Category Archives: Housing
As colder weather begins to set in, a new story on the homeless from Atlantic Cities is particularly striking: According to the U.S. Department of Education, the number of homeless students in the United States has hit a record high number.
For the 2011 school year—the latest year for which the department has data—1,168,354 homeless children were enrolled in U.S. schools from nursery through 12th grade. Nationally, that is a 10 percent jump over the previous school year, and a whopping 72 percent increase since the recession began in 2008. More striking numbers: more than 40 states showed a rise in homelessness among kids and ten states saw the number of kids without a space to call their own rise more than 20 percent since 2008.
The lack of a safe home and limited access to health care leaves America’s homeless at especially high risk for a large number of health problems. According to a fact sheet from the National Health Care for the Homeless Council, “Without homes, people are exposed to the elements, disease, violence, unsanitary conditions, malnutrition, stress and addictive substances. Consequently, their rates of serious illnesses and injuries are three to six times the rates of other people. These conditions are frequently co-occurring, with a complex mix of severe physical, psychiatric, substance use and social problems.”
>>Bonus link: Continue reading even after the numbers jump out at you to learn about a ten year old girl, reported by the San Jose Mercury News, who rides a bus with her father in Santa Clara County, Calif., each night since the $70 monthly pass makes it an affordable option. The fact that the young girl is having “one of her best years so far in school,” according to her father, is all the more remarkable considering they have to get off and reboard that bus about every two hours.
CDC Report Finds Health Disparities, Inequalities Persist across the U.S. Population
The U.S. Centers for Disease Control and Prevention (CDC) has released a new report examining the disparities in mortality and disease risk as they relate to income, education level, sex, race, ethnicity, employment status and sexual orientation. CDC Health Disparities and Inequalities Report — United States, 2013 is the second CDC report to take this wide look at the U.S. population. Among its key findings:
- The overall birth rate for teens 15-19 years old dropped 18 percent from 2007 to 2010, although it varied widely from state to state
- People who are Hispanic, are low wage earners, were born outside of the United States, have no education beyond high school, or are male are more likely to work in an occupation in which workers are more likely than average to be injured or become ill
- Binge drinking is most common for people ages 18-34, men, non-Hispanic whites and people with higher household incomes
“It is clear that more needs to be done to address the gaps and to better assist Americans disproportionately impacted by the burden of poor health,” said Chesley Richards, MD, MPH., director of CDC’s Office of Public Health Scientific Services, which produced the report. “We hope that this report will lead to interventions that will allow all Americans, particularly those most harmed by health inequalities, to live healthier and more productive lives.” Read more on health disparities.
HUD Grants to Help Transform Distressed Communities into Thriving Communities
The U.S. Department of Housing and Urban Development (HUD) is granting approximately $4.37 million to help nine areas transform their public or other HUD-assisted housing and distressed neighborhoods into thriving communities. Fifty- two communities had applied for the Choice Neighborhoods Planning Grants. The agency’s Choice Neighborhoods Initiative supports locally-driven economic developments to create renewed, sustainable communities, with a focus on creating energy-efficient, mixed-income housing that has easy access to high-quality services, education programs, early learning programs, public assets and public transportation. Full details on each community can be found here. Read more on housing.
Study: Certain Health Behaviors Tied to Complication-free Pregnancies
Women who engage in certain healthy behaviors—and avoid certain unhealthy ones—are more likely to have complication-free pregnancies, according to a new study in the journal BMJ. An analysis of health data on more than 5,600 women found that eating fruit, having a healthy weight, having lower blood pressure, having a job, and stopping drug and alcohol abuse at 15-20 weeks of gestation "may increase the likelihood of normal pregnancy outcomes," according to Lucy Chappell, of the Women's Health Academic Center of King's College London. The most common pregnancy-related complications are babies who were too small for their gestational age, high blood pressure, preterm birth and preeclampsia. Read more on maternal and infant health.
Bithlo, Fla. is a town of 8,000 that is just 30 minutes outside Orlando and not much farther from the “happiest place on Earth” — but is beset by poverty, illiteracy, unemployment and toxic dumps that have infiltrated the drinking water. The water is so bad that it has eroded many residents’ teeth, making it that much harder for them to find jobs. Streets filled with trash, frequent road deaths and injuries from a lack of transportation options and safe places to walk, and dropping out before 10th grade were all the norm.
In just a short time, a collection of partners and volunteers have begun to reverse some of the decades-old problems Bithlo has faced. And earlier this week, the town that had been forgotten for almost a century was the scene of a hubbub of activity as hundreds of volunteers descended on the town to continue work on “Transformation Village,” Bithlo’s future main street, which will sport a combination library/coffee shop, schools, shops and many other services, all long missing from Bithlo.
Over the last few months, NewPublicHealth has reported on initiatives of the participating members of Stakeholder Health, formerly known as the Health Systems Learning Group. Stakeholder Health is a learning collaborative made up of 43 organizations, including 36 nonprofit health systems, that share innovative practices aimed at improving health and economic viability of communities.
>>Read more on the Stakeholder Health effort to leverage health care systems to improve community health.
One of the Stakeholder Health members is the Adventist Health System, a not-for-profit health care system that has hospitals across the country. Recently, Adventist’s flagship health care provider, Florida Hospital in Orlando, began supporting United Global Outreach (UGO), a non-profit group aimed at building up communities in need, in their four-year-long effort to transform the town of Bithlo.
NewPublicHealth recently spoke with Tim McKinney, executive vice president of United Global Outreach, and Verbelee Neilsen-Swanson, vice president of community impact at Florida Hospital, about the partnerships and commitment that have gone into Bithlo’s transformation into a town that is looking forward to new housing stock, jobs, stores, better education and improved health outcomes for the its citizens.
Study: State Car Seat, Seatbelt Laws Leave Children Vulnerable to Injury, Death
Many state laws on car seats and seatbelts are not current with regards to modern research or are inconsistent from state to state, leaving children vulnerable to injuries or even death, according to a new study in the journal Social Science and Medicine. Researchers look at child passenger safety laws from 1978-2010 across all 50 states [Editor’s note: Go here for an interactive map]. “These laws do not keep up with the published evidence, and even when they do, there are some cases where the laws are unclear,” said Jin Yung Bae, JD, MPH, the study’s lead author, and associate research scientist at the Steinhardt School of Culture, Education and Human Development at New York University. Approximately 250,000 children are injured and 2,000 are killed each year in the United States because of vehicle crashes, which many of these preventable, according to the study authors. The study was conducted by a team from New York University in collaboration with Temple University, and supported by the Robert Wood Johnson Foundation through its Public Health Law Research. The National Institutes of Health’s National Institute on Alcohol Abuse and Alcoholism also funded the study. Read more on injury prevention.
USDA Announces Grants to Improve Rural Housing
The U.S. Department of Agriculture (USDA) has announced that organizations in 45 states, the Western Pacific and the Commonwealth of Puerto Rico will receive grants to make housing repairs and improve housing conditions for limited-income rural residents. The funding is through the USDA Rural Development's Housing Preservation Grant program and will be provided to intermediaries such as local governments; public agencies; federally-recognized Indian Tribes; and non-profit, faith-based and community organizations. The organizations distribute the grants to homeowners and owners of multi-family rental properties or cooperative dwellings who rent to low- and very-low-income residents. Grants may be used to make general repairs, such as installing or improving plumbing, providing or enhancing access to people with disabilities and making homes more energy efficient. Read more on housing.
CDC’s Emergency Management Program Receives Full EMAP Accreditation
The U.S. Centers for Disease Control and Prevention (CDC) has become the first federal agency to achieve full accreditation of its emergency management program from the Emergency Management Accreditation Program (EMAP). “Accreditation is a serious accomplishment for CDC and the emergency management community we support,” said Ali S. Khan, MD, MPH, director of the Office of Public Health Preparedness and Response. “Preparing for and responding to emergencies of any kind—natural disasters, bioterrorism events, chemical terrorism or pandemics—is a core function of public health. Everyone at CDC has a hand, at one point in time, in emergency management and execution.” EMAP’s six steps to accreditation are subscription, self assessment, application, on-site assessment, committee review and accreditation decision. Thirty one states; the District of Columbia; and 14 U.S. cities and counties are accredited. Read more on preparedness and accreditation.
DOT and HUD Release Neighborhood Affordability Tool
The U.S. Departments of Housing and Transportation (HUD and DOT, respectively) have released a Location Affordability Portal, a new tool that lets users estimate housing and transportation costs for neighborhoods across the country.
“Many consumers make the mistake of thinking they can afford to live in a certain neighborhood or region just because they can afford the rent or mortgage payment. Housing affordability encompasses much more than that,” said HUD Secretary Donovan. “The combined cost of housing and transportation consumes close to half of a working family’s monthly budget, and the [Portal] will help to better inform consumers, help them save money, and provide them with a broader perspective of their housing and transportation options.”
The new tool was developed with the input of real-estate industry professionals, academics, and staff from HUD and DOT, and uses statistical models that were developed from various sources that capture key neighborhood characteristics including population density, transit and job access, average number of commuters and distance of commutes, average household income and size, median selected monthly owner costs. and median gross rent. Read more on housing and transportation.
Health Index May Reduce Hospital Readmissions
A health risk score used during hospital stays using routine data from hospital electronic medical records may be able to identify patients at high risk of unplanned hospital readmission, according to a study published in Medical Care.
The score is calculated automatically using patient data such as vital signs, nursing assessments, skin condition, heart rhythms and laboratory tests. Lower Rothman Index scores (from a maximum of 100) indicate a higher risk of readmission. The study evaluated the ability of the Rothman Index to predict hospital readmission, based on data from more than 2,700 patients hospitalized during 2011. The researchers found that patients whom the Index calculated as being high risk for readmission were 2.5 times as likely to be readmitted within 30 days of discharge as patients calculated by the Index to be low risk.
About 20 percent of Medicare patients are readmitted to the hospital within 30 days of discharge, at an estimated cost of $17 billion per year, according to the study authors. Medicare has begun reducing payments by up to 2 percent for hospitals with high readmission rates. Read more on community health.
Rapid Flu Testing in the ER Leads to More Effective Treatment
Using rapid influenza tests to diagnose flu in patients who come to the emergency room results in fewer unnecessary antibiotics, increased prescriptions for antiviral medicines, and fewer additional lab tests compared to patients diagnosed with influenza without testing, according to a new study the Journal of the Pediatrics Infectious Diseases Society.
Among patients diagnosed with influenza without rapid testing, 23 percent of the emergency department visits included a prescription for antibiotics, which are not effective in to treat influenza because it is a viral infection. However, for patients who were diagnosed by rapid testing, only 11 percent of visits resulted in the patient getting antibiotics. Additional laboratory tests, including chest X-rays, blood tests, and urinalysis, were also ordered less frequently for patients whose influenza illness was diagnosed with a rapid test.
"While other studies have shown that physicians can accurately diagnose influenza without testing, our results suggest that using an influenza test increases diagnostic certainty and leads to the physician providing more specific and appropriate care,” says Anne J. Blaschke, MD, PhD, of the University of Utah School of Medicine, the study’s lead author. Read more on infectious disease.
When thinking about ways to improve the public's health, housing may not leap to mind at first. Reducing obesity, increasing access to healthy food and promoting tobacco control are all more popular and more obvious public health strategies. But in the past several years, leaders in the field are realizing the vital role that housing can also play in health.
So why is housing so important for health? And how can we create "healthy housing" for the public? That was the focus of Monday's American Public Health Association (APHA) panel, "Landscape of Healthy Housing: Strategies, Policies, and Initiatives."
Panelists from the U.S. Department of Housing and Urban Development (HUD) to Maryland's Green and Healthy Homes Initiative to the U.S. Environmental Protection Agency (EPA) discussed issues ranging from lead-based paint hazards, to smoke-free housing, to infrastructure problems—and how all of these impact health.
Chris Trent, who's worked on HUD's Advancing Healthy Housing a Strategy for Action, asked: "Do we really have to be concerned about our homes? Yes, we do. There are 23 million housing units with one or more lead-based paint hazards. Six million housing units in the U.S. have moderate-to-severe physical infrastructure problems."
She also re-emphasized why housing is so important to health for everybody, even if we don't think about it: 69 percent of our time is spent in a residence, and therefore housing automatically impacts how healthy people are.
Trent also pointed out the return on investment (ROI) in creating healthy housing for people. "We know these [healthy housing strategies] are working. There is a return on your investment that is beneficial to everybody."
For example, she noted, spending $1 on preventing lead hazards lead to a $17-$221 savings in health costs.
Ruth Ann Norton, Executive Director of Green & Healthy Homes Initiative, noted the impact that unhealthy housing can have on people— especially children and their education.
"The largest reason kids don't come to school is asthma," she pointed out. "And this asthma is often coming from their home environment. We need to break the link between unhealthy housing and unhealthy children."
"All of these housing issues are health issues," Norton said.
>>NewPublicHealth will be on the ground throughout the APHA conference speaking to public health leaders and presenters, hearing from attendees on the ground and providing updates from sessions, with a focus on how we can build a culture of health. Follow the coverage here.
In the 1970s and 80s, residents of the Bronx, one of New York City’s five boroughs, were so anxious to leave the crime-ridden area that many residential and commercial buildings—once majestic and architecturally rich—were torched and empty for decades. Now fifty years later there’s a waiting list of thousands for Via Verde, a new low- and middle-income Bronx housing complex that opened last year. Many features set the complex apart from almost any other housing development in the United States, including an emphasis on greenery from almost every vantage point of the building. This helps create a calming and beautiful atmosphere for the residents, many of whom grew up in crowded housing projects where any nearby parks were usually too dangerous to enjoy.
Why is housing important for health? A lack of affordable rental housing can push more tenants into substandard or overcrowded living situations. Living in unaffordable housing also leaves fewer resources for the things that can keep a family healthy, such as healthy food or preventative health care. Low-income housing also has a reputation for being unhealthy, and for good reason—more than 6 million housing units in the U.S. have deficiencies such as lead paint hazards; allergens, dampness and mold that can trigger asthma; and unsafe structural issues that can cause falls and other injuries. Via Verde and other similar efforts seek to change all that, with housing that is not only affordable but also safe, healthy and even environmentally sound and sustainable (which in turn also saves on costs).
The design for Via Verde was the winner of a 2006 competition hosted by the New York City Department of Housing Preservation and Development; the New York Chapter of the American Institute of Architects; the New York State Energy Research and Development Authority (NYSERDA); and the Enterprise Foundation. It was New York City’s first juried design competition for affordable and sustainable housing.
AAP: Children Should Be Immunized Against Influenza As Soon As Possible this Season
Parents and caregivers should have all children ages 6 months or older immunized against influenza as soon as possible, according to new updated recommendations from the American Academy of Pediatrics (AAP). Immunization options include the trivalent vaccine that protects against three influenza strains and the new quadrivalent vaccine that protects against four strains. “Parents should not delay vaccinating their children to obtain a specific vaccine,” said pediatrician Henry Bernstein, DO, FAAP, the lead author of the flu recommendations. “Influenza virus is unpredictable, and what’s most important is that people receive the vaccine soon, so that they will be protected when the virus begins circulating.” Other vulnerable groups that should definitely be vaccinated include children with chronic health conditions, children of American Indian or Alaskan Native heritage, health care workers, pregnant women, women who may become pregnant or are breastfeeding and people who have contact with children in high-risk populations. The U.S. Centers for Disease Control and Prevention estimates that between 135 million and 139 million doses of vaccine will be manufactured for the 2013-14 influenza season. Read more on influenza.
HUD: $37M to Oklahoma for ‘Unmet Needs’ of Disaster Recovery
The U.S. Department of Housing and Urban Development (HUD) has allocated approximately $37 million in disaster recovery funds for the state of Oklahoma and the City of Moore, Okla., which were severely damaged by extreme storms—including an EF5 tornado—on May 20. Dozens were killed and more than $1 billion in property damage was caused. The grants are part of HUD’s Community development Block Grant Program, which supports long-term disaster recovery efforts in places of “unmet need.” “The May storms cost the lives of dozens of Oklahomans and over $1 billion in property damage. “We are steadily rebuilding, but many families are still struggling to get back on their feet,” said Oklahoma Governor Mary Fallin. “The disaster relief grants provided by HUD—along with continued work from state and local governments and non-profits—will make a big difference in the lives of those affected by this year’s tornadoes. They will be particularly helpful as we work to provide assistance to low income Oklahomans, many of whom are uninsured.” About $26.3 million of the funds will go toward Moore, with the rest going toward the state. Read more on disasters.
Boys Faced Higher Death Risk than Girls from Multiple Causes
Boys on average face a higher risk of death than girls—not just from traumatic events such as accidents, homicides and suicides, but also from cancers and diseases of the heart, lungs and nervous system. The study found that from 1999 to 2008 there were about 76,700 more deaths among boys than girls, and that boys from infancy to age 20 were 44 percent more likely to die. The findings appear in the latest edition of the journal Pediatrics. The findings are not entirely surprising, as past research has indicated that girls have a certain survival advantage and experts already knew that boys are at increased risk of developing certain chronic health conditions. Still, the question is why. "This could be a story of resilience and ability to overcome," said study author Chris Feudtner, MD, a pediatrician at the Children's Hospital of Philadelphia. "Maybe there's some robustness factor that males are missing." Feudtner said that learning why boys faced these higher risks—and for chronic diseases in particular—could help health care experts better understand and treat the conditions. Read more on mortality.
NHTSA: Free VIN Searches Will Let Drivers Check for Safety Recalls
The U.S. Department of Transportation's National Highway Traffic Safety Administration (NHTSA) will next year require that automakers and motorcycle manufactures provide free online search services for Vehicle Identification Numbers (VIN) so that consumers can search for information on uncompleted recalls. Consumers will also be able to use a central government site (SaferCar.gov) to determine whether a recall has been issued on a vehicle and whether the remedy has been performed. "Every day NHTSA is working for the American consumer to ensure that automakers and motorcycle manufacturers address safety defects and non-compliances, and that they also recall affected vehicles in a timely manner," said NHTSA Administrator David Strickland. "By making individual VIN searches readily available, we're providing another service to car, light truck and motorcycle owners and potential owners—the peace of mind knowing that the vehicle they own, or that they are thinking of buying, is safe." Read more on transportation.
Quick Change to Mellow Music Reduces the Risk of Road Rage
Smooth jazz could save your life—or at least keep you from doing something impulsive behind the wheel. According to a new report in the journal Ergonomics, switching to mellow music in a car can help drivers stay calm during stressful situations that could lead to road rage. Studies have already linked “upbeat” music to more aggressive driver behavior and “downbeat” music with more relaxed, safer behavior. However, the question before the researchers was whether a quick change or a gradual change to calmer music was more effective; they determined that drivers in both conditions would reach the same calm state, but drivers who changed the music abruptly would become calmer—and driver safer—sooner. The results show that "during high-demand driving, abrupt changes in music led to more physiological calmness and improved driving performance and were thus safer and more effective," concluded researcher Marjolein van der Zwaag, of Philips Research Laboratories in Eindhoven, and colleagues in the Netherlands and at Stanford University in California. Read more on safety.
HUD: $12.8M in ‘Sweat Equity’ Grants to Create Affordable Homes
Through its Self-Help Homeownership Opportunity Program, the U.S. Department of Housing and Urban Development (HUD) has awarded approximately $12.8 million in “sweat equity” grants to create at least 718 affordable homes. The four non-profit, self-help housing organizations that received the funds will work to reduce the cost of the homes for working families. “Sweat equity” is the increased value of a property due to restoration and upkeep efforts by the owners. “Today, we make another investment in the American Dream for hundreds of working families,” said HUD Secretary Shaun Donovan. “Using their own labor, along with sweat equity from armies of volunteers, these families will construct their own homes and become stakeholders in their own neighborhoods.” To qualify, a minimum of 50 sweat equity hours is required from a household of one person and a minimum of 100 sweat equity hours is required from a household of at least two people. The work can include landscaping, foundation work, painting, carpentry, trim work, drywall, roofing and siding for the housing. Read more on housing.
$1.7B in HUD Grants for Major Improvements to 1.2 Million Public Housing Units
The U.S. Department of Housing and Urban Development (HUD) has awarded $1.7 billion to improve approximately 1.2 million public housing units across the country. The funds—part of HUD’s Capital Fund Program—will be shared by all 50 states, plus the District of Columbia, Guam, Puerto Rico and the U.S. Virgin Islands. They will go toward building, repairing, renovating and modernizing public housing, with an emphasis on large-scale projects such as replacing plumbing and electrical systems. About 10,000 public housing units are lost each year, with disrepair being the most common reason. HUD estimates that the nation’s public housing requires about $25.6 billion in large-scale repairs. “This funding is critical for housing authorities to maintain and improve public housing conditions for their residents,” said HUD Secretary Shaun Donovan. “However, with a significant repair backlog, I am encouraged by new, innovative long-term solutions HUD is exploring that can be combined with this funding to not only protect and preserve this housing for the next generation, but to also build the quality infrastructure necessary for families to thrive.” Read more on housing.
Study: Women in Urban Environments at Higher Risk for Postpartum Depression
In large part because of the difference in general risk factors, women who live in large urban areas are more likely than women who live in rural areas to develop postpartum depression, according to a new study in the journal CMAJ. Risk factors such as low levels of social support and having been born in another country are more common in urban environments, according to research Simone Vigod, MD, of the Women's College Research Institute in Toronto. They found that about 9 percent of women surveyed in cities of 500,000 people or more had postpartum depression, versus 6 percent of women in towns with fewer than 1,000 people. "That's a pretty big difference at the population level," said Vigod, according to Reuters. "It's not the air that you breathe in an urban area that makes you depressed," she added, "it's actually that the population characteristics of people living there are different." About 10 to 15 percent of women experience persistent and serious depression in the first year after their child’s birth, according to the U.S. Centers for Disease Control and Prevention. Read more on infant and maternal health.
New HIV Test Will Allow for Earlier Detection, Treatment and Reduce Risk of Transmission
The U.S. Food and Drug Administration (FDA) has approved a new HIV test that will allow for earlier detection and treatment of people with the immune deficiency disorder. The test looks for the HIV-1 p24 antigen as well as antibodies to both HIV-1 and HIV-2 in human serum. “This test helps diagnose HIV infection at an earlier time in outreach settings, allowing individuals to seek medical care sooner,” said Karen Midthun, MD, director of the FDA’s Center for Biologics Evaluation and Research. “Earlier diagnosis may also help to reduce additional HIV transmission.” There are about 1 million people in the United States currently living with HIV and about 20 percent of them have not been diagnosed, according to the U.S. Centers for Disease Control and Prevention. Read more on HIV/AIDS.