The current inflation rate is at its highest level in 13 years, and it is a real concern for all Americans. Housing, food, furniture and many other commodities are more expensive. The cost of another more intangible commodity-household heating-is also expected to rise in the coming months, even as high as 50%. The burden of declining purchasing power in all aspects of daily life is particularly heavy for low-income families. This winter, the poor may face an unreasonable choice: heating or eating. 

The cost of household heating is expected to increase across the board. Natural gas will rise 30% to US$746, heating oil will rise 43% to US$1,734, and electricity will rise 6% to US$1,268. Paying so much for heating will paralyze many families that are already in financial difficulties.  

The problem is that before prices soared, poor families could barely afford winter heating. Many people reluctantly live by patience. As the pressure increases, this is not just a cold winter. Without government intervention, it could be fatal. 

According to a 2015 report, nearly one-third of households in the United States are energy-insecure, which means they cannot adequately meet their household energy needs. Lack of funds leads to energy insecurity, and energy inefficiency is exacerbated; the lower the efficiency, the higher the cost of heating the home.

Although overall energy consumption is lower, the poor and people of color are more likely to live in energy-inefficient houses. Extreme energy saving is a coping strategy used by the poor, while turning to ovens, stoves or space heaters as supplementary heat sources. 

As an academic researcher, I interviewed hundreds of low- and middle-income people who cannot meet their energy needs. I visited their homes and met them at energy assistance offices across the United States. The women and men I interact with have no privilege to take energy for granted. Some people live without heating because their stove is no longer available and they have no way to replace it. More often, these families face high bills that cannot be afforded with meager wages. Many people received power outage notices and promised that they would not be able to honor their debts with the utility company. Winter is often the most expensive season. 

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Living without enough calories is suffering in private. Family members wear coats and extra clothes at home. They are tied to the bed and sofa, and blankets and quilts can provide warmth at no additional cost. They live in a room in the house to concentrate heat and control costs. Tourists are not welcome. 

The global energy crisis of the 1970s and 1980s gave birth to what is known today as the energy assistance program for low-income households. LIHEAP provides payment assistance to households that meet income criteria and provides emergency relief when the household faces the threat of power outages, power outages, or the risk of fuel shortages. 

The plan is an important lifeline for poor families, but few people really get help. In different years, only about one-fifth of eligible households received energy assistance benefits. On the contrary, a recent paper showed that many people give up food or medicine.

Despite receiving energy assistance every year for the past 20 years, a woman I interviewed in New York City described the painful but not uncommon struggle for thermal comfort every day. Her winter ritual included boiling a pot of water and turning on the space heater in the living room, where she spent her days and nights. As an elderly person who rarely uses oil-based heating, she runs the risk of freezing the pipes and dying at home. She will not be the first.

Since 1979, more than 19,000 Americans have died from cold-related causes, many of them elderly people. When heating costs rise, excessive winter deaths are a real threat.

My research shows that energy insecurity is related to poor sleep quality, mental stress and respiratory diseases. Others have found that cold stress is associated with cardiovascular risk and decreased neurological function. 

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Many energy-insecure households are also food-insecure. Like energy, food prices are also rising, up 4.6% from a year ago. 

On the bright side, families receiving energy assistance are less likely to be malnourished. The point here is that government assistance can prevent these two difficulties.

As Congress fights the infrastructure bill and the Democratic Party’s efforts to strengthen the social safety net, policymakers must remember that the poor can hardly bear the risk of an impossible cold winter. With the rising cost of heating, the emphasis on improving efficiency and expanding energy assistance is a time-sensitive and life-protecting issue. 

Diana Hernández is an associate professor of social medical sciences at Columbia University’s Mailman School of Public Health and a visiting scholar at the Russell Sage Foundation. She is writing a book on energy insecurity. For "Weakness: The American People's Energy Struggle".