Understanding the contextual influences of the health outcomes of residential energy efficiency interventions: realist review

Abstract

Residential energy efficiency interventions are complex social and construction programmes that may benefit health, yet the interactions between the material improvements, health and health-related outcomes, and householder responses are not well understood. While indoor winter warmth and householder satisfaction have been identified as the key mediators for physiological, mental and social health outcomes, this paper explores how programme contexts may have influenced the outcomes. This review revealed that common target populations were low income households, children and the elderly. The review found that people’s expectations and culturally constructed heating practices influenced indoor temperatures and householder satisfaction. Very deprived households were still affected by financial constraints despite the intervention measures. Excessive ventilation and limited technical mastery counteracted the beneficial effects of the intervention measures. Poor workmanship and ineffective handover undermined energy consumption objectives and led to householder dissatisfaction. Effective intervention design should address householder needs and the programme’s sociocultural context.