Addressing energy insecurity: Policy Considerations for enhancing energy assistance programs.

Household energy consumption is crucial for a productive and safe life. Despite its importance, 33.7 million U.S. households experienced energy insecurity in 2020. This paper examines the prevalence, correlates, and effects of energy bill assistance programs, which aim to alleviate the hardship. This analysis relies on logistic regressions and the 2020 Residential Energy Consumption Survey, a nationally representative survey administered by the Energy Information Administration. Results reveal 16 percent of the energy insecure population received assistance to pay its energy bill in 2020. Several socioeconomic and housing characteristics are associated with receipt of assistance; however, logistic regression estimates suggest prior participation in energy assistance and receipt of a disconnection notice from a utility provider are indicators substantively and significantly associated with energy assistance participation that warrant attention from scholars and practitioners. Lastly, outcomes generally indicate previous participation in energy assistance does not impact the odds a household will experience energy insecurity. Based on findings, I offer three policy recommendations: 1) increase resources spent on energy assistance to align with demand; 2) enhance communication between utility providers and low-income households regarding available assistance opportunities; and 3) prioritize engagement with populations that never participated in energy assistance to facilitate successful application processes.

Utility disconnection protections and the incidence of energy insecurity in the United States.

Energy insecurity-the inability to secure one's energy needs-impacts millions of Americans each year. A particularly severe instance of energy insecurity is when a utility disconnects a household from service, affecting its ability to refrigerate perishable food, purchase medicine, or maintain adequate temperatures. Governments can protect vulnerable populations from disconnections through policies, such as shutoff moratoria or seasonal protections that limit disconnections during extreme weather months. We take advantage of the temporary disconnection moratoria that states implemented during the COVID-19 pandemic to assess the efficacy of state protections on rates of disconnection, spending across other essential needs, and uptake of bill payment assistance. We find that protections reduce disconnections and the need for households to forgo other expenses. We further find that protections are most beneficial to people of color and households with young children. We conclude with a discussion of the policy implications for energy-insecure populations.

Behavioral and financial coping strategies among energy-insecure households.

When households struggle to pay their energy bills and avoid being disconnected from the grid, they may accrue debt, forgo expenses on food, and use space heaters or ovens to warm their homes. These coping strategies can introduce significant physical and financial risks. In this study, we analyze an original survey with a representative sample of low-income households during the first year of the COVID-19 pandemic, from June 2020 to May 2021. We evaluate the prevalence of a wide range of coping strategies and empirically estimate the determinants of these strategies. We find that more than half of all low-income households engage in at least one coping strategy, and many use multiple strategies. Households with vulnerable members, including young children or those who rely on electronic medical devices, and households that live in deficient housing conditions, are more likely to use a range of coping strategies, and many at once. Our findings have direct implications for public policy improvements, including modifications to the US Weatherization Assistance Program, the Low-Income Home Energy Assistance Program, and state utility disconnection protections.

Whole Exome Sequencing Reveals DYSF, FKTN, and ISPD Mutations in Congenital Muscular Dystrophy Without Brain or Eye Involvement.

BACKGROUND: Congenital muscular dystrophies (CMDs) are a genetically and clinically heterogeneous group of neuromuscular disorders. Several genes encoding extracellular matrix, nuclear envelope, sarcolemmal proteins and glycosylation enzymes have been implicated in CMDs. The large overlap of clinical presentations due to mutations in different genes poses a challenge for clinicians in determining disease etiology for each patient. OBJECTIVE: We investigated the use of whole exome sequencing (WES) in identifying the genetic cause of disease in 5 CMD patients from 3 families who presented with highly similar clinical features, including early-onset rapidly progressive weakness without brain or eye abnormalities. METHODS: Whole exome sequencing was performed on DNA from affected individuals. Potential functional impacts of mutations were investigated by immunostaining on available muscle biopsies. RESULTS: Pathogenic mutations in 3 different genes, DYSF, FKTN, and ISPD were identified in each family. Mutation in DYSF led to absence of dysferlin protein in patient muscle. Mutations in ISPD led to impaired ISDP function, as demonstrated by deficiency of α-dystroglycan glycosylation in patient muscle. CONCLUSIONS: This study highlights the benefit of unbiased genomic approaches in molecular diagnosis of neuromuscular disorders with high clinical heterogeneity, such as the phenotypes observed in our patients. Our results suggest that dysferlin deficiency should be in the differential diagnosis of congenital and rapidly progressive muscular dystrophy, and therefore dysferlin antibody should be in the standard immunohistochemistry panel for muscle biopsies in cases with suspected CMD.