The home is where people spend the majority of their time. Yet, most
people do not realize the important connection between their homes and
their health. If not properly designed and maintained, homes may contain
an array of health and safety hazards that can lead to cancer, injuries,
lead poisoning and asthma. The economic impact of unhealthy housing is
also considerable since it results in missed school and workdays and drives
up health care costs.
More than 6 million families in the United States
live in substandard housing conditions and millions more live in homes
with hazards that could be easily addressed. Additional resources are
critically needed to improve housing conditions and protect families and
the nation's economy against the consequences of unhealthy housing.
- Americans spend 90% of their time indoors.
- An estimated 250,000 children have blood
lead levels exceeding CDC’s level of concern.
- 1.8 million persons make emergency department
visits for asthma. An estimated 40% of new asthma cases are attributed
to home exposures.
- Each year, over 13 million are injured
and over 11,000 die from unintentional injuries in the home.
- Each year, nearly 10,000 people visit the
emergency department for carbon monoxide poisoning.
The Alliance for Healthy Homes and the National Center
for Healthy Housing call on leadership from all levels of government and
the private sector to create healthful housing for all families in America
through the following policy approaches:
- Targeting the highest risk housing stock (i.e.
low-income housing in substandard condition). This approach will yield
the greatest improvements in health and reduce disparities borne by
low-income and minority families.
- Providing incentives, including need-based subsidies
as appropriate, for property owners and tenants, financial institutions,
contractors, and builders to integrate health considerations into housing
maintenance, finance, and construction.
- Eliminating disparities in health and housing
through practical and evidence-based regulatory actions.
- Empowering communities to address and respond
to local needs.
1) Promoting Holistic Programs:
Federal programs should serve as models for integrating health considerations
into housing programs. Congress should authorize flexibility for categorical
federal grant programs to enable grantees to efficiently and effectively
address client needs. New funding should beauthorized to enable greater
coordination among housing, health, and energy programs.
2) Federal Standards: Congress
should require rental properties to meet a minimum healthy housing code.
3) Voluntary Program: The federal
agencies should develop and market a national “Healthy Homes Seal
of Approval” labeling program for existing homes.
4) Housing Funding: The President
and Congress should increase funding for affordable healthy, sustainable
housing and ensure all people can afford quality housing including, for
example, providing tax incentives and funding to offset the marginal costs
of integrating healthy homes considerations into existing housing programs.
5) Capacity Building: Congress should
require federal agencies to coordinate efforts to develop and deliver
training for architects, builders, contractors, code inspectors, home
inspectors, property owners, other housing providers, and community- and
faith-based organizations. Congress should require federal agencies to
provide technical assistance, training, and grants to equip state and
local health departments, health care providers, code agencies, and community-based
organizations to build local capacity to prevent, identify, and respond
to housing-related health hazards.
6) Medical Reimbursements: The Medicaid
and Medicare programs should pay for environmental investigations and
interventions for housing-related illnesses including but not limited
to asthma, lead poisoning, carbon monoxide poisoning, and residential
7) Indoor Environmental Action Levels:
Congress should require EPA to set and enforce widespread adherence to
health-based standards for indoor exposures including, but not limited
to lead, carbon monoxide, radon, and formaldehyde.
8) TSCA Reform: Congress should
reform the Toxic Substances Control Act to ensure that EPA has the information
and resources it needs to properly assess health threats posed by building
materials and home products.
9) Education: Congress should authorize
a new grant program to provide funding for proven health education programs
for low-income and hard-to-reach audiences. A coordinated federally-supported
social marketing campaign should be created to raise the visibility of
healthy homes and build broad support for it.
10) Data Collection: Congress should
direct federal agencies to collect and report indicators of healthy housing
at the national, state and top 50 municipal levels. Federal agencies should
support the development and implementation of integrated health and housing
data collection systems and use the data to evaluate the cost-effectiveness
healthy homes interventions.
1) Code Enactment and Enforcement: Local
and state governments should adopt and enforce the International Property
Maintenance Code and ultimately the federal healthy homes minimum property
2) Direct Service Programs: Public
and private agencies conducting in-home visits should be cross-trained
to provide healthy homes visual assessments and referrals for their clients.
3) Tax Benefits and Funding: State
and local governments should offer tax incentives, home repair grants
(e.g. through the Neighborhood Stabilization Program), and favorable financing
for property owners to correct health hazards and conduct preventive maintenance.
States should reimburse the cost of environmental investigations and interventions
for housing related health problems including CO poisoning, asthma lead
poisoning, and residential injuries through its Medicaid/SCHIP funds or
4) State Insurance Regulators: Require
property insurance carriers to provide coverage for environmental health
hazards and provide incentives to property owners who achieve the Healthy
Homes Seal of Approval.
1) Pest Control Companies: Adopt
and market Integrated Pest Management (IPM) as a superior approach to
preventing and controlling pest infestation.
2) Property Owners: Apply maintenance
practices that prevent health hazards and improve durability and energy
efficiency, and at minimum remedy any potential health hazards.
3) Consensus Standards: Consensus
Standards Organizations: The International Code Council should strengthen
its model codes to include key health and safety considerations.
4) Builders and Affordable Housing Providers:
Meet USGBC LEED-H or Enterprise Green Communities Criteria (or regional
or local equivalent) for newly constructed or substantially rehabilitated
homes. Asset managers and developers should incorporate integrated pest
management and smoke-free policies in multi-family housing.
5) Financial Institutions: Offer
low-interest loans and other favorable financing terms for housing rehabilitation
and health hazard mitigation.
6) Health Care Providers: When
patients may be affected by hazards in the home environment, health care
providers should take environmental health histories and recommend appropriate
follow-up home assessments and home interventions.
7) Health Insurers: Provide reimbursement
for appropriate hazard investigations and interventions for patients with
8) Property and Casualty Insurers:
Provide coverage for environmental health hazards and incentivize adherence
to the Healthy Homes Seal of Approval and meeting Green Building criteria
for new construction and substantial rehabilitation programs.
9) Home Inspectors and Realtors:
Comprehensively check homes for health and safety hazards and educate
buyers about potential health hazards and how to address them. Home inspectors
should serve as third-party verifiers for the Healthy Homes Seal of Approval.