Addressing Pandemic Needs

Healthy Housing: Innovation Gone Wrong

By: Marcus Smith, MBA and Jacquelyn M. Rose, MPH

This is the second in a series of four blog posts that we plan to publish during Healthy Homes Month that explores how organizations can leverage housing innovations as a platform to help children to flourish, thrive, and succeed.

Lead is a neurotoxin that can have a devastating and life-long impact on those exposed to it. When initially added into paint and other materials, public health experts, scientists and others did not fully understand the impact of lead’s toxicity. In paint, it was touted as having great promise in accelerating drying, increasing durability and maintaining a fresh appearance. Residents excitedly used it for decades to spruce up their homes. However, the government banned its use in paint and other products during the 1970s and 1980s, amid a growing understanding that exposure to lead causes serious health problems and irreversible neurological deficits in children.

Now, more than 40 years later, many communities are still dealing with the consequences of lead paint on child health, development and well-being.

Addressing the Impact of an Innovation Gone Wrong

After officials banned the use of lead in many products, there was no comprehensive and concentrated effort to remove it from homes, resulting in generations of children exposed to it through lead-based paint. In response, the U. S. Department of Housing and Urban Development (HUD) launched the Lead Hazard Reduction Program in 1992 to protect children and their families from housing-related health and safety hazards. This initiative allows communities to apply for grants and secure funding to address environmental hazards, such as lead paint, in homes.

Connecticut Children’s established the Connecticut Children’s Healthy Homes Program (Healthy Homes) in 2003 to remediate lead-based paint in Connecticut homes with support from the federal Lead Hazard Reduction Program. Initially, the sole focus of Healthy Homes was to make housing units lead-safe. We primarily served low- to moderate-income families in 15 communities with funding support from HUD and the State of Connecticut. A majority of our referrals came from pediatricians and local health officials after a child’s lead screen indicated concentrated levels of lead in their blood.

Over the course of the past 17 years, Healthy Homes has secured more than $34 million in federal funding and $29 million in matching grants from community partners and state agencies. This funding enabled us to make more than 3,000 homes lead safe, protecting more than 1,800 children under the age of 6. The program has also educated more than 38,000 people about the dangers of lead poisoning.

Expanding to Address Other Home Hazards

Throughout the years, our understanding of the connection between housing quality, stability and affordability has grown. We now know that healthy, safe and stable housing impacts a family’s capacity to grow and thrive. It affects a child’s ability to learn in school and a parent’s ability to create and maintain a nurturing environment for their children. Housing, along with access to nutritious foods, reliable transportation and stable employment opportunities, all correlate with stronger families and stronger communities.

Armed with that knowledge, team members realized there were other hazards commonly found in older homes that Healthy Homes could address to improve outcomes for children and their families. In 2015, we expanded the program’s focus to include other health and safety hazards, such as mold and moisture issues, pest manifestations, fire and safety hazards, trip and fall hazards, radon and asbestos.

With the expanded scope and focus came new opportunities for funding. In 2018, Healthy Homes received a generous $10 million grant from the Connecticut Department of Housing to deploy efforts statewide. This funding enables us to not only make homes lead safe, but to also address other environmental hazards, such as those identified above by:

  • replacing windows and doors, resurfacing walls and floors, and repairing failed exterior siding to mitigate lead exposure,
  • installing ventilation fans to reduce asthma-triggering mold and moisture in bathrooms and kitchens, and
  • replacing broken stair treads and handrails to eliminate trip and fall hazards.

Expanding our focus and working statewide enhances our capacity to not only address the lingering effects of lead paint in homes, but to also address these other concerns to improve the overall health, development, and well-being outcomes of young children.

One of the children we helped through the years is Fredrik, who has asthma. Our inspectors found water pooling in his basement, as well as lead on the outside of his home. We remediated the concerns and Fredrik is now thriving.

Read more about Fredrik’s story here.

Pivoting Our Approach in Response to COVID-19

Home visits and home assessments are two foundational activities of Healthy Homes. Our Relocation and Education Coordinator (REC) conducts our home visits. During this visit, the REC meets with the family in their home to educate them on the importance of maintaining a healthy home. The REC also engages families using a strength-based approach to link them to needed resources such as asthma education, nutrition assistance, job readiness programs, and energy efficiency services. Third-party environmental professionals facilitate our home assessments by conducting thorough evaluations of the built environment to identify a wide range of health hazards and risks. We use this information to develop remediation plans for homes.

To protect the health and well-being of our team and the children and families we serve, we made the decision to halt in-person home visits and assessments to align with state and local quarantining guidelines deployed in response to the COVID-19 pandemic. When making the decision to halt in-person activities, we immediately began exploring alternative engagement and assessment strategies. In the coming weeks, we plan to roll out a virtual home visiting and assessment protocol that will continue to effectively screen for basic needs related to housing, health and well-being, and work to connect our families with relevant services that meet their perceived needs.

While initiatives like Healthy Homes are doing meaningful and effective work, we need systemic changes to address the root cause of this problem. Without systemic changes regarding how communities uphold their commitment to healthy housing, we will continue to intervene after children have been exposed to environmental hazards and are managing the health, development and well-being consequences of these exposures. We must identify and adopt a collective approach to address the lingering impact of lead-based paint – a once promising innovation that now can only be described as an innovation gone terribly wrong.

Read additional blogs in this series:
Part 1 – When #StayHome Does Not Equal #StayHealthy
Part 3 – Healthy Housing: Moving the Needle from Intervention to Prevention
Part 4 – Innovation and Housing as a Platform for Childhood Prosperity

Are you a changemaker working at the intersection of housing and children’s health? We want to hear from you! Email us at childhoodprosperitylab@connecticutchildrens.org and tell us how you are supporting childhood prosperity.

Marcus Smith is the senior manager of Connecticut Children’s Healthy Homes Program, which is a program of Connecticut Children’s Office for Community Child Health.

Jacquelyn M. Rose, MPH, is the program manager for the Childhood Prosperity Lab, which is a program of Connecticut Children’s Office for Community Child Health.

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