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The Health Benefits of Affordable Green Housing

The Health Benefits of Affordable Green Housing David E. Jacobs, PhD, CIH National Center for Healthy Housing Green Affordable Housing Forum: Protecting the Most Vulnerable While Expanding Washington’s Green Economy March 2009 Outline Health and Housing Connection

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The Health Benefits of Affordable Green Housing

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  1. The Health Benefits of Affordable Green Housing David E. Jacobs, PhD, CIH National Center for Healthy Housing Green Affordable Housing Forum: Protecting the Most Vulnerable While Expanding Washington’s Green Economy March 2009

  2. Outline • Health and Housing Connection • Examples of Health and Monetary Benefits of Improved Housing and Health • Data Needs for Assessing Health Outcomes in Green Development • Preliminary Results of Health Studies of Green Housing • Wheeler Terrace in Washington DC

  3. Florence Nightingale “The connection between health and the dwelling of the population is one of the most important that exists.” Cited in Lowry, S, BMJ, 1991, 303, 838-840

  4. Health in the Late 19th Century • Challenge of Tuberculosis Seemed Insurmountable • Lessons for Public Health Officials, Architects and Planners: Better Ventilation, Reduce Crowding, Improve Housing Sanitation (Plumbing) • With Improved Living Conditions & Medical Interventions, Disease Rates Declined

  5. Re-establish the Housing/Health Collaboration • Green Developers, Builders, Others • Weatherization Professionals • Public & Environmental Health • Housing Professionals • Banks & Other Financial Institutions • Government • Rehab Professionals • Many others

  6. Is Housing a Shared Commons?Is Housing Part of the Infrastructure?

  7. Cuyahoga River ca. 1960

  8. Medical Care Costs and Housing Improvement

  9. US Policies & Blood Lead 1971-2004 Phase-out gasoline & lead soldered cans (1973) 18 16 14 12 10 8 6 4 2 0 ‘74 Air & Ind Workplace Standards (1978) Lead in Plumbing banned (1986) Title X Housing & Community Development Act (1992) Lead-based Paint Poisoning Prevention Act (1971) Federally Assisted Housing Rule 1999 Residential Lead Paint Ban (1978) Lead Contamination Control Act (1988) Virtual Elimination of Lead in Gasoline McKinney Act Public Housing Abatement (1989) Housing Lead Dust & Soil Std Published (1999 & 2001) Renovation/Painting Rule Published (2008) Private Housing Lead Paint Grants (1991) Ban on lead solder in food cans (1995) Const Work Stds (96) Blood Lead Levels (µ/dL) Lead Disclosure Rule (1996) Housing units with lead paint reduced by 40% since 1990 2.7 % 2.2 % 1.6 % 1.2 % ‘72 ‘76 ‘78 ‘80 ‘82 ‘84 ‘86 ‘88 ‘90 ‘92 ‘94 ‘96 ‘98 ‘00 ‘02 ‘04 Year

  10. Power of Housing & Health Surveillance Data:Dust Lead and Windows

  11. Benefits of Window Replacement • Lead Dust Accumulation • Energy Savings: Heating and Cooling • Housing Value • Other?

  12. Total Net Benefits of Lead Safe Window Replacement • Pre-1940 Housing • $5,092 x 11 million units with single pane lead contaminated windows = $56 billion • Pre-1960 Housing • $1, 092 x 11 million units with single pane lead contaminated windows = $11 billion • Total = $67 billion

  13. Data Needed for Cost Benefit Analysis of Green Healthy Housing • Housing Conditionsthat Impair Health (1) • HousingImprovements that Advance Health (2)

  14. Housing Conditions That Affect Health (1) • Categories: • Sufficient Scientific Evidence • Some Scientific Evidence • Insufficient Evidence World Health Organization (WHO)

  15. Sufficient Evidence (WHO, 2005) • PHYSICAL FACTORS: • Heat and related temperatures and winter excess mortality • Cold indoor temperatures and winter excess mortality • Energy efficiency of housing and health • Radon exposure in dwellings and cancer • Neighborhood and building noise and related health effects • SOCIAL FACTORS: • Multifamily housing, high-rise housing, housing quality and mental health • CHEMICAL FACTORS: • ETS exposure in dwellings and respiratory and allergic effects • Lead-related health effects • BIOLOGICAL FACTORS: • Humidity and mold in dwellings and related health effects • Hygrothermal conditions and house dust mite exposure

  16. Some Evidence (WHO, 2005) • PHYSICAL FACTORS: • Ventilation in the dwelling and respiratory and allergic effects • CHEMICAL FACTORS: • VOCs and respiratory, cardiovascular and allergic effects • BIOLOGICAL FACTORS: • Cockroaches and rodents in dwellings and respiratory and allergic effects • Cats, dogs and mites in dwellings and respiratory and allergic effects • Pets and mites and respiratory, allergic or asthmatic effects • BUILDING FACTORS: • Sanitation and hygiene conditions and related physical health effects • SOCIAL FACTORS: • Social conditions of housing and fear/fear of crime • Poverty and social exclusion and related health effects • Crowding and related health effects • Social factors/social climate and mental health

  17. Housing ChangesScientifically Shown to Improve Health (2)

  18. Proven Healthy Housing Improvements • Asthma Interventions • Integrated Pest Management • Moisture Intrusion Reduction • Radon Mitigation • Lead Hazard Control • Smoke & CO Alarms • Pre-Set Hot Water Temperature

  19. Green Communities Minnesota Case Study

  20. Green Rehab Elements at Viking Terrace

  21. Viking Terrace Results

  22. Viking Terrace Results

  23. Viking Terrace Results

  24. Viking Terrace Results

  25. Viking Terrace Results

  26. Viking Terrace Results

  27. Housing Improves Asthma

  28. Breathe Easy Homes:Health Outcomes With $ Benefits • Change in No. of Asthma Symptom Days: • 4.8 days for each two week period (p<0.004) • Change in Caretaker Quality of Life: • 80% improvement (p<0.002) • Reduced Visits to Urgent Care: • 40% reduction (p<0.001)

  29. Aerial Imagery

  30. Making Low-Income Housing Rehab Green and Healthy – Wheeler Terrace, DC

  31. Partners • National Center for Healthy Housing • Community Preservation and Development Corporation • Wiencek + Associates Architects + Planners, PC • Wheeler Terrace Tenant Association • GreenHOME • DC Department of Health • HUD (Healthy Homes grant)

  32. Wheeler Terrace Green Healthy Housing Redevelopment • Health outcomes measured using validated instrument from Centers for Disease Control and Prevention • Asthma • Injuries • Mental Health • Cardiovascular • Allergen levels

  33. Project Approach • Examples of Healthy Homes Interventions – 113 housing units • Upgrade HVAC system: Fresh air • Integrated Pest Management • Low-VOC carpets • New ducted range hoods • Bathroom exhaust fans • Moisture Control • Energy Efficiency

  34. Conclusions

  35. A National Conversation • High Costs of Health Care/Health Insurance • Mortgage & Affordable Housing Crisis • Economic Recovery • Green Investment in Housing Improves Health and Reduces Health Care Costs • An Unprecedented Convergence!!

  36. Contact Information David Jacobs, PhD, CIH Research Director National Center for Healthy Housing 202-607-0938 djacobs @nchh.org www.nchh.org

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