A Housing and Neighborhood Index Score for Predicting Disparities in Childhood Lead Poisoning and Asthma

A recent cross sectional study involving 353 households in Saginaw, MI revealed that there is increased likelihood of children with elevated blood lead levels (eblls) being dual diagnosed with asthma. Although the link between such health burdens and exposures to environmental risk factors found in housing and communities has been well documented, there are currently no cost effective means of measuring the health impact of multiple housing and neighborhood related hazards.

In seeking to fill this gap, a population study was conducted with the goal of developing a Housing and Neighborhood Index (HNI), a tool to identify households and neighborhoods in U.S. communities that pose the greatest health risk to children. It was hypothesized that households with an increased HNI score are more likely to have children with asthma and/or eblls. The study involved 618 randomly selected households which housed 1198 children under 13 years old and 50 pregnant women. Demographic, health, environmental and behavioral risk factor, quality of life, and neighborhood satisfaction information was collected using a 20 minute survey administered by a computer assisted telephone interview (CATI). An exterior housing & neighborhood observational evaluation was completed for each home. Simple descriptive statistics were computed to examine the population demographics and households with asthmatic and ebll children. Hierarchical linear modeling was used to assess the association between measured factors and asthma or eblls. A relative score was assigned based on the strength of association. A total HNI score for each household was calculated. Over 23% of the household had at least one child with asthma. This project represents the first systematic attempt to develop an aggregate measure of environmental risk factors that can be related to health disparities at the household and community levels.