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August 4, 2016
Guest Author: By Jamal Lewis
Housing and Health
The home has long been thought of as a place of refuge, a place where we can be safe. However, for many low-income families, the home is a source of significant stress and harm. Affordable housing is often hard to find for low-income families, and in many cases families end up in deteriorating homes with health hazards such as mold, chipping lead paint, exposed wiring and poor ventilation, which lowers their value. Even with the lower prices, low-income families still spend an average of 50 percent of their income on housing, much higher than the national average. In addition, an average of 16 percent of their income goes toward utility costs, compared to 3.5 percent for the rest of the population. In the U.S., there are about six million families living in households with moderate to severe home health and safety hazards, which increases their risk of housing-related illnesses such as asthma, lead poisoning, slips and falls, and other respiratory illnesses. Many are forced to seek treatment from hospitals and medical professionals, which incurs an overwhelming burden of unaffordable medical bills.
For families insured through Medicaid, the U.S. government covers most of these bills, amounting to billions of dollars annually in health care costs (ER visits, medications, hospital stays). Unfortunately the government doesn’t cover these costs in full, so not only do families spend a significant amount of income on housing, they also spend a substantial amount on healthcare. In addition to these expenses, society incurs a sizable loss in production as children and adults miss school and work respectively to treat their illnesses. Finally, sick days can cause an increase in stress and exacerbate existing health problems, leading to more missed days of work and school.
The Green & Healthy Homes Initiative seeks to prevent these negative outcomes by braiding together categorically separate but mission-related funding and programs to deliver healthy homes, weatherization, and energy efficiency interventions to low-income families.
The GHHI Model
The Green & Healthy Homes Initiative promotes a more efficient approach to public health as it relates to the home. Since 1993 GHHI has been working together with local partners to integrate and braid resources that deliver comprehensive home rehabilitation services to low and moderate income families. Our model begins with a holistic assessment of all the health hazards and energy inefficient areas within the home, in order to develop a comprehensive list of improvements that can be made. GHHI facilitates information and resource sharing between housing agencies and related organizations, helping them work together to develop a plan of action that captures efficiencies by working collaboratively. An example might include a Community Action Agency’s Weatherization program working with the city’s lead poisoning prevention program. Then, the home improvement project is completed as efficiently and in as few steps as possible, reducing traditional redundancies and overlap between agencies. This also minimizes the amount of time family members have to take off work, and reduces the stress that comes as a result of missed work. The last step is to provide education to occupants, outlining to families how they can further protect themselves from health hazards in the home.
According to the Robert Wood Johnson Commission to Build a Healthier America, about 40 percent of asthma episodes are attributable to unhealthy housing conditions. In 2014, GHHI studied the effects that its intervention model could have on individuals, families, and communities. The study looked at 139 individuals with asthma who received GHHI services. We conducted a baseline assessment prior to the home intervention and a six-month follow up after the intervention. The assessments measured the severity of the subject’s asthma condition, how well it’s managed, number of calls to the doctor, number of doctors’ visits, number of ER visits, number of hospitalizations, and how many days of school/work were missed. At the conclusion of the study, subjects reported a 48 percent reduction in shortness of breath, a 65.5 percent reduction in hospitalizations, and a 37 percent and 27 percent reduction in missed work days and missed school days respectively, showing a correlation between housing interventions and improved health.
Improved individual health outcomes have macro-level implications on our economy. The annual direct health care cost of asthma is approximately $50.1 billion, which would decrease as we reduce hospitalizations and other medical treatment by preventing asthma episodes through housing interventions. Furthermore, the indirect cost--including the loss of productivity--of asthma is around $5.9 billion. This amount would inevitably decrease as children and parents miss fewer days of school and work due to asthma and other housing related illnesses. Declining health care costs mean that more public dollars can be used for other government programs. Though the GHHI model is designed to better public health through prevention of disease, its impact can be felt in a broad spectrum of areas.