healthy homes essentials for environmental professionals
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Healthy Homes Essentials for Environmental Professionals. Making the Connection Start with People. Learning Objectives. Learning Objectives. Link Between Housing & Health. “The connection between health and the dwelling of the population is one of the most important that exists”. - PowerPoint PPT PresentationTRANSCRIPT
HEALTHY HOMES ESSENTIALS FOR ENVIRONMENTAL PROFESSIONALS
Making the Connection Start with People
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LEARNING OBJECTIVES
Describe four housing conditions and their associated health problems.
Identify three populations at higher risk for housing related disease and injury.
Identify three types of codes used to enforce remediation of housing-related hazards.
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LEARNING OBJECTIVES
EXPLAIN how to work with people to get important information from them about potential hazards in the home.
IDENTIFY key routes of exposure and their relationship to housing hazards.
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LINK BETWEEN HOUSING & HEALTH
“The connection between
health and the dwelling of the population is
one of the most important
that exists”.Florence Nightingale
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WHY DO WE CARE?
Housing impact on health:Physical, chemical, biological exposuresPsychological
Young children spend about 70% of the time in their home.
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WHY DO WE CARE?
Annual costs for environmentally attributable childhood diseases in the U.S: $54.9 billion.
$43.9 Billion from Lead Poisoning$ 9.2 Billion from Neurobehavioral Disorders$ 2.0 Billion from Asthma$ 0.3 Billion from Childhood Cancer
Additional costs (e.g., lost days of school/work).Asthma contributes 3% of total health care costs.
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HOW SIGNIFICANT IS THE PROBLEM?American Housing Survey
Occupied Housing Units
Severe Physical Problems
Moderate Physical Problems Total
2007 1.8 million 4.0 million 5.8 million
2009 1.9 million 3.9 million 5.8 million
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MASLOW’S HIERARCHY OF NEED
Self-Actualization
Ego
Belonging
Safety and Security
Physiological Needs
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INSTITUTE OF MEDICINE (2000)
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INSTITUTE OF MEDICINE (2004)
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HOLISTIC APPROACH
Integrated approach that considers:
People living in the home
The structure
Potential health hazards
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Why a Holistic Approach?
Moisture/water intrusion
Mold
Asthma exacerbation
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Moisture/water intrusion
Structural damage
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Structural damage
Pests
Deteriorated lead paint/lead poisoning
Fire
Injuries
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Pests
Pesticides
Asthma & allergy exacerbation
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PesticidesPage 1.9
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DIFFERENT APPROACHES
HEALTH• Primary
Prevention• Secondary
Prevention• Epidemiologic
Triangle
HOUSING• Well constructed• Well maintained• Comfortable• Affordable• Healthy
ENVIRONMENTALHEALTH
LeadRadon
Allergens/asthma Combustion productsUnintentional Injuries
Insects & RodentsMold & Moisture
Pesticides Asbestos
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WHAT IS HEALTHY HOUSING?
•Designed,•Constructed,•Maintained, and•Rehabilitated
Healthy Housing is:
in a manner that is conducive to good occupant health.
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AMERICAN HOUSING SURVEY
Conducted:• Every two years since the
1980s• Periodically for 46
Metropolitan Statistical Areas (MSA)
• Consistent set of homes• Phone survey since 1997
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EXERCISE #2
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YOUR COMMUNITY
Healthy Homes Profiles• Comparison to similarly situated housing
Interior-Exterior Relationships• Likely to be interior problems if exterior problem is present.
More Detailed Snapshot
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Until effective standards for the domestic environment are devised, it is likely that children will continue to be employed as biological indicators of substandard housing.
Click icon to add picturePage 1.14
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CODES BENEFITING HEALTHY HOMES
Health / Sanitation CodesHousing / Property Maintenance CodesLandlord-Tenant LawsProduct StandardsHazard Management Laws
Housing v. Building v. Zoning Codes
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KEY PROVISIONS OF CODES
Structural IntegrityWeatherproofMaintenanceCracks & HolesLoose or Rotting MaterialsDampness & DeteriorationPeeling Paint
Ventilation / WindowsInfestationSanitation & TrashCleanability Clothes DryerSpace Heater
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MODEL CODES FOR HOUSINGModel Codes for Housing
Building Construction Internat’l Building CodeResidential Construction Internat’l Residential CodeRehab Internat’l Existing Building CodeElectrical ICC Electrical CodeFire Internat’l Fire Code and
National Fire Protection AssociationVentilation Internat’l Mechanical CodePlumbing Internat’l Plumbing CodeSewage Internat’l Private Sewage Disposal CodeALL BUILDINGS Internat’l Property Maintenance Code
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INT’L PROPERTY MAINTENANCE CODE
Adopted in:More than 550 communities Two states – New York & VirginiaSeveral states including Georgia & Oklahoma recommend it as a model for locals codes
ApplicabilityExisting BuildingsRental and Owner Occupied HomesLocal Variations
Code Official Enforces
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Does this violate the
IPMC?
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LANDLORD-TENANT LAWS
Rights and Responsibilities
Common Requirements• Certificate of Occupancy• Duty to Pay Rent• Withholding Rent to Make Repairs• Retaliation
Eviction and Enforcement
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HEALTHY HOMES PRINCIPLES
1. Keep it DRY
2. Keep it CLEAN
3. Keep it PEST-FREE
4. Keep it VENTILATED
5. Keep it SAFE
6. Keep it CONTAMINANT-FREE
7. Keep it MAINTAINED
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START WITH PEOPLESteps to Healthier Homes
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Why do you go into houses?
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WHY START WITH PEOPLE?
What good are they?
What’s difficult about people?
How can you deal with people?
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OPEN V. CLOSED QUESTIONS
•How•What•Tell me about•Describe for me
Open-Ended or Indirect
•Are•Is•DoClosed-
Ended or Direct
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BRACKETINGMethod to:
Stay Calm and Non-JudgmentalKeep Ability to Listen
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SPECIAL COMMUNICATION ISSUES
LanguageCultural
Shoes in the HomeMen and Women
Responding to ProblemsHoardingTolerance for Clutter and Pests
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RESIDENT CHOICES
Health
Comfort
Cost
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WHAT’S GOING ON IN THE NEIGHBORHOOD?
Land useZoningServices
Water SewerSolid waste
Water supply
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ROUTES OF EXPOSUREo Inhalationo Ingestiono Skin Absorptiono Injectiono Built-In Protection Mechanisms
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Signs are objectiveBlood pressure, heart rate, peak flowBloody nose, rash
Symptoms are subjectiveBack pain, fatigue, headaches
Some can be a combinationShortness of breath
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2.5HOUSING RELATED DISEASESigns and Symptoms
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Timing Location Corroboration
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2.5HOUSING RELATED DISEASESigns and Symptoms
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MENTAL HEALTH
Poor housing conditions
Poor-quality multifamily homes
Lack of light
Dampness or mold and depression
Bed bugs
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Don’t overlook or ignore housing
conditions that may affect health.
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OFTEN OVERLOOKED
Lead• Was your home built before 1978? 1950?
Radon• Was your home ever tested for radon?
CO (Carbon Monoxide)• Do you have a carbon monoxide detector?
Sources of health problems
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OFTEN IGNOREDSources of health problems
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2.7Environmental Tobacco Smoke• Does anyone in the family smoke?• Do they want help quitting?
Consumer chemicals• What cleaning chemicals do you use?• Where do you store them?
Pesticides• Any Pesticides used? Which ones?
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EPIDEMIOLOGIC TRIANGLE OF DISEASE
Host
Agent Environment
Transport Mechanism
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NO PLACE LIKE HOME!Resident Overall Opinion of Structure, American Housing Survey – National 2009
Worst BestType of resident 1 2-4 5-7 8 9 10
All 0.5% 1.9% 22.8% 27.4% 16.0% 27.6%
Renters 0.9% 3.8% 32.8% 27.2% 11.9% 19.6%
Below Poverty 1.5% 4.1% 28.0% 23.2% 10.9% 27.1%
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WILL THINGS CHANGE?
Homes With “No Smoking” Rule
• 43% in 1992-1993• 72% in 2003• 82% in 2009-2010
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HEALTHY HOMES INTERVENTIONS
2008 Expert Panel Convened by CDC and NCHHCategories
EffectiveNeeds More Field EvaluationNeeds Formative ResearchNo Evidence or Ineffective
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HEALTHY HOMES INTERVENTIONS
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HEALTHY HOMES INTERVENTIONS
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NATIONAL HEALTHY HOMES TRAINING CENTER & NETWORK
Brings together public health and housing practitioners Forum for exchanging information on new research and best practices.
Funded through a contract with the U.S. Department of Housing & Urban Development , and with support from the U.S. Environmental Protection
Agency and the U.S. Centers for Disease Control & Prevention
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FEDERAL HEALTH PRIORITIESHealthy People 2020 Objectives
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blood lead levels in children
pesticide exposures
indoor allergen levels
homes with operating radon mitigation system
new single family homes with radon-reducing features
lead-based paint or related hazards in homes
units with moderate or severe physical problems
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GREEN BUILDING PRIORITIES
NCHH Comparison – February 2009Major National Programs
Green CommunitiesLeadership in Energy and Environmental Design for Homes (LEED for Homes)National Green Building StandardEnergy Star with Indoor Air Package
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KEY MESSAGESLink between housing and health
Vulnerable groups
Basic public health and housing principles
Holistic approach
Codes and regulations
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LEARNING OBJECTIVES
Describe four housing conditions and their associated health problems.
Identify three populations at higher risk for housing related disease and injury.
Identify three types of codes used to enforce remediation of housing-related hazards.
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LEARNING OBJECTIVES
EXPLAIN how to work with people to get important information from them about potential hazards in the home.
IDENTIFY key routes of exposure and their relationship to housing hazards.
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