Category Archives: Housing
Earlier this year, when a federal task force convened to look at how to help Detroit pull out of bankruptcy and regain resident and business confidence, one of the first recommendations was to assess the many blighted areas of the city—typically created when residents leave an area in droves, or when a business moves out of a building and isn’t replaced by another—and begin restoring them for residential, business or green space use.
Blight matters. Beyond making a city ugly, abandoned areas become a haven for trash, toxic elements, drug sales and prostitution. In Dorchester, outside Boston, a space sold by the city for a parking lot was left vacant for years and became a trash dump with mounds of cigarettes, and cars and tires—all leaching toxins.
A growing number of communities are starting to clean up those lots. In Baltimore, flight from the city has left close to a million homes and apartment buildings vacant over the last few decades, leaving in their place empty, dirty spaces that invite crime and trash. Bon Secours Community Works—the foundation of the Bon Secours Health System with hospitals in Baltimore and other cities—supports initiatives aimed at creating stable housing, including a program called Clean and Green, which is a part of Bon Secours' Housing and Neighborhood Revitalization Department.
Clean and Green is a landscaping training program that has transformed more than 85 vacant lots into green spaces, and has also begun to initiate community arts projects such as large public murals and community gardens. The program is designed to teach green job development skills, as well as provide free cleanup and beautification services to Baltimore neighborhoods.
Each program team is hired for six months of on-the-job training in green landscaping, during which they learn how to use landscaping and gardening tools and then go out into the field to clean lots, plant trees, pick up trash and do weeding. As part of their training, each individual gives at least three presentations about some aspect of green landscaping that they’ve learned, further preparing them for job interviews and jobs in the field. Each summer, youth employees also join the Clean and Green team for six weeks, working alongside the adults to learn about green landscaping and giving back to a community.
Planners, public health experts, community development leaders, architects and many others have come together over the past decade to focus on housing as a framework for a healthy life. A report released earlier this year by the Robert Wood Johnson Foundation’s (RWJF) Commission to Build a Healthier America made the link between health and housing clear:
“Living in unhealthy homes and communities can severely limit choices and resources. Healthy environments—including safe, well-kept housing and neighborhoods with sidewalks, playgrounds and full-service supermarkets—encourage healthy behaviors and make it easier to adopt and maintain them.”
Housing also impacts health when people spend so much on their rent or mortgage that they don’t have enough left over to pay for critical expenses such as food and medicine. According to the MacArthur Foundation—which released its second annual “Housing Matters” survey last month—during the past three years more than half of all U.S. adults have had to make at least one sacrifice in order to cover their rent or mortgage, including:
- Getting an additional job
- Deferring saving for retirement
- Cutting back on health care and healthy foods
- Running up credit card debt
- Moving to a less-safe neighborhood or one with worse schools
Ianna Kachoris, a MacArthur Foundation program officer who oversees its How Housing Matters to Families and Communities research initiative, said that the quality and safety of a home make a significant impact on a person’s overall quality of life. Among the housing specifics that can impact health are lead or mold; the need to move frequently; having to live with many other people to make housing affordable; and concern over being able to afford the rent, the mortgage or needed housing repairs. The survey also found that accessing affordable quality housing in their communities is difficult for many people, including families with average income, young people just getting started in the labor force and families who want to live in quality school districts.
Report: Food Sodium Levels at Many Top Chains Continue to Be Unhealthily High
From 2009 to 2013, the nation’s top restaurant chains reduced the sodium in their foods by an average of only 1.5 percent annually, according to a new report from the nonprofit Center for Science in the Public Interest (CSPI). In a review of 136 meals from 17 chains, researchers determined that approximately 79 percent of the 81 adult meals contained more than 1,500 milligrams (mg) of sodium—or one mg more than the U.S. Centers for Disease Control and Prevention recommends as a full day’s limit. The study also found efforts to reduce sodium to be inconsistent, with some chains actually increasing the amounts over the studied time period. CSPI Executive Director Michael F. Jacobson said the findings indicate that the U.S. Food and Drug Administration’s “wait-and-see” approach to sodium in packaged and restaurant food doesn’t work and that a new approach is needed. Read more on nutrition.
CDC: Antibiotic-resistant Foodborne Germs Remain a Serious Public Health Issue
New data from the U.S. Centers for Disease Control and Prevention (CDC) indicates both positive and negative trends in the ongoing public health fight against antibiotic-resistant foodborne germs, which contribute to an estimated 430,000 U.S. illnesses every year. According to the data, multi-drug resistant Salmonella—which causes approximately 100,000 U.S. illnesses annually—decreased over the past decade, but Salmonella typhi resistance to certain drugs increased by 68 percent in 2012, meaning one of the common treatments for typhoid fever may not be effective. “Our latest data show some progress in reducing resistance among some germs that make people sick but unfortunately we’re also seeing greater resistance in some pathogens, like certain types of Salmonella,” said Robert Tauxe, MD, MPH, deputy director of CDC’s Division of Foodborne, Waterborne, and Environmental Diseases. “Infections with antibiotic-resistant germs are often more severe. These data will help doctors prescribe treatments that work and to help CDC and our public health partners identify and stop outbreaks caused by resistant germs faster and protect people’s health.” Read more on food safety.
Four Communities to Share $120M in HUD Grants for Community Revitalization
Four U.S. communities will split nearly $120 million in U.S. Department of Housing and Urban Development (HUD) grants earmarked for the redevelopment of severely distressed public or HUD-assisted housing and their surrounding neighborhoods. "HUD's Choice Neighborhoods Initiative supports local visions for how to transform high-poverty, distressed communities into neighborhoods of opportunity," said HUD Secretary Shaun Donovan. "By working together, with local and state partners we will show why neighborhoods should always be defined by their potential—not their problems. Together, we will work to ensure that no child's future is determined by their zip code and expand opportunity for all."
The four communities are:
- Columbus (Ohio) Metropolitan Housing Authority — Columbus, Ohio
- Housing Authority of the City of Norwalk/Norwalk (Conn.) Redevelopment Agency
- City of Philadelphia, Office of Housing & Community Development/Philadelphia Housing Authority
- Housing Authority of the City of Pittsburgh/City of Pittsburgh
Read more on housing.
Depression Linked to Higher Heart Disease Death Risk in Younger Women
Women age 55 and younger are twice as likely to suffer a heart attack, die or require artery-opening procedures if they’re moderately or severely depressed, according to new research in the Journal of the American Heart Association. Investigators assessed depression symptoms in 3,237 women with known or suspected heart disease who were scheduled for coronary angiography, an X-ray that diagnoses disease in the arteries that supply blood to the heart. After nearly three years of follow-up, researchers found:
- In women 55 and younger, after adjusting for other heart disease risk factors, each 1-point increase in symptoms of depression was associated with a 7 percent increase in the presence of heart disease.
- In men and older women, symptoms of depression didn’t predict the presence of heart disease.
- Women 55 and younger were 2.17 times as likely to suffer a heart attack, die of heart disease or require an artery-opening procedure during the follow-up period if they had moderate or severe depression.
- Women 55 and younger were 2.45 times as likely to die from any cause during the follow-up period if they had moderate or severe depression.
Read more on heart health.
HUD Provides Additional Funds for Hundreds of U.S. Programs for the Homeless
The U.S. Department of Housing and Urban Development has announced a second round of grants totaling $140 million to nearly 900 local homeless assistance programs for both permanent and transitional housing programs. The grants will fund programs including 436 new local projects aimed at providing permanent supportive housing for people experiencing chronic homelessness. Read more on housing.
NIH Launches Public Website on 3D Printing
The National Institutes of Health (NIH) has launched the NIH 3D Print Exchange, a public website that lets users share, download and edit 3D print files related to health and science. Among other uses, the files can be used to print custom laboratory equipment, as well as models of bacteria and human anatomy. NIH uses 3D printing—or the creation of a physical object from a digital model—to study viruses; repair and enhance lab apparatus; and help plan medical procedures. The 3D Print Exchange also includes video tutorials; a discussion forum; and tools that convert scientific and clinical data into ready-to-print 3D files. Read more on research.
Evidence-based practices and model homelessness reduction programs that have been effective in other cities are the key tools behind a new initiative, the Mayors Challenge to End Veteran Homelessness, launched earlier this month by the U.S. Department of Housing and Urban Development (HUD) and the U.S. Department of Veterans Affairs (VA).
The goal of the Mayors Challenge is to end veteran homelessness by the end of 2015.Close to 60,000 veterans are homeless on any given night. Housing experts say the model practices and speed of their deployment can also serve as examples to greatly reduce homelessness in the general population—which can be as high as 3.5 million in any given year, according to HUD surveys.
Ending veteran homelessness has received increased attention in recent years. According to Eric Grumdahl, policy director of the U.S. Interagency Council on Homelessness, there has already been a 24 percent reduction in veteran homelessness in the last three years that is directly tied to evidenced-based practices, including:
- Housing First, a concept that eliminates prerequisites such as sobriety and minimum income before a veteran can be given housing.
- Permanent supportive housing, which adds mental health services.
- Rapid re-housing aimed at people who are homeless from time-to-time rather than chronically homeless.
San Diego and Phoenix were both recently cited by both HUD and the VA for effectively ending chronic homelessness among veterans.
In Phoenix, where one in five homeless adults was a veteran—about twice the national average—the city leveraged partnerships and local, state and federal funding to find housing solutions for veterans. Partnerships included state and federal government; the business and faith community; and non-profit groups. The city’s mayor, Greg Stanton, credits “a united front” and Housing First’s work to speed up placing veterans in safe housing.
Older Hispanics Taking their Medicines Because of Medicare Prescription Drug Plans
Hispanics have reduced the gap with whites in taking prescribed heart medicines since the 2006 launch of Medicare’s prescription drug benefit—Medicare Part D. The findings were reported in a study presented at the American Heart Association’s Quality of Care and Outcomes Research 2014 Scientific Sessions earlier this month. Researchers reviewed prescription drug data from Medicare’s national Medical Expenditure Panel Survey for white, African-American and Hispanic Medicare seniors for the years 2007-10. After Part D, adherence rates increased among all racial groups, with the highest increase in whites and Hispanics, but increased only slightly among African-Americans.
- Hispanics’ total group adherence rate improved about 60 percent.
- Whites’ adherence rate improved 47 percent.
- African-Americans’ adherence rate improved about 9 percent.
Read more on heart health.
USDA Announces Grants to Help Repair Houses in Rural Areas
The U.S. Department of Agriculture (USDA) has announced it is seeking applications for grants of about $4 million to preserve and repair housing for very-low- and low-income families living in rural areas. The funds are being made available by the USDA Rural Development's Housing Preservation Grant program. Eligible applicants include town or county governments; public agencies; federally recognized Indian Tribes; and non-profit and faith-based organizations. Applications are due July 28. Examples of previous grants include a 2012 award to Habitat for Humanity Lake County (Calif.), which received a $55,000 Housing Preservation Grant to help 12 low-income homeowners repair their homes. One person helped was a Vietnam veteran who used a wheelchair and could not leave his home without assistance. Habitat for Humanity widened his doorway and installed a wheelchair lift. Read more on housing.
Many U.S. Cancer Survivors Face Serious Financial Burdens
Many U.S. cancer survivors face significant economic burdens due to growing medical costs, missed work and reduced productivity, according to a study by the U.S. Centers for Disease Control and Prevention (CDC). “Cancer survivors face physical, emotional, psychosocial, employment and financial challenges as a result of their cancer diagnosis and treatment,” said Donatus U. Ekwueme, PhD, a senior health economist at CDC’s Division of Cancer Prevention and Control. The number of cancer survivors is expected to increase by more than 30 percent in the next decade—to 18 million Americans. Researchers analyzed data from the Agency for Healthcare Research and Quality’s 2008-2011 Medical Expenditure Panel Survey to estimate annual medical costs and productivity losses among cancer survivors aged 18 years and older, and among persons without a cancer diagnosis. Among those employed, more than 42 percent had to make changes to their work hours and duties. The report also found that about 10 percent of survivors aged 65 years and younger were uninsured and likely to have a larger financial burden compared to survivors with some source of payment for medical services. Read more on cancer.
HUD Awards $40 Million in Housing Counseling Grants
The U.S. Department of Housing and Urban Development (HUD) has awarded more than $40 million in grants to hundreds of national, regional and local organizations to help families and individuals with their housing needs and to prevent future foreclosures.
“HUD-approved counseling agencies use this funding to support a wide range of services from assisting lower income persons to locate an affordable apartment to helping first-time homebuyers avoid unsustainable mortgages,” said Secretary of Housing Shaun Donovan.
More than $38 million will directly support the housing counseling services provided by 29 national and regional organizations, seven multi-state organizations, 22 state housing finance agencies and 232 local housing counseling agencies. In addition, HUD is awarding $2 million to three national organizations to train housing counselors with the instruction and certification necessary to effectively assist families with their housing needs.
In 2012, HUD released two reports on the impact of HUD-approved housing counseling for families who purchase their first homes and those struggling to prevent foreclosure. In both studies, HUD found housing counseling significantly improved the likelihood homeowners remained in their homes.
Read more on housing
Chest Pain Incidence Drops for Whites, But not for Blacks
The percentage of people reporting angina (chest pain) dropped in the last two decades among Americans 65 and older and white people 40 and older — but not among black Americans, according to a study in the American Heart Association journal Circulation: Cardiovascular Quality and Outcomes.
Angina is chest pain or discomfort that occurs when the heart isn’t getting enough oxygen-rich blood.
Researchers analyzed national health survey data starting in 1988 to find how many patients reported that a health care professional had told them they have the condition and how many people report angina symptoms.
- The rates for whites 40 and older reporting a history of angina dropped by about one-third, from the 2001-04 survey to the 2009-12 survey.
- The rates for whites 40 and older reporting angina symptoms declined by half from the 1988-94 survey to 2009-12 survey.
- For blacks, the rates were essentially unchanged.
- The rates for American women 65 and older reporting a history of angina dropped nearly in half from the 2001-04 survey to the 2009-12 survey.
- The rates for women 65 and older reporting angina symptoms declined by almost 60 percent from the 1988-94 survey to 2009-12 survey; the rates for men in this age group declined by more than 40 percent during this same time period
Read more on heart health
United States, Canada and Mexico Set Guidelines to Strengthen Information Sharing in Health Emergencies
The United States, Canada and Mexico have adopted a set of principles and guidelines on how the three countries’ governments will share advance public information and communications during health emergencies impacting the countries.
The Declaration of Intent calls on the three countries to:
- Share public communications plans, statements and other communications products related to health emergencies with each other prior to their public release;
- Apprise other appropriate authorities, depending on the type of health emergency, within their respective governments when the declaration is invoked;
- Conduct an annual short communications exercise to improve joint coordination; and
- Hold recurrent meetings to review and propose amendments to the Declaration of Intent.
Read more on preparedness
New NCHH, APHA Standards to Improve U.S. Housing Health
A new report from the National Center for Healthy Housing (NCHH) and the American Public Health Association (APHA) establishes new standards to help improve housing for all Americans. The new National Healthy Housing Standard outlines a health-focused property maintenance policy for the nation’s 100 million existing homes—single family, multifamily, rental and owner occupied. Approximately 40 percent of metropolitan homes have one or more health and safety hazards, according to the NCHH, while the American Housing Survey determined that approximately 6.3 million housing units are considered to be substandard. “While we have made great strides in improving the quality of housing nationwide, too many Americans are left making the false choice between affordable or quality housing. Families deserve access to quality and affordable housing that allows them to put down roots in a community, build wealth, put kids through college and start businesses,” said U.S. Department of Housing and Urban Development Secretary Shaun Donovan, in a release. Read more on housing.
Red Cross Campaign Will Work to Cut Drowning in Half in 50 U.S. Cities
As part of its celebration of 100 years of swimming safety education, the Red Cross is launching a new national campaign to reduce the drowning rate by 50 percent in 50 U.S. cities. The 3-5 year campaign will target 50,000 people across 19 states. A new survey from the organization’s drowning prevention campaign found that while 80 percent of Americans said they could swim, only about 56 percent of those people exhibited “water competency”—meaning that they could perform these five critical water safety skills:
- Step or jump into the water over your head
- Return to the surface and float or tread water for one minute
- Turn around in a full circle and find an exit
- Swim 25 yards to the exit
- Exit from the water
“We're asking every family to make sure that both adults and children can swim and that parents make water safety a priority this summer,” said Connie Harvey, director of the Red Cross Centennial Initiative. Read more on injury prevention.
CDC Releases Vaccine Schedule App for Clinicians, Health Care Professionals
The U.S. Centers for Disease Control and Prevention (CDC) has launched a new app that provides clinicians and other health care professionals access to the CDC’s latest recommended immunization schedules. The CDC Vaccine Schedules app replicates the appearance of the printed schedules that are reviewed and published each year, and includes information such as the correct vaccine and dosage. The schedules include:
- Child and adolescent schedules with immunization recommendations from birth through age 18
- Catch-up schedule for children 4 months through 18 years
- Adult schedule, including recommended vaccines for adults by age group and by medical condition
- Contraindications and precautions table, with all footnotes that apply to schedules
The app is available in the iTunes App Store and will be released for Android devices in a few months. Read more on vaccines.
“Five years after the Great Recession officially came to an end, the United States has yet to fully recover from the economic devastation sparked by the collapse of an $8 trillion housing bubble and the ensuing turmoil that saw global financial systems teetering on the brink of collapse. But while the economic costs of the downturn have drawn the lion’s share of attention, the damage to our bodies could end up far surpassing the damage to our bank accounts.”
Those are the opening lines of a new special report from the Harvard School of Public Health (HSPH), “Failing Economy, Failing Health: The Great Recession’s Toll on Body and Mind,” detailing how poverty and inequality resulting from the economic maelstrom pulled down so many—and what that will mean for public health in the long term.
“Health is a long-run thing, but the methods we use to analyze current data only estimate short-term effects,” says SV Subramanian, HSPH professor of population health and geography. “It may take awhile for the health impact of the Great Recession to kick in, but once it does, it could be dramatic.”
The data is strong on the links between employment and health—people who are unemployed, underemployed or laid off are less healthy and don’t live as long.
A 2009 study found that in the 12 months after men lost their jobs in mass layoffs, they saw their chances of dying nearly double. While over time the risk lessened it was still significant two decades later. Another study that same year found that losing a job when a business shuts its doors increases the odds of fair or poor health by 54 percent among workers with no preexisting health conditions while also increasing the risk of new health conditions by 83 percent. The stress of the situation, according to the researchers, heightens the odds of stress-related conditions such as stroke, hypertension, heart disease, arthritis, diabetes and psychiatric problems.
Yet another study, this one in 2010, found that about 4 in 10 Americans with heart disease or diabetes and 1 in 5 with cancer said the stress of the Great Recession made it more difficult to manage their illnesses.
What’s more complex is unearthing the pathways behind why this is the case. The HSPH article outlines some of the mechanisms by which unemployment affects health.
Place Matters is a national initiative of the Joint Center for Political and Economic Studies, a non-profit organization based in Washington, D.C., whose mission it is to improve the lives of African Americans and other people of color through policy analysis and change. The Place Matters initiative was designed to build the capacity of local leaders around the country to identify and improve social, economic and environmental conditions that shape health. Nineteen teams are working in 27 jurisdictions.
NewPublicHealth recently spoke with seven Place Matters teams about their ongoing efforts. We will be showcasing their work in a series that begins today with a conversation with Brian Smedley, PHD, Vice President and Director of the Joint Center’s Health Policy Institute.
NPH: What are some initial steps that a community has to take when making changes in order to impact health?
Brian Smedley: Several things we believe are important, and these are principles that we employ in our Place Matters work. One is first and foremost to start with the very communities that are most affected by economic and political marginalization and that have suffered from disinvestment for years. These are often communities that have the leadership and sources of strength and resiliency to begin to tackle these problems. We believe that engaging with communities; identifying their key concerns; identifying the sources of strength and resiliency in the community; and finding out from the community what their vision is for a healthy and vibrant community are all important first steps for anyone engaged in this kind of work.
We also believe that there’s an important role for research to document the inequitable distribution of health risks and resources, and to show how that often correlates with patterns of residential segregation. We have worked with our Place Matters teams to produce what we call community health equity reports, where we document such issues as where people can buy healthy food; how close polluting industries are to neighborhoods and residential areas; sources of jobs; and neighborhoods that have high levels of poverty concentration.