living in inefficient housing means higher bills and temperature swings that disrupt sleep and trigger physical stress responses. Add the anxiety of potential utility shutoffs, the shame of choosing between medication and electricity, the constant mental math of which bill to delay—and you're not just uncomfortable. You're chronically stressed in ways that accumulate.
The study didn't prove that energy insecurity directly causes anxiety and depression, but the researchers are clear: these populations face compounding pressures. Each stressor amplifies the others. A broken window that drives up heating costs becomes a debt that becomes a sleepless night that becomes a missed dose of medication.
Graff is now pushing healthcare systems to screen for energy insecurity the way they screen for food insecurity—as routine information that informs treatment and connects patients to resources. She's also investigating how energy insecurity links to eviction rates and how state aid programs actually reach the households that need them most.
The broader implication is straightforward: energy access belongs in the same conversation as food and housing. It's not a luxury. It's the foundation that lets everything else—work, health, sleep, dignity—function.
