Targeting home as a 'first level' safe environment across the lifespan with the implementation of low-cost injury prevention for "healthy homes"

Unintentional injury is a significant cause of morbidity and mortality in the U.S. Incidence and causes of unintentional injury vary across the lifespan. Many unintentional injury hazards are found in home environments. Marion County Public Health Department is currently completing a 3-year study of health & safety factors in homes of low income residents in Indianapolis. This study was funded in 2009 by HUD. An important area being addressed as part of this study is injury prevention in homes across the lifespan. Baseline and 6-month assessment data were collected in 2010 and 2011 with in-home interviews for 186 households. Information included interviews with self-identified ‘heads-of-household' utilizing the adapted ' Pediatric Environmental Home Assessment Survey' and home inspections. Homes were older (62% built prior to 1950), owner-occupied (85%) and single-story (75%). Results showed 11% of households had young children, 85% of self-identified heads-of-household were black, and 40% had persons 65 years of age or older. It was noted that 60% of the population targeted had no education beyond high school. Elderly persons were assessed via self-report regarding recent falls and medical service use for unintentional injury. Injury prevention item assessment on checklist focused on child, elderly, and fire safety. After initial assessment, individualized interventions were developed for households consisting of education, referrals, and low-cost safety items ($142 average per household).There were significant reductions in the number of safety hazards in homes between initial assessment and final assessment at 6 months. The number of measured safety hazards decreased from a mean of 3.5 out of 11 to 0.9. Child safety scores decreased significantly from 3.2 out of 12 to 1.3. While reported number of elder falls (over 65 years) declined, change was not significant. Time frame and number of subjects may not have had enough power to measure significant change.