Over the past decade, parents, property
owners, policy makers, and others have grappled with how best to deal with
lead-based paint hazards in housing, just as the nation similarly struggled
with asbestos in buildings in the 1990s. While significant progress was
made on each of these fronts, important lessons were learned—in some
cases through painful experience. Applying the conclusions, with appropriate
modifications, can accelerate progress towards achieving healthy housing
for all through cost-effective approaches to problems, such as asthma triggers
and mold and moisture in housing. The Alliance offers the following observations
and ideas for consideration:
The traditional approach of addressing housing-related
health hazards one-by-one (radon, asbestos, lead, etc.) is inherently
inefficient. Since many housing-related health hazards share common
causes, solutions to individual problems often offer collateral benefits.
Therefore, viewing the house as a system and addressing multiple hazards
simultaneously makes more sense in most cases.
The design of prevention strategies and tools
needs to recognize that the scope and severity of housing-related health
hazards differ significantly. Hazards differ from community to community
based on climate, topography, housing type, age, and many other factors—and
the risk of health hazards in housing in individual properties varies
from miniscule to extreme.
Minimizing the cost of making and keeping homes healthy is extremely
important, especially for low-income properties with limited resources,
which typically pose the highest risk. While strategies to prevent and
control hazards must be effective, strategies that are unaffordable
protect no one. Creating broad health benefits requires practical, low-cost
strategies that can be implemented on a wide scale in all categories
of housing, with appropriate subsidies for low-income residents.
Health and housing practitioners and policy makers must be involved
in defining the research agenda to ensure that scientists and those
who fund their research focus on issues that are relevant to real-world
housing problems and that studies are designed to provide sufficient
confidence to justify action based on their results.
Researchers need to reveal conclusions and recommendations in a timely
manner. Withholding findings from the public pending further study (or
the publication of peer-reviewed material) is a de facto decision to
let others who may have less valid information (e.g., the media, attorneys,
the courts, product manufacturers, legislators) fill the void. Early
advice about principles and the direction of needed change based on
preliminary results is valuable, even if definitive advice and standard
setting requires more study. Conversely, technical guidelines and standards
need to be reviewed regularly in light of experience and emerging research.
Hazard evaluation and control tools and terminology
are usually designed for worst-case situations and to meet the highest
burden of proof. While greater precision and reliability is sometimes
needed, simple tools that point to corrective and preventive action
are also valuable, given that risks in housing run the gamut from the
miniscule to the extreme. In many cases, a visual inspection is the
logical first step to identify obvious clues for housing-related hazards.
Achieving true prevention requires equipping the larger housing industry
and trades to avoid hazards in the first place. Since modest changes
in work practices by painters, maintenance staff, and contractors can
help prevent and avoid hazards, training such personnel in healthy homes
principles and practices is critical to improving conditions in the
housing stock that affect health.
Whenever possible, rely on existing delivery systems and personnel
instead of creating a new category of experts in a single specialty.
While property owners and residents must be protected from incompetent
and unscrupulous contractors, over-regulation can create inappropriate
barriers to entry, restrict capacity as well as results, and increase
Performance-based standards are generally superior to prescriptive
regulations because they afford flexibility to achieve the most cost-effective
solutions to problems.
Many can benefit from education, but care must be taken to avoid inappropriately
shifting responsibility to tenants and others who have little ability
to change structural or physical conditions. Education and training
should be targeted to increase knowledge and build the skills of those
who bear responsibility for providing healthy housing.
Making physical improvements to properties provides only narrow benefits.
It is vital that economically-distressed communities, which are typically
impacted by the greatest housing-related health hazards, be directly
involved in designing and implementing solutions in order to build capacity
and economic power within the community.
No single strategy can bring about corrective and preventive action
across the housing stock. While public subsidies, government standards,
regulatory requirements, and enforcement are essential in many cases,
healthy homes practices also need to be reinforced through industry
standards, recommended best practices, consumer demand, community action,
and legal strategies.