THE IMPACT OF HOUSING QUALITY ON HEALTH Office of Lead Hazard Control and Healthy Homes (OLHCHH) U.S. Department of Housing and Urban Development (HUD)
Strategic What is Unhealthy What is the Extent Why Does Our What Does What More Can We Framework Housing? of the Problem? Work Matter? OLHCHH Do Now? Do? What is OLHCHH? • The Office of Lead Hazard Control and Healthy Homes (OLHCHH) is an office within the Department of Housing and Urban Development (HUD) that protects children and families from health and safety hazards in housing. • The Office was established in 1992 as the Office of Lead Based Paint Poisoning Prevention. • 5 Divisions: • Programs Division • Regional Management and Technical Services Division • Lead Programs Enforcement Division • Grant Services Division • Policy and Standards Division 2
Strategic What is Unhealthy What is the Extent Why Does Our What Does What More Can We Framework Housing? of the Problem? Work Matter? OLHCHH Do Now? Do? OLHCHH’s Mission, Vision, and Goals Mission To help all Americans, but especially children and other vulnerable populations in low-income households, reach their full potential by making homes safe and healthy. Vision To lead the nation to a future where homes are both affordable and designed, constructed, rehabilitated, and maintained in a manner that supports the health and safety of occupants. Goals Enabling Communities to Building a National Creating Healthy Housing Mainstreaming the Create and Sustain Framework through Key Research Healthy Homes Approach Healthy Homes (OLHCHH, 2009, Healthy Homes Strategic Plan) 3
Strategic What is Unhealthy What is the Extent Why Does Our What Does What More Can We Framework Housing? of the Problem? Work Matter? OLHCHH Do Now? Do? Strategy for Action Vision To substantially reduce the number of American homes with residential health and safety hazards Goals Create and Support Support Research Training and Establish Healthy Encourage Adoption Educate the Public that Informs and Workforce Homes of Healthy Homes about Healthy Advances Healthy Development to Recommendations Recommendations Homes Housing in a Cost- Address Health Effective Manner Hazards in Housing 4 (Federal Healthy Homes Working Group, 2013, Strategy for Action)
Strategic What is Unhealthy What is the Extent Why Does Our What Does What More Can We Housing? Framework of the Problem? Work Matter? OLHCHH Do Now? Do? What Does OLHCHH Do Now? Grants for Producing Lead-Safe and Healthy Housing Units • OLHCHH provides and monitors funding to states and local governments to produce lead- safe and healthy housing units Technical Studies Grants (a.k.a. Research Grants) • OLHCHH provides and monitors funding to grantees to research methods, costs, and health benefits of making homes safe and healthy Enforcement • OLHCHH enforces the Lead-Based Paint Disclosure Rule and works with HUD program offices on compliance with the Lead Safe Housing Rule Guidance and Performance Criteria • OLHCHH develops and promotes development of healthy homes guidance and performance criteria Outreach • OLHCHH provides education and outreach to homeowners, tenants, and stakeholders on how to make homes safe and healthy 5
Strategic What is Unhealthy What is the Extent Why Does Our What Does What More Can We Framework Housing? of the Problem? Work Matter? OLHCHH Do Now? Do? What is Unhealthy Housing? Economic Impacts Health Effects Hazards Lead poisoning, which Costs to the Individual causes • Health problems • School absenteeism • Lead Hyperactivity • Academic failure • Reduced IQ • Learning difficulties • Behavioral Problems • Lack of employment • Learning Disabilities • Life-long health problems Pests • Socialization CO problems Mold Asthma • Criminal record VOCs Noise Radiation Cancer Asbestos Housing Problems Entry by Intruder Costs to Society Falls • Electrical hazards Healthcare • Fire Unintentional Injuries Hospitalization • Flames etc. Joblessness • Collision & entrapment Special education • Explosions Juvenile and criminal Ergonomics justice Numerous Health Other Health Impacts Hazards 6 (Based on: OLHCHH, 2014, Healthy Homes Rating System Operating Guidance; Loyola University 2015)
Strategic What is Unhealthy What is the Extent Why Does Our What Does What More Can We Framework Housing? of the Problem? Work Matter? OLHCHH Do Now? Do? Hazards These are the health and safety hazards examined by the Healthy Homes Rating System: Asbestos Carbon Damp & Cold Heat and man- Biocides Monoxide et Mold Growth made fibers al. Volatile Crowding Entry by Uncombusted Lead Radiation organic fuel and Space Intruders compounds Domestic Personal Water Lighting Noise Food Safety Hygiene etc. Hygiene Supply Falls in Falls on the Falls on Falls from Electrical Fire hazards baths etc. level stairs etc. windows etc. hazards Hot surfaces Collision/ Structural Ergonomics Explosions etc. Entrapment collapse 7 (OLHCHH, 2014, Healthy Homes Rating System Operating Guidance)
Strategic What is Unhealthy What is the Extent Why Does Our What Does What More Can We Framework Housing? of the Problem? Work Matter? OLHCHH Do Now? Do? Health Effects Health and safety hazards trigger, worsen, or cause a wide range of health effects. Here are some of the most prevalent housing-related health effects: Asthma & Unintentional Cancer Lead poisoning Death allergies injuries Cardiovascular Respiratory Depression Anxiety Arthritis conditions conditions Genitourinary Cognitive Unconsciousness Headaches Mental disorders disease impairment Gastrointestinal Neurological Mental Behavioral Skin infections illness problems retardation problems 8 (OLHCHH, 2014, Healthy Homes Rating System Operating Guidance)
Strategic What is Unhealthy What is the Extent Why Does Our What Does What More Can We Framework Housing? of the Problem? Work Matter? OLHCHH Do Now? Do? Economic Impacts Health and safety hazards impose a considerable economic burden on Americans living in unhealthy housing and on society as a whole. Costs to the Individual Life-long School Academic Learning Lack of Socialization Criminal health absenteeism failure difficulties employment problems record problems Costs to Society Juvenile and Healthcare Hospitalization Joblessness Special education criminal justice 9 ( See Gould, 2009; Trasande & Lui, 2011; Loyola University 2015)
Strategic What is Unhealthy What is the Extent Why Does Our What Does What More Can We Framework Housing? of the Problem? Work Matter? OLHCHH Do Now? Do? Multiple Impacts Housing problems cause a ripple effect of impacts. Here is an example of how a single housing problem can lead to multiple health effects and economic impacts: Academic failure Legend Life-long health Lack of problems employment l Housing Allergies Asthma problem Socialization Criminal history problems Damp and l mold Burns Hazard Physical growth injuries Electrical Electric Structural Water School Learning l hazards shock collapse leaks Health absenteeism difficulties effect Learning disabilities Lead l Costs to Hyperactivity Juvenile and Special the Behavioral criminal justice education Health problems Individual Reduced Problems IQ l Costs to Society Hospitalization Joblessness Healthcare 10 (Created by OLHCHH for Educational purposes only)
Strategic What is Unhealthy What is the Extent Why Does Our What Does What More Can We Housing? Framework of the Problem? Work Matter? OLHCHH Do Now? Do? Housing Quality and Health: Asthma & Allergies Related Hazards 1 Extent of the Problem 2 Economic Impact 3 $3.5 billion per year Domestic hygiene, pests, ~24 million homes for asthma due to dampness and refuse have elevated levels of four or and mold in the home. more allergens that have been associated with Carbon monoxide and fuel symptoms of allergic asthma combustion products among residents. Asthma Damp & mold growth affects 18.7 million U.S. adults and VOCs 6.8 million U.S. children. Noise 4 1. (OLHCHH, 2014, Healthy Homes Rating System Operating Guidance) 2. (The number of homes was calculated by multiplying 18% (Salo et al., 2008) by 133 million (HUD & Census, 2013, American Housing Survey); CDC, 2012) 3. (Mudarri & Fisk, 2007) 4. Children under combined exposure to traffic related noise and air pollution have been found to have relative 11 risks of chronic bronchitis, asthma and skin allergies, which cannot be explained by air pollution alone.
Strategic What is Unhealthy What is the Extent Why Does Our What Does What More Can We Housing? Framework of the Problem? Work Matter? OLHCHH Do Now? Do? Housing Quality and Health: Cancer Extent of the Problem 2 Economic Impact 3 Related Hazards 1 > $2 billion per year Radiation 6.8 million homes for radon-induced lung have radon exposures above cancer deaths the current EPA action level. Lung cancer from radon exposure causes 21,000 deaths Asbestos in the U.S. each year. 1. (OLHCHH, 2014, Healthy Homes Rating System Operating Guidance) 2. (EPA, 2013; EPA, 2003) 3. (Oster, Colditz, Kelley, 1984) 12
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