Indianapolis Healthy Homes: Low income households' triggers for asthma

Background: Environmental asthma triggers such as mold, moisture, presence of pests, & indoor smoking cause and/or exacerbate asthma symptoms, especially among low income communities. A large urban health department is entering the 2nd year of a HUD supported longitudinal study to develop and evaluate public health assessments and low cost interventions to reduce disparate environmental health and safety hazards in very low income and predominantly Black households. This initiative addresses identified hazards, including asthma triggers, preventable injury, radon, lead and general health risk factors. Methods: Preliminary data are presented for 117 of 452 volunteer eligible homes (income under 80% FPL) evaluated for asthma triggers in targeted neighborhood (6,800 households). Household heads were interviewed and homes assessed at baseline for asthma triggers using model Pediatric Environmental Home Assessment Survey adapted for this study. Findings: Half (45%) of homes were constructed before 1950, over 80% owner occupied. About 60% of households had an asthma case (and 31% with 1+), including 44% of children under 18 (vs. 9% in Indiana) and 20.1% of adults (vs 9.9% in the county and 12% among Blacks and low income Indiana residents). Asthma triggers included 36% of residences with pets (76% kept indoors), 25% allowed indoor smoking, 22% had mice and 9% with cockroach evidence. While 30% had basements, 19% had visible mold in the living areas, and few had wood/oil-burning heating systems. Conclusions: Following initial assessment, Healthy Homes teams provides personalized environmental health education, low cost intervention items, and referrals to public health and health care services for asthma and other environmental hazards. Homes are followed over 6 months with 4 in-home visits (for period 11/2010-8/2011) allowing ongoing assessment and evaluation of accepted interventions per household. Presenters will discuss implications for a sustainable public health outreach and intervention to improve the health of vulnerable populations.