B-More Healthy Environments: Asthma Education and Environmental Assessments Jalyce Martin, MPH Candidate School of Community Health and Policy

Background  1.2 million children under the age of five and 7 million children under the age of 18 living with asthma today.  There was 11.5% of insured individuals and 40.3% of uninsured who were unable to afford their asthma medication prescriptions  Asthma prevalence was 13.5% among poor children and 17% among non-Hispanic black children the > prevalence among all children

GHHI Assessment Process Environmental Health & Safety Education 3 Healthy Homes Resident Education on o Asthma triggers reduction o Household injury prevention, o Lead poisoning prevention o Other Healthy Homes topics Distribution & explanation of Healthy Homes Maintenance Kit Referrals to partnering organizations for any other Healthy Homes related services

GHHI Baltimore Model Assessments & Interventions Comprehensive, Integrated, Holistic Combination of different types of Interventions o Lead Hazard Reduction, o Healthy Homes  IPM, Indoor Allergens, Safety o Weatherization, o Energy Efficiency 4

Indoor Pollutants o Mold/moisture issues & history o Tobacco smoke practices o Pest issues & pesticide usage Indoor Hazards Management o Cleaning practices o Ventilation/Moisture o AC/Heating issues & practices Safety & Injury Prevention o Smoke detectors & CO alarms o Maintenance issues & history o Recent accidents GHHI Assessment Process Home Owner/Tenant Interview

 Cost to Communities of Unsafe and Unhealthy Housing  Lead Poisoning, Asthma Episodes, Household Injury  Wealth depletion  Disinvestment  Foreclosure  Abandoned properties  Housing Code/Condemned  Increased Homelessness  Housing-based illness  Excessive Energy Users

Based on the Healthy Home Framework Element of a Healthy Home Keep it Dry Keep it Well Ventilated Contaminant Free Pest Free Keep it Well Maintained Keep it Safe Keep it Clean Energy Efficient GHHI Assessment Process Home Health & Safety Audit

Healthy Homes Element 1 & 2 A dry & well ventilated home Signs of moisture & mold issues Mold, water leaks & condensation

10 Healthy Homes Element 3 Contaminant free home Presence of lead hazards  Chipping paint  Friction surfaces  Dust accumulation

11 Reducing Asthma Triggers in the Home  Examples:  Mold  Cockroaches  Mice and Rats  Dust Mites  Dogs & Cats  Chemical Odors  Tobacco Smoke  Poor IAQ

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Low Income Levels Number of People in Household Low Income Limits 200% of Poverty 122, , , , , ,940

Public Health Implications  Maintaining a healthy environment is fundamental to increasing quality of life and years of healthy life. Roughly 25 percent of all deaths and the total disease burden can be attributed to environmental factors.  A healthy environment for all is a goal of Healthy People This includes outdoor air quality, surface and ground water quality, toxic substances and hazardous wastes, homes and communities, infrastructure and surveillance, and global environmental health.

 Atlanta  Providence Baltimore  Philadelphia  Cleveland  Chicago  Detroit  Flint  Denver  Oakland  Cowlitz Indian Tribe  Spirit Lake Nation Tribe  San Antonio Current & Next Generation GHHI Sites  New Haven  Austin  Houston  St. Louis  Omaha  Seattle  Portland  New York City  Buffalo  Minneapolis / St. Paul  Green – Current GHHI sites  Blue – possible next generation GHHI sites  San Francisco  New Orleans  Boston  Montgomery  Boise  Cedar Rapids  Dubuque  Erie  Greensboro  Raleigh  Los Angeles  Miami  Milwaukee  Riverside  State of Delaware State of Connecticut  Jackson  Spokane  Salt Lake County  Mesa  Santa Fe  Albuquerque  Kansas City  Nashville  Toledo

References  CDC - Morbidity and Mortality Weekly Report (MMWR). (2011, May 6). Centers for Disease Control and Prevention. Retrieved March 1, 2013, from  Environmental Health - Healthy People. (n.d.). Healthy People Improving the Health of Americans. Retrieved March 1, 2013, from rview.aspx?topicid=12 rview.aspx?topicid=12  Green and Healthy Homes Initiative | Breaking the link between unhealthy housing &unhealthy children. (n.d.). Green and Healthy Homes Initiative. Retrieved February 20, 2013, from