costs and lost wages due to inefficient and un- healthy housing and ... visits, are largely the domain of hospitals, whi
Breaking the Link Between Unhealthy Housing and Unhealthy Children By Ruth Ann Norton, Executive Director, Green & Healthy Homes Initiative™
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merican taxpayers lose hundreds of millions of dollars annually in medical bills, energy costs and lost wages due to inefficient and unhealthy housing and nearly six million households live with moderate to severe physical housing problems. These hazards increase the risk for illnesses and injuries including asthma, falls, respiratory problems and lead poisoning. Children and seniors in low-income housing are hardest hit by home-based environmental health hazards. Extensive research by CDC, HUD, NIH, and others confirm that home-based environmental health hazards that trigger asthma episodes and cause home injury cannot be fixed in the doctor’s office but must be remedied by taking the traditional health care system to the new frontier of prescriptive housing intervention services. Currently severe home-triggered asthma attacks, which result in emergency room and hospital visits, are largely the domain of hospitals, which are somewhat powerless to actually stop these attacks from occurring. The hospitals treat the patient and then send him/her back to the same place that triggered the episode. It’s a revolving cycle, during which millions of dollars are spent and few are spared from preventable negative health outcomes in the future.
Besides the physical health toll an unhealthy home can have on its inhabitants, the monetary costs are enormous. Total annual costs for housing related childhood environmental diseases are estimated to be $54.9 billion.70 In addition, improving energyefficiency provides financial relief to low-income families by cutting utility costs, better enabling them to meet basic needs, pay for much needed medications and invest in healthy housing maintenance. Families eligible for federal home energy assistance spend 20 percent of their income on energy bills — six times more than the national average. Siloed and fragmented programs across all levels of government and the community undermine the ability of families, and the programs designed to serve them, to adequately address the high costs of unhealthy and energy inefficient housing. Without a coordinated assessment, intervention and investment strategy, residents with multiple housing
deficiencies have to fill out countless applications and needlessly endure multiple home assessments. Far too often this scattered approach has left hundreds of thousands of homes unable to receive energy efficiency investments due to health and safety issues. These barriers leave the families most in need to be the least likely to receive necessary improvements and upgrades. The Green & Healthy Homes Initiative™ (GHHI) was founded to address these glaring and costly gaps. GHHI, a national program designed to break the link between unhealthy housing and unhealthy children, utilizes a single stream education, assessment and intervention model to revolutionize health care service delivery, health-based housing intervention strategies, housing standards and intervention decision-making in the U.S. Currently, GHHI is engaged at the ground level in 16 cities nationwide. In each site, GHHI works with local governments, nonprofits, and private sector entities to implement an integrated health, housing and energy efficiency platform that better aligns the multiple programs currently available to low-income residents. GHHI produces measureable results that demonstrate better service delivery and health outcomes for Medicaid and Medicare children and families and reduce long term costs for health care providers and CMS. In short, people get healthier and health care costs go down. In Baltimore, one of our sites, we recently worked with the O’Bannon family. Dorothy O’Bannon and her two daughters, aged 4 and 13, lived in the home her family had owned for 40 years. Both girls were diagnosed with asthma, with the youngest daughter having been to the emergency room or hospitalized 13 times in the previous year due to severe asthma attacks, resulting in medical costs exceeding $53,000. When Mrs. O’Bannon sought services to help her improve the conditions in her home that were exacerbating her daughters’ illnesses, she was turned away by five different publicly funded programs before she was referred to GHHI. Because the problems in her home were so significant, none of the available programs could address the issues individually.
When GHHI performed a comprehensive assessment of her home, multiple issues were found, including: lead paint hazards; damaged roof causing leaks in many rooms throughout the home; mice and roach infestations; little or no insulation causing air leaks and drafty doors and windows and high utility costs; holes in the living room floor; defective plumbing causing mold and dampness. All of the hazards found in the O’Bannon home were causing excessive asthma episodes for the children. GHHI aligned and coordinated intervention services from seven different federal, city and community programs and funding sources to address the health and safety hazards in the home, completing the work in just four days.71 The scope of work included roof and floor repairs, lead and mold remediation, integrated pest management, window replacement, installation of foam insulation, and weather-stripping and other energy efficiency measures. The repairs and improvements performed in the O’Bannon home have had a dramatic impact on the health and well-being of the family. Since the work was completed, neither child has returned to the emergency department nor the hospital with asthma-related illnesses and the girls have not missed school as a result of asthma either. In addition, Mrs. O’Bannon’s gas usage to heat the home has been reduced by 27 percent. By coordinating the services, the work was completed
in less than half the time it would otherwise take and the cost for all of the interventions was 28 percent lower than it would have been had all of the work been done independently. Unfortunately, Mrs. O’Bannon’s story is not unique. Thousands of families are faced with the same challenges and the same choices when it comes to improving their housing in order to improve their health. GHHI was designed to serve families just like this all over the country. To date, more than 4,500 families have benefited from the integrated service model GHHI implements in local communities. Initial data shows similar results across the country as those experienced by the O’Bannon family, most notably: n A 67 percent reduction in hospitalizations and emergency department visits for children with asthma episodes, saving taxpayer funds supporting Medicaid; n Fewer missed school days, which improve academic performance and decrease parent’s need to miss work; and n 20 percent to 25 percent more efficient use of federal funds. Innovative programs like GHHI provide key opportunities under for investments in primary prevention by hospitals and managed care organizations.
