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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 l.jpg

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 l.jpg
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


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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


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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


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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


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




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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



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Benefits of Window Replacement

  • Lead Dust Accumulation

  • Energy Savings: Heating and Cooling

  • Housing Value

  • Other?


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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


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Data Needed for Cost Benefit Analysis of Green Healthy Housing

  • Housing Conditionsthat Impair Health (1)

  • HousingImprovements that Advance Health (2)


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Housing Conditions HousingThat Affect Health (1)

  • Categories:

  • Sufficient Scientific Evidence

  • Some Scientific Evidence

  • Insufficient Evidence

World Health Organization (WHO)


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Sufficient Evidence (WHO, 2005) Housing

  • 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


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Some Evidence (WHO, 2005) Housing

  • 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


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Housing Changes HousingScientifically Shown to Improve Health (2)


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Proven Healthy Housing Improvements Housing

  • Asthma Interventions

  • Integrated Pest Management

  • Moisture Intrusion Reduction

  • Radon Mitigation

  • Lead Hazard Control

  • Smoke & CO Alarms

  • Pre-Set Hot Water Temperature


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Green Communities HousingMinnesota Case Study










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Breathe Easy Homes: HousingHealth 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)




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Partners Wheeler Terrace, DC

  • 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)


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Wheeler Terrace Green Healthy Housing Redevelopment Wheeler Terrace, DC

  • Health outcomes measured using validated instrument from Centers for Disease Control and Prevention

    • Asthma

    • Injuries

    • Mental Health

    • Cardiovascular

  • Allergen levels


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Project Approach Wheeler Terrace, DC

  • 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


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Conclusions Wheeler Terrace, DC


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A National Conversation Wheeler Terrace, DC

  • 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!!


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Contact Information Wheeler Terrace, DC

David Jacobs, PhD, CIH

Research Director

National Center for Healthy Housing

202-607-0938

djacobs @nchh.org

www.nchh.org


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