A Business Case for Green and Healthy Housing

An increasingly robust evidence base shows widespread improvements in asthma patients' health when primary and specialist care are supplemented by in-depth asthma education, home environmental assessment, and mitigation of home-based triggers provided by a team of health care providers. These green and healthy homes interventions are particularly effective in low-income and minority high risk populations.

Public and private health care payers rarely cover the costs of these critical and effective asthma management services, however, and they are reluctant to consider doing so without information on cost and cost-effectiveness.

To help strengthen the case for increased access to asthma education and home-based environmental interventions, the Asthma Regional Council and the University of Massachusetts Lowell developed a “business case,” summarizing both the peer-reviewed research literature and the practice-based gray literature.

Our review reveals that when targeted and delivered appropriately, asthma education programs that include environmental trigger information typically result in net cost savings. Although the cost evaluation literature relevant to promoting green and healthy homes interventions for asthma is more limited, the evidence suggests that programs are cost-effective, although they do not appear to generate net cost savings.

In addition to a review of the relevant literature, our business case also includes a model framework for allocating asthma education and in-home “green” interventions appropriately. In recent months, this framework has proven a useful tool to decision-makers in government, private and public insurance plans, provider and advocacy organizations seeking to reduce the burden of asthma by increasing access to needed preventive environmental services.