Housing and health: Interventions and strategies from Seattle

摘要: The physical, biological and social characteristics of the built environment have been associated with health status. Asthma and housing quality is one of the best studied examples. We will describe how efforts in the Seattle area began by improving indoor environmental quality and have grown into a broader effort to improve the built environment to promote health. We initially addressed exposure to indoor asthma triggers through a community health worker program which provides education, resources and support to learn and maintain actions which can improve indoor environmental quality (eg vacuuming, ventilating and dust control). The program increased actions taken by residents to reduce exposure to triggers, reduced dust exposure, decreased urgent health service utilization and increased asthma-related quality of life. However, this program was unable to address underlying structural conditions which increase trigger exposure. We therefore began testing the impact of low-cost housing remediation strategies ($7000 per unit to include installing ventilation fans, removing carpeting, eliminating leaks and water-damaged materials, etc.) on asthma morbidity. We next partnered with a public housing agency and community-based organizations to incorporate healthy homes guidelines and principles of healthy community design (eg opportunities for physical activity, access to healthy foods, sites to experience nature, design to promote social interaction) into the physical redevelopment of a 600 unit public housing site, along with resident-led community building activities to promote social cohesion and interaction. We now plan to review …