Incorporating Health Into Green Physical Needs Assessments

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1 Incorporating Health Into Green Physical Needs Assessments Opportunities to Include Integrated Pest Management and Green Cleaning NYC Preservation and Development Provided by NYC Department of Mental Health and Hygiene, NYC Local Initiatives Support Corporation (LISC), & Tohn Environmental Strategies

2 Key Partners and Resources NYC Housing Preservation Department NYC Department of Health and Mental Hygiene NYC Local Initiatives Support Corporation Two Shades of Green

3 Today s Goals Understand the connections between building conditions and resident health, particularly for asthma Role of Integrated Pest Management to safely and effectively reduce pest and improve building conditions How transitioning to green cleaning can create a healthier living environment and reduce operating costs Gain skills and tools to incorporate IPM and green cleaning guidance into Green PNA reports and staff and tenant training

4 Two Shades of Green (TSG) Collaboration Effort Collaborative Effort: Local Initiatives Support Corporation,, NYC Department of Health & Mental Local Initiatives Hygiene, Support NYC Coalition Corporation, for a Smoke-Free, NYC Department City and of our Health CDC partners & Mental Hygiene, NYC Coalition for a Smoke-Free City and our CDC partners Goals Goals Promotes green and healthy retrofits and property maintenance in existing affordable housing using Promotes cost effective green and measures healthy retrofits and property maintenance in existing affordable housing using cost effective measures Building wide approach and one stop shop Building wide approach and one stop shop Target housing of most at-risk individuals Target housing of most at-risk individuals Demonstrate how health driven upgrades have non-health benefits Demonstrate how health driven upgrades have non-health benefits Incentivize good housing maintenance Incentivize good housing maintenance Cost effective and scalable Cost effective and scalable

5 The Role of of the the TSG TSG Team Team Select building/s going through rehab with high energy and water use and/or Select building/s going through rehab with high energy and water use and/or deteriorating housing conditions. Benchmark and track energy and water use and other maintenance and operation costs. Conduct green and healthy building assessment Work with owners/managers to assess current practices & support implementation (technical assistance, training and resource identification) Evaluate results: asthma triggers, operating costs, complaints, tenant/staff postsurvey

6 West Side Federation Senior and Supportive Housing WSFSSH renovation (145 unit senior housing and center in South Bronx) Energy efficiency measures Water conversation - toilets, showerheads, fixed leaking pipes Used 45% less water Saved $50,000/year, 12 month payback Fewer leaks & asthma triggers, reduced tenants complaints. Reduced maintenance workload (running toilets, plumbing). Less unreported plumbing leaks Transition to green cleaning supplies 28% reduction in cleaning cost Integrated Pest Management Plan Fewer pests Fewer tenant complaints and sightings by staff Reduced pesticide use Improved property maintenance

7 Housing Asthma Triggers Vary with Income Housing Disrepair, Allergens, and Poor Health Outcomes Increase with Neighborhood Poverty Source: NYC EPHT Portal - HVS 2011; CHS 2012, SPARCS 2010.

8 Asthma ED Rates (per 10,000 residents) Vary by Neighborhood Source: New York State Statewide Planning and Research Cooperative System (SPARCS) Deidentified Hospital Discharge Data, 2012.

9 Homes with 3 or More Maintenance Deficiencies by Neighborhood Source: NYC EPHT Portal, NYC HVS 2011.

10 Asthma is a NYC Health Priority Most common childhood chronic illness (13% of NYC children ages 12); adults impacted too ~800,000 adults and children A leading cause of school absences, lost work days and hospitalizations Improvements, but rates too high Addressing asthma triggers in the home key to improving health outcome

11 Housing-Based Asthma or Respiratory Triggers Moisture Tobacco Smoke Dust Mite Pest: Cockroach Feces Cleaning Products Pest: Mice Feces 11

12 Living in Damp Homes Increases Health Risks Health Problem Upper respiratory tract symptoms Estimated % Increase Risk of Health Problem in Damp Homes 52% Cough 50% Wheeze 44% Current asthma 50% Ever-diagnosed asthma 33% Source: National Academy of Sciences (2004) 12

13 Rx for Asthma:Breathe Easy Homes Upgrades to renovation to reduce triggers in homes of persistent asthmatics: moisture controls in envelope; enhanced ventilation (ERVs), improved temperature control, finishes and flooring to reduce dust mites and off gassing, and community health worker visits. 1 year later we see: 4.8 fewer symptom days/2 weeks 42% reduction in urgent clinical care trips Takaro, TK, Krieger J, The Breathe-Easy Home: The impact of asthma-friendly home construction on clinical outcomes and trigger exposure. Amer J Public Health

14 Rx for Asthma: Green Rehab Chicago Public Housing, after green rehabilitation: energy efficiency, water conservation, moisture and dust controls, ventilation, low toxicity materials: Reduced asthma (61% adults, 65% children with fewer symptoms), headaches, sinus infection Less urgent care for child asthma (20% reduction) Fewer missed school/work days due to asthma (4%) Jacobs, et al., 2014 Moving into Green Housing: The Yield, J Public Health Management and Practice

15 RX Asthma: Weatherization Improved asthma outcomes when weatherization plus health added to community health worker visits of asthmatics (Bryesse, 2013) o o King County WA: Bath fans, replace carpet, CO/smoke detectors, insulation, air sealing, duct work, lighting, minor moisture/leak repairs, range hood, dryer venting Median costs $4200/apartment, $6300s/single family home or duplex Weatherization yielded fewer sinus infections, reduced asthma medication use, increased asthma symptoms (Wilson, 2013) o o NYC, Boston, Chicago multi family properties Weatherization: Insulation, air sealing, heating system repairs, limited window replacement, minor moisture repairs