Benefiting Residentswith Greener, Healthier Homes

David E. Jacobs, PhD, CIH

May, 2011

LISC Webinar

National Center forHealthy Housing

The seven principles of healthy housing How green building programs stack up against healthy housing principles Health benefits for residents of green developments – The EvidenceKey health dangers found in the homeGreen measures to improve resident health

Session Overview

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

Miasma & Housing-Related Disease

Health in the Late 19th Century

Challenge of Tuberculosis, Typhoid, Cholera Seemed Insurmountable Lessons for Public Health Officials, Architects and Planners: Light, Fresh Air, Reduce Crowding, Improve Sanitation. With Improved Living Conditions & Medical Interventions, Disease Rates Declined

Is Housing a Shared Commons?

Cuyahoga River ca. 1960

Keep Homes:• Dry• Clean• Pest-Free• Ventilated• Safe• Contaminant-Free• Maintained

7 Healthy Homes Principles

Control Asthma and Respiratory Triggers

Make Homes Smoke- Free

Test for Radon

Control Moisture to Avoid Mold

No or Low-VOC

Products

Carbon Monoxide/

Nitrogen Dioxide

Healthy Housing: It Doesn’t Stop at the Threshold

Health Principles

Enterprise Community Partners Green Communities

EPA Indoor Air Package

USGBC LEED for Homes

ICC-700 National Green Building

Standard

Dry A A B C

Clean D D D D

Ventilated A A+ A C

Safe D D D D

Contaminant-Free A A D D

Pest-Free A+ A+ B D

Maintained A+ A A+ A

Verified/Certified B A+ A+ A+

Overall Grade* B B+ C D

* Based on total score across all criteria in comparison to 85 target score.

National Center forHealthy Housing

National Green Program Health Grades

Green Homes: Benefiting Residents with Greener, Healthier HomesNational Center for Healthy Housing Case Studies

National Center for Healthy Housing

Green Housing Series:

The Advent of a Green Community National Center for

Healthy Housing

Green Housing Series:Rebuilding a Community through

Healthy Green Renovation

National Center for Healthy Housing

Green Housing Series:A New Prescription for Asthma

Sufferers: Healthier Homes

Viking Terrace Worthington, MN

Breathe-Easy Homes Seattle, WA

Wheeler Terrace Washington, DC

Each year in the U.S. hazards in the home lead to:• 250,000 lead poisoning cases• 18,000 injury deaths each year• 21,000 lung cancer deaths due to Radon• 450 deaths and 15,000 emergency department

visits due to carbon monoxide poisoning• 2 million asthma-related emergency

department visits

New ConstructionHousing and Health: Examples from Seattle’s Breathe-Easy Homes

Costs:$5-$7000 additional/unit

BenefitsHealth:• asthmatic children have

more symptom-free days• Able to participate in more

outdoor activities

Economic:• Unit cost=approx 1 night

hospital cost for severe asthmatic episode

• Est. Annual cost of U.S. Asthma Care: $18billion

Green Communities Minnesota Case Study

Green Process

1. Integrated Design Process2. Location and Neighborhood Fabric3. Site4. Water Conservation5. Energy Conservation6. Materials and Resources7. Healthy Living Environment8. Operations and Management

Preserve affordable housing while reducing operating costsIncrease life expectancy and efficiency of affordable housingReduce maintenance costs and wasteImprove residents’ health and community livabilityEliminate hazardous materials, asbestos, radon and moldsMinimize water and energy consumptionBuild recycling and on-site conservation into construction practices

Green Healthy Housing RehabViking Terrace SW Minnesota

Energy efficient lighting & windows, occupancy sensors, enhancedinsulation Improved roofing system and enhanced attic insulationGeo-thermal heating and cooling systemEnergy star rated appliancesSealed building envelope*Radon Testing*Improved ventilation system*Bathroom and kitchen exhaust fans*Integrated Pest Management*Rubber walk-off mats*Low-VOC paints, sealants, adhesives, cabinets, carpet and flooring*Construction, development and maintenance staff training*Resident education*

* Specific Health-Related Elements

Viking Terrace

Building Performance Assessment:Center for Sustainable Building Research

Energy use and costEmissions and environmental impactMaterials performance evaluationWater use and costCost Benefit Analysis

Livability & Health Assessment:National Center for Healthy Housing

Resident health pre and post renovationPhysical condition of units, buildings and surrounding areaLevel of physical activity/exercise

Green Homes: Benefiting Residents with Greener, Healthier HomesResearch and Evaluation

Long-term benefits exceed upfront costs every timePartnering for assessment and evaluation is keyConduct pre-renovation/construction testingand assessment before, during and after Building commissioning worth extra expense

Green Homes: Benefiting Residents with Greener, Healthier HomesViking Terrace

Green Rehab Elements Health

Other Green Rehab Elements

• High efficiency geothermal heating and cooling system.

• Enhanced insulation of the building envelope.• Energy Star appliances.• Water conserving appliances and fixtures.• Cement fiber siding.• Interior finish materials using recycled content.• On-site recycling of demolition and construction

materials.

Demographics

Mostly immigrant, minority race and all low-income (mean household income = $29,000)43% of adults had been born in the US82% of the children were born in the USWhite - 37%African immigrant (not African-American) -35%Hispanic – 29%Female – 58%

Baseline Questionnaire Results

Comfort in Apartment Compared to Old Home

73%

10%

17%

More Comfortable Less Comfortable About the Same

Baseline Questionnaire Results-2

Ease of Cleaning Compared to Old Home

63%10%

27%

Easier Harder About the Same

Baseline Questionnaire Results-3

Amount of Time Children in Household Play Outside Compared to Old Home

64%9%

27%

Play Outside More Play Outside Less About the Same

Baseline Questionnaire Results-4

29%

14%

57%

Child's Health Compared to When In Old Home

Better Now Worse Now About the Same

Baseline Questionnaire Results-5

Adult's Health Compared to When in Old Home

37%

11%

52%

Better Now Worse Now About the Same

Baseline Questionnaire Results-6

Safety of Building Compared to Old Home

41%

7%

52%

Safer Less Safe About the Same

Minnesota Findings (Adults)

General health reported as either very good or excellent increased from 33% to 62% (p=0.052)• Chronic bronchitis 10% 0% (p=0.025);• Hay fever (12% 4% (p=0.046);• Sinusitis (12% 2%; p=0.025);• Asthma (12% 4%; p=0.046);• Hypertension (10% 4%; p=0.083).

Minnesota FindingsChildren

General health reported as either excellent or very good increased from 53% to 65% (p= 0.286) • Respiratory allergies decreased from 15% 4%

(p=0.083)• Ear infections also improved by the same amount

(p=0.083).• Doctor diagnosis of eczema or other skin allergy

decreased from 23% 0% (p=0.083). • No change in asthma (n=2)

Residents reported that their newly renovated homes were:• easier to clean (86%, p<0.001),• more comfortable (88%, p<0.001), • safer (86%, p=0.008)• and that their neighborhood was safer (83%,

p=0.021)• that their children played outside more often

(86%, p=0.059).

Moisture

Fewer people reported that their newly renovated homes had:• moisture problems (29% 4%; p=0.020)• evidence of water or dampness due to broken

pipes, leaks, heavy rain, or flooding • (39% 18%; p=0.083)

• a need for either a dehumidifier • (24% 3%; p=0.014)

• or a humidifier (17% 7%; p=0.083).

Pests

Fewer problems with cockroaches • (17% 7%; p=0.083).

Lower use of insecticides by residents • (21% 4%; p=0.059)

Lower use of insecticides by exterminators or maintenance personnel • (37% 4%; p=0.003)

Fewer problems with mice or rats • (25% 0%; p=0.046).

Smoking

Fewer people reported that there was smoke inside their homes due to incense, cigarettes, cigars, pipes, wood fires, or non-tobacco cigarettes • (54% 36%; p=0.025)

Carbon Dioxide and VOCs

Year-long average CO2 = 982 ppmAll VOCs below ATSDR minimum risk levels

Energy & Water Consumption

46% reduction in total energy useAn estimated 39% reduction in CO2emissions from power plants.

Conclusions

High Costs of Health Care/Health InsuranceMortgage Crisis & Affordable HousingEconomic RecoveryHealthy Housing, Green Development, Climate ChangeProblems?? ORAn Unprecedented Opportunity!!

Contact Information

David Jacobs, PhD, CIHResearch DirectorNational Center for Healthy HousingWashington DCdjacobs @nchh.orgwww.nchh.org