ABSTRACT

OBJECTIVE

To evaluate the “ Energía, la justa ” program, aimed at reducing energy poverty in the city of Barcelona, from the point of view of the target population and the workers involved in the intervention.

METHODS

A qualitative, descriptive and exploratory pilot study was carried out, with a phenomenological approach. Twelve semi-structured interviews were conducted: to three users, three energy agents who performed interventions in the homes, and six professionals who participated in the program coordination. A thematic content analysis was carried out using Atlas-ti software . Interviews were conducted between October 2016 and March 2017.

RESULTS

Trust in a contact person (e.g. social workers) facilitated the participation, although there were difficulties reaching people who had illegal energy supplies, immigrant women or immigrants who subrent properties. Regarding implementation, home visits, energy efficiency advice and the relationship with energy agents were the best assessed aspects. However, not being able to carry out reforms in deteriorated dwellings was considered a limitation. The program also contributed to raise awareness on energy rights, to save on utility bills and to generate tranquility and social support.

CONCLUSIONS

Programs such as this one can promote energy empowerment and improve psychosocial status. However, strategies with a gender and equity perspective should be considered to reach other vulnerable groups.

Energy Supply, policies; Social Inequity; Qualitative Research

INTRODUCTION

Energy poverty (EP) has been defined as not being able to pay for energy services to satisfy essential domestic needs or to allocate an excessive part of the income for the payment of energy bills¹1. Tirado Herrero S, Jiménez Meneses L, López Fernández J, Perrero Van Hove E, Irigoyen Hidalgo V, Savary P. Pobreza, vulnerabilidad y desigualdad energética: nuevos enfoques de análisis. Madrid (ES): Asociación de Ciencias Ambientales; 2016 [cited 2018 Jan 8]. Available from: https://www.ecestaticos.com/file/45aae51d7181a4dd96418a571b2e71ec/1496831519-estudio-pobreza-energetica_aca_2016.pdf
https://www.ecestaticos.com/file/45aae51... , ²2. García Paris M, Mundó J. La pobresa energetica a Catalunya: situació actual i propostes d’acció. Barcelona (ES):Ecoserveis; 2013 [cited 2018 Jan 8]. (Dossiers del Tercer Sector; N. 23). Available from: http://www.ecoserveis.net/wp-content/uploads/Dossier-Pobresa-energetica-Catalunya.pdf
http://www.ecoserveis.net/wp-content/upl... . This situation is associated with a type of residential exclusion characterized by legal and economic problems³3. Marí-Dell’Olmo M, Novoa AM, Camprubí L, Peralta A, Vásquez-Vera H, Bosch J, et al. Housing policies and health inequalities. Int J Health Serv. 2017;47(2):207-32. https://doi.org/10.1177/0020731416684292
https://doi.org/10.1177/0020731416684292... . The intermediate determinants of EP are low household income, high prices of energy services and low energy efficiency of homes, all of which are conditioned, in turn, by structural factors such as socio-environmental policies³3. Marí-Dell’Olmo M, Novoa AM, Camprubí L, Peralta A, Vásquez-Vera H, Bosch J, et al. Housing policies and health inequalities. Int J Health Serv. 2017;47(2):207-32. https://doi.org/10.1177/0020731416684292
https://doi.org/10.1177/0020731416684292... , ⁴4. Departament of Energy & Climate Change (UK). Annual fuel poverty statistics report: 2015. London: DECC; 2017 [cited 2018 Jan 8]. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/468011/Fuel_Poverty_Report_2015.pdf
https://assets.publishing.service.gov.uk... .

Scientific literature has shown that EP can have health consequences, such as circulatory diseases, respiratory problems, as well as anxiety and depression⁵5. Marmot Review Team. The health impacts of cold homes and fuel poverty. London: Friends of the Earth; the Marmot Review Team; 2011 [cited 2014 Mar 13]. Available from: https://friendsoftheearth.uk/sites/default/files/downloads/cold_homes_health.pdf
https://friendsoftheearth.uk/sites/defau... . There is also an association between living with EP and the excess of winter mortality directly related to macroeconomic indicators⁶6. Fowler T, Southgate RJ, Waite T, Harrell R, Kovats S, Bone A, et al. Excess winter deaths in Europe: a multi-country descriptive analysis. Eur J Public Health. 2015;25(2):339-45. https://doi.org/10.1093/eurpub/cku073
https://doi.org/10.1093/eurpub/cku073... . In fact, cold-related mortality is greater in regions with Mediterranean climatic conditions, which have poorer economic indicators than regions of central and northern Europe, with colder climates⁷7. Peralta A, Camprubí L, Rodríguez-Sanz M, Basagaña X, Borrell C, Marí-Dell’Olmo M. Impact of energy efficiency interventions in public housing buildings on cold-related mortality: a case-crossover analysis. Int J Epidemiol. 2017;46(4):1192-201. https://doi.org/10.1093/ije/dyw335
https://doi.org/10.1093/ije/dyw335... , ⁸8. Bouzarovski S. Energy poverty in the European Union: landscapes of vulnerability. Wiley Interdiscip Rev Energy Environ. 2013;3(3):276-89. https://doi.org/10.1002/wene.89
https://doi.org/10.1002/wene.89... .

Between 2008 and 2014, Spain was the second country, after Greece, with the highest increase in the price of electricity in the European Union, which coincided with a period of strong economic recession in which unemployment increased and wages decreased¹1. Tirado Herrero S, Jiménez Meneses L, López Fernández J, Perrero Van Hove E, Irigoyen Hidalgo V, Savary P. Pobreza, vulnerabilidad y desigualdad energética: nuevos enfoques de análisis. Madrid (ES): Asociación de Ciencias Ambientales; 2016 [cited 2018 Jan 8]. Available from: https://www.ecestaticos.com/file/45aae51d7181a4dd96418a571b2e71ec/1496831519-estudio-pobreza-energetica_aca_2016.pdf
https://www.ecestaticos.com/file/45aae51... . In 2014, it was estimated that 11% of households, that is, around 5.1 million people, were unable to maintain their homes at an adequate temperature in the cold months¹1. Tirado Herrero S, Jiménez Meneses L, López Fernández J, Perrero Van Hove E, Irigoyen Hidalgo V, Savary P. Pobreza, vulnerabilidad y desigualdad energética: nuevos enfoques de análisis. Madrid (ES): Asociación de Ciencias Ambientales; 2016 [cited 2018 Jan 8]. Available from: https://www.ecestaticos.com/file/45aae51d7181a4dd96418a571b2e71ec/1496831519-estudio-pobreza-energetica_aca_2016.pdf
https://www.ecestaticos.com/file/45aae51... . The population most affected by EP comes from low-income households with some unemployed members⁹9. Tirado Herrero S, Jiménez Meneses L. Energy poverty, crisis and austerity in Spain. People Place Policy. 2016;10(1):42-56. https://doi.org/10.3351/ppp.0010.0001.0004
https://doi.org/10.3351/ppp.0010.0001.00... . Likewise, the EP has been associated with single-parent, retired families and women who are engaged in domestic tasks¹⁰10. Gonzalez Pijuan I. Desigualdad de género y pobreza energética: un factor de riesgo olvidado. Barcelona (ES): Ingeniería Sin Fronteras; 2017 [cited 2018 Jan 8]. (Esferas Estudios; 17). Available from: https://esf-cat.org/wp-content/uploads/2017/09/ESFeres17-PobrezaEnergeticaiDesigualdadGenero.pdf
https://esf-cat.org/wp-content/uploads/2... , ¹¹11. Sanz Fernández A, Gómez Muñoz G, Sánchez-Guevara Sánchez C, Núñez Peiró M. Estudio técnico sobre pobreza energética en la ciudad de Madrid. Madrid (ES): Ayuntamiento de Madrid; 2017 [cited 2018 Jan 8]. Available from: https://www.madrid.es/UnidadesDescentralizadas/Consumo/NuevaWeb/pobreza%20energ%C3%A9tica/Estudio%20Pobreza%20energ%C3%A9tica%204%20febrero%202017.pdf
https://www.madrid.es/UnidadesDescentral... .

Interventions carried out in other countries aimed at increasing energy efficiency in homes have been shown to improve thermal comfort, increase savings and, at the indirect benefits level, create a greater sense of security and well-being¹²12. Hernández D, Phillips D. Benefit or burden? Perceptions of energy efficiency efforts among low-income housing residents in New York City. Energy Res Soc Sci. 2015;8:52-9. https://doi.org/10.1016/j.erss.2015.04.010
https://doi.org/10.1016/j.erss.2015.04.0... . Likewise, it has been observed that carrying out reforms at the architectural level can significantly reduce winter mortality⁷7. Peralta A, Camprubí L, Rodríguez-Sanz M, Basagaña X, Borrell C, Marí-Dell’Olmo M. Impact of energy efficiency interventions in public housing buildings on cold-related mortality: a case-crossover analysis. Int J Epidemiol. 2017;46(4):1192-201. https://doi.org/10.1093/ije/dyw335
https://doi.org/10.1093/ije/dyw335... . However, evaluations of interventions on energy poverty are scarce. Therefore, the objective of this study was to know the valuations of an intervention aimed at reducing EP, incorporating both the perspective of the target persons and the workers involved in the program.

METHODS

A qualitative, descriptive and exploratory pilot study was conducted from a phenomenological perspective¹³13. Wojnar DM, Swanson KM. Phenomenology: an exploration. J Holist Nurs. 2007;25(3):172-80. https://doi.org/10.1177/0898010106295172
https://doi.org/10.1177/0898010106295172... . This research is part of the evaluation of the “Energía, la justa” program, promoted by the Barcelona City Council during the first semester of 2016¹⁴14. Ayuntamiento de Barcelona. Memòria d’actuació: energia, la justa. Barcelona (ES); 2016. . This program aimed to reduce EP in vulnerable populations through intervention in three areas. First, promoting energy efficiency habits to achieve savings; second, optimizing energy services such as discounting invoices through the processing of the social bonus; and third, installing micro-efficiency measures such as energy-saving light bulbs. On the other hand, the program included an employment insertion for long-term unemployed people, who were offered training to be “energy agents” (EA) and perform the intervention in the homes. The pilot study was conducted between October 2016 and March 2017.

The qualitative evaluation was carried out through 12 semi-structured interviews with eight women and four men. The sample consisted of the following key agents: three people who were the recipients of the program, three EA and six people who worked on the coordination of the program, including a territory technique that carried out tasks of liaison between territorial agents, besides selecting the EA; a technical coordinator, responsible for training and advising the EAs; a program coordinator, responsible for the entities of the territory; and three social service social workers, who made contact with the candidate families to participate.

A script of interviews was designed based on the assessment of the key agents on the implementation and coordination of the program, the implementation and impact of the intervention ( Box 1 ). The selection of the interviewees was carried out through a theoretical sampling, stratified by subgroups. The study was approved by the ethical committee of the Hospital del Mar in Barcelona (code 2017/7286/I) and all informants signed an informed consent form.

The interviews were recorded on audio and, once transcribed, a thematic content analysis was carried out using Atlas-ti software. The most relevant areas were identified according to the perspective of the key agents. Once the categories were identified, they were examined through a comparison process with the rest of the data¹⁵15. Mays N, Pope C. Qualitative research in health care: assessing quality in qualitative research. BMJ. 2000;320(7226):50-2. https://doi.org/10.1136/bmj.320.7226.50
https://doi.org/10.1136/bmj.320.7226.50... . The saturation of the discourse was used as closure criterion. The results were triangulated by different investigators who participated in the study.

RESULTS

The results are presented according to the perspective of the different key agents.

Trust in the Initial Contact person and Distrust in Showing Housing Conditions

Regarding the implementation and coordination of the intervention ( Box 2 ), the recipients saw as positive that the initial contact came from the social worker, considered trustworthy. The clarity of the information received by the EA was assessed, as well as the good treatment and the willingness to collaborate in case of any problem or urgency. In fact, the link created with the EA was a facilitator for the program to be carried out.

According to the AE, despite not always having the necessary materials to do the intervention generated frustration. On the other hand, among the contact barriers, there were people who distrusted the program, either because they had bad previous experiences with the energy companies or because they obtained the energy supplies illegally. In the immigrant population, there were cases with language barriers, such as women who did not speak Spanish and who, in addition, depended on the husband’s consent to participate. It was also commented that a part of the population was afraid to participate, especially immigrants who sublet rooms.

According to the coordinators and the EAs, motivation and involvement were key factors, since, although sometimes they had to improvise, the conviction on the part of the agents facilitated their development. They also commented that the program did not manage to contact people who obtained their energy supplies illegally or had no connection with the social services of the neighborhood. On the other hand, it was pointed out that there was a clear gender inequality in the selection of the EA staff, with a male predominance associated with the construction profile of the workforce.

Empathy as a Facilitating Factor and Structural Problems as a Barrier

Regarding the implementation of the intervention ( Box 3 ), the following of the EAs in the procedures for tariff optimization, home visits and the installation of materials were very well-assessed by the recipients. Training in energy efficiency was also assessed, although one informant commented that they already knew these tips and that the EAs lacked training.

According to the EA, actions that favored saving and improvements in housing were implemented. However, in the floors with structural problems, as in the case of air leaks through windows or doors, the program could not obtain improvements due to not having the necessary resources to carry out reforms. The program was considered to be too short, and interventions were not completed. In addition, the lack of time limited the follow up.

According to the coordinators, the home visits served to detect populations with significant personal and economic problems. Considering that the intervention was free and that the changes in the home were optional facilitated its implementation. On the other hand, the fact that the EAs had experienced EP situations facilitated the development of empathy and involvement in the intervention. Both the coordinators and the EAs identified the procedures that had to be carried out to change the tariffs with the energy companies as an obstacle, considered too bureaucratic and delaying the management.

Empowerment, Savings and Well-being

Regarding the impact of the intervention ( Box 4 ), the recipients commented that the possibility of saving generated a greater sense of tranquility and well-being. They also pointed out that receiving advice was seen as a learning tool, since they managed to change habits and make better use of household appliances. However, some people indicated that they did not believe that the intervention would improve thermal comfort or health status.

Both from the perspective of the EAs and the coordinators, it was commented that the intervention fostered knowledge about more efficient energy consumption. This was seen as an empowerment strategy, especially for the youngest ones. According to the EA, making sure there would be no supply cuts reduced the concern and increased welfare. On the other hand, contacts with some people were beneficial from the social support point of view, especially in cases with few support networks.

According to the coordinators, the training of the recipients contributed to saving and to experiencing a greater sense of comfort thanks to having, for example, the light on for a longer time. Also, the program had a possible impact on aspects of mental health such as stress, as well as on respiratory diseases. However, the impact was low when housing conditions were extremely deficient. In addition, due to the same circumstances of economic restriction of some families, the development of strategies to save on energy consumption was carried out in some cases before the intervention.

DISCUSSION

The main results of the study indicate that changes in the rates of energy supplies, receiving advice on energy efficiency, as well as carrying out the intervention within the homes were highly valued aspects. On the one hand, the program allowed some recipients to reduce their financial expenses, resulting in more tranquility. On the other hand, the fact of carrying out actions in situ allowed to know more about people’s life conditions and establish a closer relationship with them.

Regarding its implementation, the people who participated in the program assessed it as a positive municipal initiative and the professional contact as trustworthy. However, the program did not reach some of the most vulnerable populations. On the one hand, those people who were in a legal limbo with the energy companies showed greater distrust to perform any type of intervention in their homes. However, certain groups of immigrants sublet the housing, an illegality situation that generated greater resistance to participate. This social phenomenon, more frequent for immigrants than for Spaniards, shows social inequality related to the job insecurity, the difficulty of signing contracts with homeowners and the existence of a high-priced housing market with high rent prices¹⁶16. Colom Andrés MC, Molés Machí MC. Homeownership and living conditions of the immigrant population in Spain: differences and similarities among immigrant groups. Hous Theory Soc. 2017;34(4):477-504. https://doi.org/10.1080/14036096.2016.1268201
https://doi.org/10.1080/14036096.2016.12... . In addition, a sociocultural pattern related to gender inequalities was observed as immigrant women have fewer opportunities to learn the language of the country of destination and are more exposed to social problems¹⁷17. Viruell-Fuentes EA, Miranda PY, Abdulrahim S. More than culture: structural racism, intersectionality theory, and immigrant health. Soc Sci Med. 2012;75(12):2099-106. https://doi.org/10.1016/j.socscimed.2011.12.037
https://doi.org/10.1016/j.socscimed.2011... . This situation placed them at a greater disadvantage to understand and participate in this program, highlighting the importance of developing effective strategies to contact socially excluded and difficult-to-reach sub-populations, especially considering the feminization of the EP¹⁰10. Gonzalez Pijuan I. Desigualdad de género y pobreza energética: un factor de riesgo olvidado. Barcelona (ES): Ingeniería Sin Fronteras; 2017 [cited 2018 Jan 8]. (Esferas Estudios; 17). Available from: https://esf-cat.org/wp-content/uploads/2017/09/ESFeres17-PobrezaEnergeticaiDesigualdadGenero.pdf
https://esf-cat.org/wp-content/uploads/2... .

Regarding the implementation of the program, there was a good perception of the follow up made by the EAs to make the changes in the type of rate hired, which is especially relevant if one considers that one of the barriers was the bureaucratic procedures with the energy companies. In this sense, it has been observed that electricity and gas bills are seen as those that provide less information and less clear regarding the prices of their services, the conditions of supply and the type of contract¹1. Tirado Herrero S, Jiménez Meneses L, López Fernández J, Perrero Van Hove E, Irigoyen Hidalgo V, Savary P. Pobreza, vulnerabilidad y desigualdad energética: nuevos enfoques de análisis. Madrid (ES): Asociación de Ciencias Ambientales; 2016 [cited 2018 Jan 8]. Available from: https://www.ecestaticos.com/file/45aae51d7181a4dd96418a571b2e71ec/1496831519-estudio-pobreza-energetica_aca_2016.pdf
https://www.ecestaticos.com/file/45aae51... . In addition, the lack of understanding about what is paid in an energy bill contributes to the figure of the “vulnerable consumer,” who sees limited ability to make decisions about the management of their economy²⁰20. Lorenc A, Pedro L, Badesha B, Dize C, Fernow I, Dias L. Tackling fuel poverty through facilitating energy tariff switching: a participatory action research study in vulnerable groups. Public Health. 2013;127(10):894-901. https://doi.org/10.1016/j.puhe.2013.07.004
https://doi.org/10.1016/j.puhe.2013.07.0... .

The fact that many of the EAs themselves had experienced EP facilitated the creation of a link with the target persons. In this way, the program not only provided energy support, but also offered social support to the extent that people noticed that an institution assessed as important was concerned about their living conditions. There is ample literature that shows the impact of having social support on people’s health, which translates into the need to understand energy vulnerability as a complex social system that should not only consider the energy field⁸8. Bouzarovski S. Energy poverty in the European Union: landscapes of vulnerability. Wiley Interdiscip Rev Energy Environ. 2013;3(3):276-89. https://doi.org/10.1002/wene.89
https://doi.org/10.1002/wene.89... , ²¹21. Kaplan B, Cassel J, Gore S. Social support and health. Med Care. 1977 [cited 2018 Jan 8];15(5 Suppl):47-58. Available from: www.jstor.org/stable/3763353
www.jstor.org/stable/3763353... , ²²22. Middlemiss L, Gillard R. Fuel poverty from the bottom-up: characterising household energy vulnerability through the lived experience of the fuel poor. Energy Res Soc Sci 2015;6:146-54. https://doi.org/10.1016/j.erss.2015.02.001
https://doi.org/10.1016/j.erss.2015.02.0... .

For the different key agents, the program had an economic impact and in the acquisition of knowledge about rights, which was considered a tool for the empowerment of the population. In general, the informants highlighted that saving contributed to the increase of well-being and less feelings of stress related to the non-payment of invoices. These results would be consistent with those found in another study, which showed that an intervention that improves energy efficiency in the home brings positive impact in the users, by experiencing fewer financial difficulties and by feeling healthier²³23. Grey CNB, Schmieder-Gaite T, Jiang S, Nascimento C, Poortinga W. Cold homes, fuel poverty and energy efficiency improvements: a longitudinal focus group approach. Indoor Built Environ. 2017;26(7):902-13. https://doi.org/10.1177/1420326X17703450
https://doi.org/10.1177/1420326X17703450... . However, in this program there were no improvements in people with very poor condition homes, since they required structural reforms. All this suggests the need to carry out actions that intervene on social and economic conditions to help alleviate the EP and its consequences.

Among the limitations of the study, it is noteworthy that we did not include a sample that could handle the experiences according to different characteristics of the target persons. However, having selected different agents allowed to provide a global vision of the program. In addition, this pilot study will lead to another qualitative evaluation that will allow us to analyze different types of people targeted by this intervention. Regarding the strengths, it should be noted that this is the first study at the Spanish state level that has made a qualitative assessment of different agents that have participated in a EP program. Thus, the results obtained will contribute to generate evidence on EP and health, an emerging and very relevant field in our context.

In conclusion, the impact of the program was observed in terms of energy efficiency, at the economic level, and also improvements in the psychosocial health. In addition, the program fostered energy empowerment by increasing knowledge and the capacity to act for energy rights. It is worth noting the complexity that surrounds the population that lives in a EP situation, considering both the social determinants of health and the different axes of inequality such as gender, cultural diversity, migratory status and social class, among others. For this reason, this type of programs should be developed within the framework of agreements that are continued over time and associated with structural social policies that affect the multiple factors taking part on housing problems.

REFERENCES

Publication Dates

History