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Health and equity present obligations and currently under-realised opportunities in low carbon transitions. Energy efficiency improvements of homes may benefit health and access to affordable energy, yet better knowledge about contextual mechanisms and household practices is needed for the development of effective programs. This paper presents a mixed methods evaluation of a quasi-randomised controlled retrofit trial targeting low-income older householders. Socio-technical systems thinking offered a useful approach to explore the construct of the engineering-dominated concept of residential energy efficiency in combination with the people-focused experience of housing and health. The study combined a phenomenological enquiry into householder practices with quantitative analyses to explain health, energy cost, temperature and psycho-social outcomes for winter.

The findings showed that small retrofits may mitigate the growing energy demands of this ageing population group, provide better comfort and reduce energy costs, but that the effectiveness of the retrofits was reduced by socially shared heating and ventilation practices that contradicted engineering assumptions, the physiological capabilities of the householder and the modes of energy bill payments. A program that is framed around caring and safety and combines retrofits, tariff optimisations and householder practices could provide equitable climate change mitigation outcomes and co-benefits for health for this population group. The paper concludes with implications for the integration of equity and health as goals into low carbon transitions.