Abstract
Background:
Utility services for electricity, gas, heat, and hot water are necessities for everyday activities (e.g., lighting, cooking, and thermal safety). Utility outages can threaten health; however, information is limited on the prevalence of electricity, gas, heat, and hot water outages in representative studies. We characterized infrastructure-related electricity, gas, heat, and hot water outages in New York City (NYC) and within subgroups.
Methods:
Using a representative 2022 survey of NYC adults (18+), we assessed the prevalence for 6+ hour utility outages and compared across building, demographic, and health subgroups. Building characteristics included age, number of floors, rental type, and owner/rental status. Demographics included household poverty, neighborhood poverty, and race/ethnicity. For health, we focused on cognitive impairment, electricity-dependent medical equipment use, and mental health conditions.
Results:
Outages impacted 20% of NYC residents. Heat outages were nearly 3× and 2× more common in mid-rise and high-rise buildings respectively, vs. low-rise buildings. Similarly, hot water outages were 5× and over 6× more prevalent in mid-rise and high-rise residences. Renters faced 2× more heat and hot water outages compared with owners. Compared with low-poverty households, high-poverty households faced 2× more hot water outages. Residents with mental health conditions experienced more electricity (11% vs. 5%), heat (15% vs. 7%), and hot water (16% vs. 8%) outages compared with those without.
Conclusions:
NYC utility outage prevalence varied by type with heat and hot water being most common. Disparities across building, sociodemographic, and health characteristics were also larger and more frequent for heat and hot water outages.
Keywords: Utility service outage, Power outage, Energy insecurity, Housing, Health, Infrastructure
What this study adds:
Our study expands the current literature by simultaneously evaluating the prevalence of electric, gas, heat, and hot water outages in a representative New York City survey. Furthermore, we investigated whether disparities in utility outage types exist across individual- and building-level characteristics. We determined that one in five NYC adults experienced a utility outage over a 12-month period. Disparities were most common for heat and hot water outages. In addition, we observed electric, heat, and hot water outage disparities by building, demographic, and health attributes. This study highlights the importance of considering all types of utility outages and their distribution across subgroups.
Introduction
Utility services (i.e., electricity, gas, heat, and hot water) are basic requirements to function in society and maintain health. They are essential services1 and necessary for lighting the home, cooking, habitable dwelling, and controlling indoor temperatures.2,3 Interruptions of essential utility services (i.e., utility outages) disrupt everyday life and may represent health risks. Utility outages can reflect issues in utility infrastructure or buildings. Neglected and deteriorating buildings with features such as damaged electrical outlets, worn-down pipes, and overloaded circuits could give rise to utility outages.
Outages also impact health. Electrical outages are associated with increased respiratory hospitalizations4 and mortality,5 likely in part because many individuals rely on electricity-dependent medical equipment (EME) including ventilators and oxygen equipment.6 Heat outages may expose individuals to extreme temperatures, precipitating adverse health outcomes.7 Hot water outages can contribute to mental and physical stress,8 exacerbating preexisting health conditions. Thus, it is crucial to understand who experiences utility outages.
Not all communities are equally exposed to utility outages. Electrical outages disproportionately occur in low-income groups, communities of color, and socially vulnerable communities.9,10 Studies on nonelectrical outages find similar disparities. In New York City (NYC), gas shutoffs are more frequent in census tracts with majority Black and Hispanic populations and with higher concentrations of public housing.11
Few studies characterize the prevalence of multiple outage types within the same population. Prior studies center on electrical outages9,10,12–15 and investigate disparities across area-level attributes (e.g., county-level social vulnerability).9,13 Flores et al.16 examined Texas electrical outage disparities across individual-level race, education, home medical equipment use, and age. However, the study was not representative of the population and did not include building-level data, which can be necessary to identify strategies such as retrofits to reduce outages. Presently, there is a gap in our understanding of nonelectrical outage prevalence in a representative population, as well as its distribution across individual- and building-level attributes.
We examined the prevalence of NYC utility outages unrelated to the inability to pay bills. Using a representative survey on household energy, we described the distribution of utility outages by type (i.e., electrical, gas, heat, and hot water). In addition, we assessed the prevalence of each utility outage type by building attributes, demographic characteristics, and health conditions in the household to investigate possible disproportionate infrastructure-related outage burdens.
Methods
Data collection and survey design
We leveraged the NYC Household Energy and Health Survey. From February to April 2022, the NYC Department of Health and Mental Hygiene surveyed a subset of the NYC Health Panel – a probability-based survey panel of adults (≥18 years old) living in NYC with a response rate of 30.4%, resulting in 1,950 participants. Responses were weighted by selection probability and nonresponse by borough, sex, age group, and race/ethnicity to represent the NYC adult population from the 2019 US Census Bureau’s American Community Survey (ACS) 1-year estimates (n = 6,418,000).17
Utility outage type
Participants were asked about 6+ hour interruptions in electric, gas, heat, and hot water services for reasons unrelated to inability to pay (e.g., weather, maintenance, or construction) in the 12 months prior to taking the survey. We analyzed responses for each service and the number of outage types experienced regardless of combination (e.g., participants reporting both electrical and heat outages faced two outage types).
Building, demographic, and health characteristics
We extracted survey data on building, demographic, and health characteristics as in a prior study.17 For buildings characteristics, we included year built (<1940, 1940–1969, 1970–1999, and ≥2000), number of floors (low-rise 1–2 floors, mid-rise 3–5 floors, and high-rise 6+ floors), rental type (market rate, public housing, rent-controlled/stabilized, and rental assistance program), and home-owned or rented status. Building characteristics were self-reported, except for the number of floors and year built, which were based on respondent tax lot from NYC Department of City Planning Primary Land Use Taxlot Output data.
For demographic information, we included household poverty (household income <200% of the federal poverty line (FPL), ≥200%), neighborhood poverty (<20% of households live in poverty, ≥20%), and race/ethnicity (Non-Latino White, Non-Latino Black, Latino, Asian/Pacific Islander, and Non-Latino Other/Multi-Racial). All variables except neighborhood poverty were self-reported. Neighborhood poverty (based on self-reported ZIP code) was the population percentage living below the FPL based on the ACS (2016–2020) data.
For self-reported health diagnoses, we evaluated binary categories for cognitive impairment, EME use, and mental health conditions. Questions on health characteristics were not limited to the survey respondent and inquired if the survey respondent or anyone else in the household had reported the health diagnosis.
Statistical analysis
We assessed utility outage prevalence for NYC overall and within subpopulations. Chi-square tests were run to determine whether differences among subpopulation levels were statistically significant (P < 0.05). All analyses were performed using R version 4.1.0 (18 May 2021). Code is available at https://github.com/viviando/nyc_utility_outages.
Results
Study population and utility outages for New York City overall
Among NYC residents, 20% experienced at least one 6+ hour utility outage type within the 12 months. Most affected residents reported one outage type (13%), whereas 5% reported two outage types (Figure 1). Heat (10%) and hot water (10%) outages affected NYC residents most, followed by electrical (6%) and gas (3%) outages (Table 1).
Figure 1.
Distribution of the number of utility outage types experienced by NYC adults. Utility outage types included electricity, gas, heat, and hot water. Utility outages lasted at least 6 hours. Numbers above each bar represent the percent estimate and corresponding 95% confidence interval of the number of utility outage types experienced by the NYC adult population.
Table 1.
Prevalence of adult New Yorkers exposed to utility outages for New York City overall and by building, demographic, and health characteristics
| Category | Characteristic | Level | Weighted count (n) | Percent (%) | Electrical (%) | Gas (%) | Heat (%) | Hot water (%) |
|---|---|---|---|---|---|---|---|---|
| New York City | 6,499,000 | 100 | 6 (5–8) | 3 (2–4) | 10 (8–12) | 10 (8–12) | ||
| Building | Building year built | <1940 (ref) | 3,261,000 | 52 (48–55) | 6 (4–9) | 4 (2–5) | 12 (9–16) | 8 (6–11) |
| 1940–1969 | 1,732,000 | 27 (25–30) | 4 (3–7) | 2 (1–4) | 7 (5–9)a | 10 (7–13) | ||
| 1970–1999 | 589,000 | 9 (8–11) | 14 (7–27)b | 8 (4–18)b | 15 (8–25)b | |||
| ≥2000 | 744,000 | 12 (10–14) | 5 (2–10)b | 7 (4–12) | 11 (6–21)b | |||
| Number of floors in building | Low-rise (1–2 floors) (ref) | 1,435,000 | 23 (20–26) | 9 (5–15) | 3 (1–6)b | 5 (3–8)b | 2 (1–4)b | |
| Mid-rise (3–5 floors) | 2,130,000 | 34 (30–37) | 8 (5–11) | 4 (2–7) | 14 (9–20)a | 10 (7–15)a | ||
| High-rise (6 stories of higher) | 2,748,000 | 44 (40–47) | 3 (2–5)a | 3 (2–4) | 9 (7–11)a | 13 (10–16)a | ||
| Rental type | Market rate (ref) | 2,080,000 | 47 (43–51) | 8 (5–12) | 3 (2–4) | 13 (9–18) | 12 (9–17) | |
| Public housing (New York City Housing Authority) | 684,000 | 15 (12–19) | 9 (5–18)b | 10 (5–19)b | ||||
| Rent-controlled/stabilized | 1,124,000 | 25 (22–30) | 2 (1–5)a,b | 1 (1–3)b | 12 (7–20) | 11 (6–17) | ||
| Rental assistance program | 547,000 | 12 (10–15) | 5 (2–10)b | 3 (1–6)b | 12 (5–26)b | |||
| Owner/rental status | Owner (ref) | 2,064,000 | 32 (29–35) | 9 (6–13) | 4 (2–6) | 6 (4–8) | 7 (5–10) | |
| Renter | 4,434,000 | 68 (65–71) | 5 (4–7) | 3 (2–4) | 12 (9–15)a | 11 (9–14)a | ||
| Demographic | Household poverty | <200% FPL (ref) | 2,464,000 | 44 (41–47) | 5 (3–8) | 4 (2–6)b | 10 (7–14) | 7 (4–11) |
| ≥200% FPL | 3,177,000 | 56 (53–59) | 7 (5–10) | 3 (2–4) | 11 (8–13) | 12 (10–15)a | ||
| Neighborhood poverty | Low poverty (<20% below poverty) (ref) | 3,646,000 | 57 (54–60) | 7 (5–10) | 4 (2–5) | 8 (7–10) | 9 (7–11) | |
| High poverty (≥20% below poverty) | 2,762,000 | 43 (40–46) | 5 (3–7) | 3 (1–5)b | 12 (8–17) | 11 (8–15) | ||
| Race/ethnicity | White, Non-Latino (ref) | 2,079,000 | 33 (31–36) | 9 (6–13) | 3 (2–4) | 11 (9–14) | 12 (9–16) | |
| Black, Non-Latino | 1,291,000 | 21 (18–24) | 5 (3–9) | 5 (2–9)b | 12 (7–20)b | 9 (5–16)b | ||
| Latino | 1,740,000 | 28 (25–31) | 6 (3–11)b | 2 (1–5)b | 9 (6–14) | 9 (6–14) | ||
| Asian/Pacific Islander | 940,000 | 15 (13–18) | 3 (1–7)a,b | 3 (1–7)b | 8 (4–18)b | 6 (3–11)a | ||
| Other/Multi-Racial, Non-Latino | 174,000 | 3 (2–4) | 7 (3–17)b | 18 (8–38)b | ||||
| Health | Cognitive impairment | No (ref) | 5,796,000 | 95 (93–96) | 6 (5–9) | 3 (2–4) | 10 (8–13) | 10 (8–13) |
| Yes | 317,000 | 5 (4–7) | 6 (2–14)b | 13 (6–26)b | ||||
| Electricity-dependent medical equipment | No (ref) | 5,791,000 | 89 (87–91) | 6 (5–8) | 3 (2–4) | 10 (8–12) | 10 (8–12) | |
| Yes | 706,000 | 11 (9–13) | 7 (4–12) | 6 (2–14)b | 13 (8–21) | 11 (6–19)b | ||
| Mental health condition | No (ref) | 3,942,000 | 66 (63–69) | 5 (3–7) | 3 (2–5) | 7 (5–10) | 8 (6–10) | |
| Yes | 2,028,000 | 34 (31–37) | 11 (7–15)a | 4 (3–7) | 15 (11–20)a | 16 (11–21)a |
Numbers in parentheses are the 95% confidence intervals. Counts are rounded to nearest thousand, and percentages are rounded to the nearest whole number.
P-value <0.05 in chi-square tests.
Estimate should be interpreted with caution. Estimate’s relative standard error (a measure of estimate precision) is greater than 30%, or the 95% confidence interval half-width is greater than 10 or the sample size is too small, making the estimate potentially unreliable. Missing estimates are suppressed due to unreliable estimates.
Utility outages across building characteristics
Residents in mid-rise and high-rise buildings experienced far more heat and hot water outages compared with residents in low-rise buildings. Heat outages were almost 3× and 2× more common for those in mid-rise and high-rise buildings, respectively, relative to low-rise buildings (14% and 9% vs. 5%) (Table 1). Hot water outages were 5× and over 6× more prevalent for mid-rise and high-rise residents (10% and 13% vs. 2%). However, residents in high-rise buildings had fewer electrical compared to low-rise buildings (3% vs. 9%).
Utility outages also differed by home-owned vs renter status. Renters faced 2× more heat outages compared with homeowners (12% vs. 6%). Hot water outages were also higher among renters (11% vs. 7%). Rent-controlled renters appeared to have fewer electrical outages compared with market-rate renters (2% vs. 8%).
Utility outages across demographic characteristics
High-poverty (≥200% federal poverty level) households experienced more hot water outages compared with low-poverty households (12% vs. 7%). Asian/Pacific Islander residents faced fewer electrical (3% vs. 9%) and hot water (6% vs. 12%) outages compared with White, Non-Latino residents.
Utility outages across health characteristics
Households with an individual with a mental health condition experienced more outages for electricity (11% vs. 5%), heat (15% vs. 7%), and hot water (16% vs. 8%) than those without household mental health conditions. Data suggest that all outage types were more common in EME users compared to non-EME users.
Discussion
Our research expands the outage and health literature by considering multiple infrastructure-related utility outage types by building, demographic, and health characteristics in NYC. We observed disparities most often for heat and hot water outages. High-poverty residents were more likely to experience hot water outages. Individuals with a mental health condition faced more types of outages (i.e., electricity, heat, and hot water) compared with those without.
Disparities were most frequent for heat and hot water outages. Prior work in New York City Housing Authority housing found that equipment investments decreased heat and hot water outages.18 These outages can be due to building-level issues like aging boiler units or pipes. Owners have incentive to invest in building infrastructure to minimize these outages in owner-occupied homes, whereas there may be less incentive for renter-occupied properties. Because high-poverty households may be more likely to rent, they may face more outages due to these same reasons. Moreover, high-poverty owners may not have financial resources to maintain building infrastructure without assistance.
Heat and hot water outages were also higher in households with an individual reporting a mental health condition compared with those without. Lack of affordable, high-quality housing can cause stress, leading to worse mental health.19 We found that 11% of New Yorkers using EME or who had someone in their household using EME were more likely to experience outages of all types. This finding aligns with research showing that EME users are highly vulnerable to the health consequences of energy insecurity and electrical outages.17,20,21
This study has several limitations and strengths. Responses were self-reported, which could lead to inaccurate outage reporting. However, because the survey asked specifically about 6+ hour events, responses still likely represented long, disruptive outages. Participants may also recall winter outages (i.e., outages occurring closer to when the survey was taken, which was February–April) more readily than summer outages. Future work should consider seasonality in outage types. Another limitation was that small sample sizes for some characteristics produced estimate uncertainty. However, a study strength was the representative sample of and results for all NYC adult residences. We were also able to measure outages across various essential utility service types instead of just one service type.
Our study highlights the importance of considering multiple infrastructure-related outage types as environmental exposures with potential adverse health impacts and advancing understanding of varied energy insecurity manifestations.22 Future efforts to track various building-level utility outages will improve our ability to characterize such exposures. Research could investigate health effects and implications for equitable access to safe housing and high-quality utility infrastructure.
Conflicts of interest statement
The authors declare that they have no conflicts of interest with regard to the content of this report.
Acknowledgments
Authors would like to acknowledge and thank the NYC Health Panel participants and the Division of Epidemiology at the New York City Department of Health and Mental Hygiene for their instrumental roles in this work.
Footnotes
Published online 9 January 2025
Supported by the Alfred P. Sloan Foundation, the JPB Foundation, and grants F31 HL172608 from NHLBI, Centers for Disease Control and Prevention (CDC), including Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases Supplemental Covid-19 Cares, Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases Supplemental Covid-19 PPPHCE, ELC COVID Enhancing Detection Expansion Supplemental, Immunization & VFC COVID-3 Cycle Vaccination Supplemental, CDC COVID-19 Crisis Response Workforce Supplemental, and CDC Public Health Infrastructure.
Data used for this study are stored and overseen by the New York City Department of Health & Mental Hygiene (NYC DOHMH). It is not made publicly available due to the risk of re-identification of survey participants. However, researchers can contact NYC DOHMH to request data access via a data use agreement. Code used for analysis can be found on GitHub (https://github.com/viviando/nyc_utility_outages).
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