Seattle-King County Healthy Homes: Reducing asthma morbidity through improving home environmental quality

The 130th Annual Meeting of APHA

4119.0: Tuesday, November 12, 2002 - 1:15 PM

Abstract #42920

James W Krieger, MD, MPH¹, Tim Takaro, MD,, MPH², Lin Song, PhD³, Carol Allen³, and Marcia Weaver, PhD⁴. (1) Schools of Public Health and Medicine, Public Health-Seattle & King County and University of Washington, 999 Third Ave Suite 1200, Seattle, WA 98104, 206-296-6817, james.krieger@metrokc.gov, (2) Department of Environmental Health, University of Washington, P.O. Box 354695, Seattle, WA 98195-7234, (3) Public Health-Seattle & King County, 999 Third Ave Suite 1200, Seattle, WA 98014, (4) School of Public Health/Department of Health Services, University of Washington, 901 Boren Avenue, Suite 1100, Seattle, WA 98102

Introduction: Exposure to indoor asthma triggers plays an important role in asthma pathogenesis. We evaluated using community health workers to assist households in reducing exposure to residential triggers. Methods: We randomly assigned 274 low-income asthmatic children to a high or low intensity group. Health workers visited all homes to assess exposures, develop an action plan and provide bedding encasements. The high group received cleaning equipment and 5-9 additional visits over a year while the low group received only the initial visit. Results: Caregiver quality of life, health care utilization, exposure to triggers and cleaning behaviors improved for both groups, more so in the high group.

Outcome	High Intensity Group				Low Intensity Group				∆H-L
	Before	After	∆	p	Before	After	∆	p	p
Symptom days/2 weeks	8.0	3.5	-4.5	.000	7.7	4.1	-3.6	.000	.220
Caretaker’s quality of life	4.0	5.6	1.6	.000	4.4	5.4	1.0	.000	.046
Percent with hospitalization, ER visit, or unscheduled clinic visit/2mos	26.1	7.8	18.3	.000	20.2	14.9	5.3	.239	.045
Floor dust loading (g/m²)	2.64	0.96	1.68	.008	2.67	1.74	0.93	.172	.042
Asthma trigger score	1.26	0.96	0.30	.013	1.39	1.23	0.15	.152	.070
Percent. vacuuming child’s bedroom > 2times/2wks	63.9	78.7	14.8	.004	62.5	64.4	1.9	.706	.017

Conclusions: The Healthy Homes intervention was beneficial (with greater benefit in the high group). Challenges included difficulties in remediating structural deficits and inability to assist participants with extensive cleaning needs. Overcoming these challenges will require advocacy and policy work by public health and its partners.

Learning Objectives:

Understand components of a Healthy Homes program.
Describe effectiveness of a Healthy Homes program.
Understand limitations of a Healthy Homes program.
Discuss policy and advocacy issues for making housing healthier.

Keywords: Asthma, Housing

Related Web page: www.metrokc.gov/health/phnr/eapd/healthyhomes.htm

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Healthy Homes Projects on Asthma and Housing: Implementation, Outcomes, Policy Issues and Advocacy

The 130th Annual Meeting of APHA