Abstract
Background: As climate change intensifies the frequency and severity of extreme heat events, the absence of comprehensive federal heat stress prevention standards in the United States exposes millions of workers to severe health risks. While some states have enacted or introduced legislation to protect workers from heat-related illnesses, others remain without protections or have adopted restrictive policies that limit the capacity to protect workers. Concurrently, low-income households rely on federally funded programs such as the Low Income Home Energy Assistance Program (LIHEAP) to access cooling assistance. This study explores whether there is a relationship between the strength of state-level worker protections and use of LIHEAP cooling subsidies, with implications for public health policy and climate resilience.
Materials and Methods: All 50 U.S. states were classified into four policy categories, “Enacted”, “Introduced”, “Nonexistent”, and “Restrictive”, based on occupational heat protection legislative activity and was used to further evaluate the comprehensiveness of the states with “Enacted” and “Introduced” legislation. LIHEAP Performance Management data, U.S. Census data, and American Community Survey data from 2002 to 2022 was analyzed to determine the percentage of LIHEAP eligible households and households receiving cooling assistance in each state.
Results: States with “Enacted” occupational heat mitigation policies demonstrated higher scores on the 13 key factor framework and showed more consistent policy structure. These states generally had lower average reliance on LIHEAP cooling subsidies, while states in the “Introduced” category exhibited greater variability in policy strength and states in the “Restrictive” category had higher levels of program utilization. Gaps in state policy appeared to coincide with increased dependence on federally funded cooling assistance, suggesting that state level legislative inaction may shift the burden of heat mitigation onto federal public assistance programs.
Summary and Significance: This study finds that proactive and comprehensive state-level heat protections are associated with reduced reliance on LIHEAP cooling subsidies, reinforcing the importance of prevention-oriented policy frameworks. The lack of a national heat standard leaves significant disparities in worker protections and energy access across states. These findings highlight the need for national policies that safeguard vulnerable and at-risk populations from the growing threat of extreme heat while simultaneously reducing reliance on reactive assistance programs such as LIHEAP.