The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #55603

James W Krieger, MD, MPH, 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, Donna L. Higgins, PhD, Centers for Disease Control and Prevention, 4770 Buford Highway, MS-K73, Atlanta, GA 30341, and Tim Takaro, MD,, MPH, Department of Environmental Health, University of Washington, P.O. Box 354695, Seattle, WA 98195-7234.

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 (e.g. 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 (e.g. 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 local housing code to incorporate healthy homes guidelines and promote more effective housing inspection and code enforcement.

Learning Objectives:

At the conclusion of the session, the participant in this session will be able to:
• Describe at least three public health strategies for improving health through improving the quality of the built environment.
• Understand how these strategies can be applied for improving the health status of people with asthma.
• Recognize the multiple dimensions of the environment (built, social, chemical, biological) that affect health, and how they interact.

Keywords: Housing, Asthma

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.