B-More Healthy Environments:

Asthma Education and Environmental Assessments

Jalyce Martin, MPH CandidateSchool of Community Health and Policy

Background 1.2 million children under the age of five

and 7 million children under the age of 18 living with asthma today.

There was 11.5% of insured individuals and 40.3% of uninsured who were unable to afford their asthma medication prescriptions

Asthma prevalence was 13.5% among poor children and 17% among non-Hispanic black children the > prevalence among all children

GHHI Assessment ProcessEnvironmental Health & Safety Education

3

• Healthy Homes Resident Education ono Asthma triggers reductiono Household injury prevention,o Lead poisoning preventiono Other Healthy Homes topics

• Distribution & explanation of Healthy Homes Maintenance Kit

• Referrals to partnering organizations for any other Healthy Homes related services

GHHI Baltimore Model

• Assessments & Interventions• Comprehensive, Integrated,

Holistic• Combination of different

types of Interventionso Lead Hazard Reduction, o Healthy Homes

IPM, Indoor Allergens, Safety

o Weatherization, o Energy Efficiency

4

• Indoor Pollutants o Mold/moisture issues & historyo Tobacco smoke practiceso Pest issues & pesticide usage

• Indoor Hazards Managemento Cleaning practiceso Ventilation/Moistureo AC/Heating issues & practices

• Safety & Injury Preventiono Smoke detectors & CO alarmso Maintenance issues & history o Recent accidents

GHHI Assessment ProcessHome Owner/Tenant Interview

93%

3% 4%

Participants by Race

BlacksWhitesOthers

Cost to Communities of Unsafe and Unhealthy Housing

Lead Poisoning, Asthma Episodes, Household Injury Wealth depletion Disinvestment Foreclosure Abandoned properties Housing Code/Condemned Increased Homelessness Housing-based illness Excessive Energy Users

Based on the Healthy Home Framework

Element of a Healthy HomeKeep it Dry

Keep it Well Ventilated

Contaminant Free

Pest Free

Keep it Well Maintained

Keep it Safe

Keep it CleanEnergy Efficient

GHHI Assessment ProcessHome Health & Safety Audit

Healthy Homes Element 1 & 2 A dry & well ventilated home

Signs of moisture & mold issues

Mold, water leaks & condensation

10

Healthy Homes Element 3

Contaminant free homePresence of lead hazards

Chipping paint Friction surfaces Dust accumulation

11

Reducing Asthma Triggers in the Home

Examples:MoldCockroachesMice and RatsDust MitesDogs & CatsChemical OdorsTobacco SmokePoor IAQ

12

Low Income Levels

Number of People in Household

Low Income Limits 200% of Poverty

1 22,340

2 30,260

3 38,180

4 46,100

5 54,020

6 62,940

Roaches Mice Rats Insecti-cides

Always 61 96 12 42

Sometimes 80 88 27 95

Never 126 91 223 117

25

75

125

175

225

Frequency of Pests and Insecticides#

of

Part

icip

an

ts

Public Health Implications Maintaining a healthy environment is

fundamental to increasing quality of life and years of healthy life. Roughly 25 percent of all deaths and the total disease burden can be attributed to environmental factors.

A healthy environment for all is a goal of Healthy People 2020. This includes outdoor air quality, surface and ground water quality, toxic substances and hazardous wastes, homes and communities, infrastructure and surveillance, and global environmental health.

Atlanta

Providence

Baltimore•Philadelphia

ClevelandChicagoDetroit

Flint

DenverOakland

Cowlitz Indian Tribe

Spirit Lake Nation Tribe

San Antonio

Current & Next Generation GHHI Sites

New Haven

Austin

Houston

St. Louis

Omaha

Seattle

Portland

New York City

Buffalo

Minneapolis / St. Paul

· Green – Current GHHI sites

· Blue – possible next generation GHHI sites

San Francisco

New Orleans

Boston

Montgomery

Boise

Cedar Rapids

Dubuque Erie

GreensboroRaleighLos Angeles

Miami

Milwaukee

Riverside

State of Delaware

State of Connecticut

Jackson

Spokane

Salt Lake County

MesaSanta Fe

Albuquerque

Kansas City

Nashville

Toledo

References CDC - Morbidity and Mortality Weekly Report (MMWR). (2011,

May 6). Centers for Disease Control and Prevention. Retrieved March 1, 2013, from http://www.cdc.gov/mmwr

Environmental Health - Healthy People. (n.d.). Healthy People 2020 - Improving the Health of Americans. Retrieved March 1, 2013, from http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=12

Green and Healthy Homes Initiative | Breaking the link between unhealthy housing &unhealthy children. (n.d.). Green and Healthy Homes Initiative. Retrieved February 20, 2013, from http://www.greenandhealthyhomes.org