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"Healthy Homes,"

by Julia Burgess In contrast to the significant environmental gains in reducing pollution in our air, water and land, progress on housing-related health hazards has lagged behind. Substandard housing poses environmental health hazards to low-income families due to the failure of multiple systems: poor maintenance by landlords; laws and codes that provide inadequate protection and are laxly enforced; and insufficient subsidies for decent, safe and affordable housing.July/August 2004 issue of Poverty & Race

In contrast to the significant environmental gains in reducing pollution in our air, water and land, progress on housing-related health hazards has lagged behind. Substandard housing poses environmental health hazards to low-income families due to the failure of multiple systems: poor maintenance by landlords; laws and codes that provide inadequate protection and are laxly enforced; and insufficient subsidies for decent, safe and affordable housing. All too often, housing-related environmental hazards, especially in communities of color, go unexamined, unidentified and ignored until human health has been harmed.

Indoor environmental health hazards pose far greater risks to human health than outdoor exposures, a disparity due both to the higher levels of toxics associated with confined spaces and the preponderance of time spent indoors. Among the health hazards encountered in homes are those that cause and contribute to asthma (such as dust allergens, mold and pests), toxic materials (such as lead, asbestos and chemical pesticides) and dangerous gases (such as carbon monoxide and radon).

Moisture is a major cause of paint deterioration, which is primarily responsible for children’s exposure to lead dust and paint chips. Moisture problems also encourage the growth of mold, mildew, dust mites and cockroaches, which contribute to asthma and other respiratory diseases. Inadequate ventilation increases the concentration of indoor air pollutants and exacerbates moisture and humidity problems.

Older homes with deferred maintenance pose substantially greater risks for lead poisoning and other health hazards. In most cities, low-income rental properties in economically distressed communities, particularly low-income communities of color, bear the brunt of housing-related health hazards. While the prevalence of childhood lead poisoning has declined to 2.2% nationwide, lead poisoning rates commonly exceed 25% in high-risk neighborhoods across the country. African-American children are at five times higher risk than white children; low-income children are at eight times higher risk than children from upper-income families. In some distressed neighborhoods, one-third of preschool children suffer from elevated blood lead levels.

Asthma is the most common chronic disease of childhood, affecting almost 5 million American children. Nationally, asthma prevalence has increased 75% from 1980 to 1994. Asthma is 26% more prevalent in African-American children than in white children. African-American, Hispanic and low-income children suffer higher rates of hospitalization, emergency room visits and deaths from asthma.

Housing Codes

Most health hazards in housing are the direct result of conditions that in most communities constitute code violations. Many owners of low-income rental properties are unaware of or unconcerned about lead and other health hazards in their properties. For example, many owners of high-risk rental properties lack sufficient motivation even to take advantage of generous federal subsidies available through lead hazard control grants. Despite the fact that lead and other health hazards are pervasive in low-income rental housing, few properties are checked for hazards until after a child’s health has been harmed – and even then the response is often inadequate. Peeling paint, water leaks and other code violations frequently go unattended. When government agencies do order paint repair, many fail to make provision for lead-safe work practices, oversight of the work or final testing to make sure the residence is lead-free.

Role of Community-Based Organizations

Protecting residents and their children requires detecting and correcting hazards in their homes before health problems develop. Traditionally, the tools to assess such hazards have belonged to “experts,” but recent technological advances have reduced the cost and simplified their use. The Community Environmental Health Resource Center (CEHRC) provides low-cost tools, training, technical assistance, strategy advice and grants to help local staff and members of community-based organizations identify and address health hazards in high-risk housing.

Individual families stand to benefit from the knowledge about health hazards in their homes that environmental testing can reveal. But CEHRC’s main purpose is to advise community-based organizations on how data that documents such hazards can be used as an organizing and advocacy tool to hold landlords accountable, change public policy and strengthen government programs. In fact, most families cannot effectively protect themselves and their children from health hazards in substandard housing through changes in their day-to-day behavior (e.g., diet, housecleaning and hygiene), and most very-low-income families do not have the resources to relocate to safe housing. Even if families have the ability and means to move, safe and affordable housing is scarce in many neighborhoods in most cities.

Avoiding Potential Dangers

However, the fact that a responsible and representative community-based organization seeks to identify health hazards expressly to help families at highest risk does not rule out the possibility that unintended consequences could harm these very families. The following possibilities are reminders of the need to respect and protect individual rights:
  • A landlord might evict a family in retaliation for reporting code violations or board up his property instead of making mandated repairs;
  • A landlord might aggravate hazards by using unsafe work practices or harass tenants by making only partial repairs;
  • A resident might misunderstand the test results and abandon the property without good cause; or
  • Undocumented residents might be deported.

Because reporting address-specific data on health hazards or code violations to a landlord, government agency or the media could result in unintended adverse consequences to tenants, organizations should obtain the concurrence of any affected residents in what data will be released, to whom, by whom and when. As part of its outreach to residents, the organization should explain the possible risks involved in notifying the landlord, a government agency or the media about documented hazards. Organizations should also be prepared to assist the family in dealing with any negative consequences. If the organization does not have the capacity to do so itself, it should coordinate arrangements in advance with other organizations to provide assistance, such as legal services. In determining whether or not particular data should be considered “address-specific,” groups should err on the side of caution.

If a resident is fearful about the disclosure of the address, other options are still available for using those data for broader advocacy and organizing:
  • Tenants in an apartment building or development can encourage their neighbors to have their units tested as well. A building-wide or development-wide approach spreads the risks among multiple tenants, while providing a tool for organizing to win a common victory against a bad landlord.
  • An organization fighting an owner of multiple problem properties can investigate a few units in each building to document a pattern of deferred maintenance and neglect in order to trigger targeted code enforcement.
  • The organization can postpone reporting a health hazard to the landlord or government agency until after the resident has moved and the unit is vacant.

But the most effective means to avoid unintended consequences is to build a strong base of community support. Experience in CEHRC projects indicates that data documenting health hazards in housing can be a powerful lever for organizing residents in economically distressed communities. Achieving systemic, long-term solutions depends on residents understanding their rights and organizing their communities to hold the responsible parties accountable for taking corrective action and instituting preventive measures.

Residents should be included to the maximum extent possible both in designing strategies to leverage data for maximum benefit and in actually releasing the information. To ensure that residents’ privacy and rights are protected in using data for advocacy and organizing, the important distinction must be recognized between “address-specific” information and data that do not reveal the specific premises tested or otherwise identify specific tenants.

Consistent with a written agreement with the residents, local groups may freely release and report data that are aggregated and analyzed so that residents’ names and addresses are not revealed or ascertainable. For example, an organization can compile data collected in units throughout a geographic area to document community-wide housing-related health hazards. Reporting such “macro data” at the block, census block group, census tract or zipcode level can effectively support broad advocacy campaigns, such as passage of a new ordinance, increasing systematic enforcement efforts, or increased public funding for housing rehab in the identified neighborhood.

In most cases, however, community-based organizations will find that citing data for specific properties provides much more pointed, vivid and compelling documentation of hazards to trigger overdue action. Such address-specific information can also serve organizing and advocacy aims in multiple ways, including:
  • Discovering that health hazards are present in many units in a building or housing complex can bring residents together in common cause, increasing individuals’ power through numbers;
  • Putting a landlord on notice about the presence of a lead hazard in a specific unit engages the federal disclosure law, which requires the landlord to disclose the hazard to future tenants in the building or face stiff federal fines and penalties; and
  • Disclosing multiple code violations identified in an apartment building, complex or neighborhood can pressure government officials to step up concentrated code enforcement.

Healthy Homes and Affordability

Over the past quarter century, the number of families facing housing affordability problems has grown significantly. More than 5 million households now live in severely inadequate housing or pay more than 50% of their low income in rent, a measure of severe economic distress that portends physical deterioration. As government subsidies for housing continue to be scaled back and the amount and incidence of substandard housing grows, community-based organizations are beginning to recognize that the health and safety of housing must be addressed at the same time as affordability. Examples include:
  • Guided by CEHRC hazard assessment protocols, Greensboro [NC] Housing Coalition staff and volunteers visited more than 1,200 high-risk homes in predominantly African-American neighborhoods to inform residents about lead and perform health and safety inspections. GHC documented bad housing conditions, including paint deterioration and lead in damaged paint (using lead check swabs), finding lead hazards in 40% of the tested homes. They presented their findings to the City, and as a result of community pressure and collaborative planning, the City Council reformed Greensboro’s inspection system by passing RUCO (Rental Unit Certificate of Occupancy). It requires proactive and systematic inspections of all rental housing. GHC is now educating landlords, tenants and others about RUCO; ensuring that as many units as possible are up to standard; and ensuring that tenants are not evicted if landlords do not make repairs.
  • In the Dominican community of Washington Heights, New York City, Union Communal, a large coalition of tenant organizations sponsored by the Northern Manhattan Improvement Corporation (NMIC), used their hazard investigation findings to support efforts by the NYC Coalition to End Lead Poisoning to win enactment of a new municipal lead poisoning prevention ordinance. They compiled their hazard investigation results into a written report entitled, “More that 1 out of 4 children in Washington Heights is at risk of being lead poisoned in his or her home.” The report was released along with a press tour of bad buildings that received extensive media coverage, providing additional support for a strong City Council vote in favor of the lead ordinance three weeks later. The law, which became effective after the City Council overrode a mayoral veto, requires peeling paint and lead dust to be safely controlled by trained personnel in pre-1960 apartments with children under age 7. Landlords may not have tenants evicted because of having to do repairs. Currently, NMIC and Union Communal are working to make the changes necessary within city bureaucracy in order for the law to be effectively enforced.

Affordable housing must and can at the same time be safe and healthy. It may require government intervention to hold landlords accountable to avoid displacement. But more and more successes show that an organized community can achieve this goal.

Julia Burgess is Director of the Community Environmental Health Resource Center, a project of the Alliance for Healthy Homes. Prior to that, she spent 14 years at the Center for Community Change, where she was Director of Special Initiatives.

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