Cincinnati healthy homes assessment and code enforcement

Background: Cincinnati is an industrialized Midwestern city, with older housing stock, and a high percent of rental households. The Cincinnati Health Department (CHD) provides safety net services to the city, and upon request sends registered sanitarians to inspect homes and enforce Board of Health regulations for unsanitary living conditions (ex. roaches, mold, or rats). Many apartment buildings have repeated complaints from tenants. In 2011, the CHD initiated a Healthy Homes (HH) program, offering a global assessment of household hazards (for example, signs of pest infestation, moisture intrusion, indoor smoking, ventilation problems, lack of smoke/CO detectors, harmful chemicals, missing handrails, and trip hazards). Methods: Data was compiled comparing the number and type of initial complaints with the number and type of code violations found by sanitarians during HH assessments. Results: Between April and December 2011, 2,446 complaints were lodged by tenants. Of 845 tenants (complainants and/or tenants in the same building as complainants) that accepted the offer for a HH assessment, only 774 environmental hazards were self identified, but more than 1,800 significant code violations relating to moisture control, cleanliness, and pests were identified; in addition, 765 safety issues were identified and referred to the appropriate city departments. Conclusion: There is a low level of tenant knowledge about significant health hazards in their home environment. A comprehensive plan is needed to educate tenants and landlords about health and safety hazards in the home, and effective measures to abate these environmental hazards.