Category Archives: Housing
IDSA Issues New Strep Throat Guidelines
Most sore throats are the result of a virus—not the bacteria that causes strep throat—so should not be treated with antibiotics, according to new guidelines from the Infectious Diseases Society of America (IDSA) appearing in Clinical Infectious Diseases. Strep throat, caused by streptococcus bacteria, should be treated with penicillin or amoxicillin, assuming the patient is not allergic. The IDSA also recommends against removing the tonsils of children who suffer repeated cases of strep throat. Read more on infectious disease.
USDA Grants to Provide Housing for Farm Workers in Rural Communities
The U.S. Department of Agriculture (USDA) has announced new grants to develop farm labor housing. “These grants will help communities submit quality applications to increase their chances of getting funding to build much-needed affordable housing for farm workers,” said Agriculture Secretary Tom Vilsack. “Increasing the supply of affordable housing in rural communities not only helps the residents, it helps the entire community.” You can go here to read more about submitting applications. Read more on housing.
Climate Change Could Lead to Increase in Avian Flu
A new report in Biology Letters by researchers from the University of Michigan says that climate change—among all its other many effects—could also increase the rate of avian influenza in wild birds. They utilized a mathematical model to show how climate change could alter the interactions between birds and crabs in Delaware Bay, increasing the rate of infection and expanding from there to other areas. “We’re not suggesting that our findings necessarily indicate an increased risk to human health,” said Pejman Rohani, a professor of ecology and evolutionary biology, a professor of complex systems and a professor of epidemiology at the School of Public Health. “But every single pandemic influenza virus that has been studied has included gene segments from avian influenza viruses. So from that perspective, understanding avian influenza transmission in its natural reservoir is, in itself, very important.” Read more on environment.
CDC: Millions of Americans with High, Untreated Blood Pressure
High blood pressure affects 67 million of U.S. adults, or almost one-third, according to the Centers for Disease Control and Prevention (CDC). And as many as 36 million of those aren’t treating the condition properly. High blood pressure contributes to about 1,000 deaths each day and about $131 billion each year in health care costs. The CDC says the key to treating high blood pressure in U.S. adults is for everyone—from patients to providers—to act together as a team. “We have to roll up our sleeves and make blood pressure control a priority every day, with every patient, at every doctor’s visit,” said CDC Director Thomas R. Frieden, MD, MPH. “With increased focus and collaboration among patients, health care providers and health care systems, we can help 10 million Americans’ blood pressure come into control in the next five years.” Read more on heart health.
HUD Releases New Lead-Paint Guidelines for Housing Providers
The U.S. Department of Housing and Urban Development (HUD) has released new Guidelines for the Evaluation and Control of Lead-Based Paint Hazards in Housing, updating its guidance from 1995. The guidelines are designed to help property owners, government agencies and private contractors dramatically reduce childhood exposure to lead while still keeping renovation costs as low as possible. “HUD is committed to providing healthier housing for all families,” said Jon L. Gant, Director of HUD’s Office of Healthy Homes and Lead Hazard Control. “These Guidelines will help communities around the nation protect families from lead exposure and other significant health and safety hazards.” Read more on housing.
People More Likely to Guzzle Beer from a Curved Glass than a Straight One
A new study in PLoS ONE shows social drinkers will drink beer almost twice as fast from a curved glass than they will from a straight one—meaning they will become intoxicated far quicker. Researchers at the University of Bristol School of Experimental Psychology said this could be because it is harder to judge the amount consumed when using a curved glass. “Due to the personal and societal harms associated with heavy bouts of drinking, there has been a lot of recent interest in alcohol control strategies,” said Angela Attwood, PhD, adding that “[p]eople often talk of ‘pacing themselves’ when drinking alcohol as a means of controlling levels of drunkenness, and I think the important point to take from our research is that the ability to pace effectively may be compromised when drinking from certain types of glasses.” Read more on alcohol.
Study Details Bullying Involvement for Adolescents with Autism Spectrum Disorder
Approximately 46 percent of adolescents with autism are the victims of bullying, according to a new study in the Archives of Pediatrics & Adolescent Medicine, a JAMA Network publication. Bullying is harmful behavior coming from a position of power, whether physical, social or cognitive. There is still very little research on bullying related to adolescents with an autism spectrum disorder (ASD), according to the study’s researchers. The study’s authors concluded that bullying intervention strategies need to address core ASD deficits, such as conversational ability and social skills, while also increasing social integration, empathy and social skills. Read more on bullying.
The twelfth HIA International Conference held this week in Quebec will be the first to take place in North America. Health impact assessments (HIAs) bring together scientific data, health expertise and public input to identify potential health effects of proposed laws, regulations, projects and programs, providing decision-makers with the information they need to advance smarter policies for safe, healthy, thriving communities.
Alain Poirier, MD, chair of the conference local organizing committee and former minister of health and social services in Quebec says the location provides an excellent opportunity for Americans and Canadians, who have not attended this HIA conference in large numbers previously, to learn what is going on in the field across the world, particularly now that HIA is a burgeoning field in the United States. An updated map from the Health Impact Project, a joint program of the Pew Charitable Trusts and the Robert Wood Johnson Foundation, offers an updated look at HIAs completed or underway in the United States. According to the Health Impact Project, in 2007, there were only 27 completed HIAs in the U.S. but the map now counts 100 completed and more than 200 total HIAs. The built environment is the most popular field for HIAs in the country right now, with over 70 completed or in process, followed by transportation, agriculture and food, natural resources, and food and housing.
The map details some recent critical examples of HIAs in the United States:
Economic Policy: New Hampshire State Budget. An HIA will inform lawmakers on how funding changes in parts of the state budget might affect the health of residents.
Built Environment: San Pablo (CA) Corridor. This HIA addressed the health implications of placing affordable housing units along the San Pablo Corridor, a high traffic transit and retail corridor in Richmond and El Cerrito, Calif.
Housing: Trinity Plaza Housing Redevelopment. This HIA examined a proposed redevelopment project in San Francisco that would demolish an older apartment building with over 360 rent-controlled units, and replace them with 1,400 market-rate condominiums.
>>Recommended Reading: NewPublicHealth frequently covers emerging HIA projects across the country. Read about HIAs that examined the potential health impacts of:
How does housing impact health?
A new commentary in the journal Health Affairs tracks the history of health and housing in the United States and says that while a connection between housing conditions and public health has been known since the 1800s, federal housing policy only began during the Great Depression. The Department of Housing and Urban Development (HUD) has increased awareness of that connection since the agency was founded in the 1960s.
HUD’s housing initiatives have included:
- Prohibitions on lead and gasoline in HUD housing
- Programs to allow HUD tenants to move to more affluent neighborhoods
- Integration of health-oriented policies with other departments including the Department of Health and Human Services
Authors of the commentary worry that current congressional funding policies lead to “predetermined silos,” which could impede the needed integration of projects among federal agencies. HUD’s adoption of a health in all policies approach, according to the authors, “signals an active recognition that the investments have implications for social determinants of health and ultimately for the health of the populations HUD serves.”
>>Read the full article.
>>Bonus Links: Read a NewPublichealth interview with one of the commentary authors, Raphael Bostic, called “Housing Policy is Health Policy” and an interview from our National Prevention Strategy Series with Estelle Richman, senior advisor to the Secretary of Housing and Urban Development.
Tobacco Smoke Exposure Weakens Cough Reflex in Children
Secondhand smoke exposure can weaken a child’s response to cough-eliciting irritants, possibly explaining why children of smokers are more susceptible to respiratory illnesses such as pneumonia and bronchitis, according to a new study from the Monell Center. “Cough protects our lungs from potentially damaging environmental threats, such as chemicals and dust,” said Julie Mennella, PhD, a Monell developmental biologist and co-director of the study. “Living with a parent who smokes weakens this reflex, one of the most vital of the human body.” Sixty percent of kids ages 3-11 and 18 million youth ages 12-19 are regularly exposed to secondhand smoke from tobacco. Read more on tobacco.
Roofers, Other Asphalt Workers, May Have Increased Cancer Risk from Chemical Exposure
Laborers who work with hot asphalt may be at increased risk of DNA damage and cancer due to exposure to polycyclic aromatic hydrocarbons (PAHs), according to a new study from Cancer Center at the University of Colorado School of Public Health. Researchers found that the PAH blood levels in roofers was increased after working a shift. The study looked at 19 roofers in Miami-Dade County. While roofers and road construction workers also have higher rates of smoking, alcohol use and UV exposure, these findings can help narrow down the causes of their higher cancer rates and possibly improve worker safety. Read more oncancer.
Calorie Counter May Be Useful Policy Tool
Researchers at the Columbia University Mailman School of Public Health have developed a new online tool to help understand and improve the state of childhood obesity. The Caloric Calculator enables policy-makers and other officials to examine how different food and exercise choices could improve the health of different populations. “While childhood obesity can sometimes seem like an insurmountable problem, there are many proven interventions that can make a difference,” said Claire Wang, MD, assistant professor in the department of health policy and management. “The Caloric Calculator shows that, when implemented in combination, they add up to what is needed.” Read more onobesity.
Study: Treating High Infectious Disease Rates in Homeless Could Impact Overall Public Health
The high rates of tuberculosis, HIV and hepatitis C in homeless populations around the world are clear public health risks that could lead to dangerous—and costly—epidemics, according to a new study in The Lancet Infectious Diseases. Researchers analyzed 43 surveys covering almost 60,000 homeless people, concluding that the prevalence of certain serious infectious diseases was much higher in homeless populations than in general populations. For example, tuberculosis rates in the United States were 46 time greater and hepatitis C was four times as common. Seena Fazel, a senior research fellow in clinical science at the University of Oxford and head of the study, told Reuters that focusing more on treating these high-risk populations could have a “pronounced” effect on overall public health. The study concluded that more research needs to be performed at the local levels in order to determine how best to address health issues in homeless people. Read more on homeless health in a Q&A with Robert Taube of the Boston Healthcare for the Homeless Project.
Idea Gallery is a recurring editorial series on NewPublicHealth in which guest authors provide their perspective on issues affecting public health.
We all know that living in a walkable neighborhood is good for your health. The more surrounded we are by trees, water and parks and the more we are within walking distance of meaningful places for daily needs, the more likely these destinations are a part of our day-to-day lives. In a recent op ed for the New York Times, Christopher Leinberger comments on a new Brookings Institution study he co-authored with Mariela Alfonzo, PhD, a research fellow at Polytechnic Institute of New York University, which shows that more walkable neighborhoods also fare better economically. In this Idea Gallery for NewPublicHealth, Leinberger expands on the benefits of walkability for a community.
The takeaway from our report is that there’s been a structural shift in how we build the built environment. This is not a cyclical change caused by a periodic recession. This is a structural shift. The last time we had this was after the Second World War. We’re building fundamentally a different America.
Before you build it you have to be sure that you have the strategy and management structures in place to make it happen. Generally in this country, walkable urban development is illegal—there is no zoning in place to allow it to happen. Plus it works best when the place has a strategy and management entity in place, generally taking the form of a non-profit building improvement district (BID).
There is then the possibility of achieving the triple bottom line: 1) make money, 2) be responsible to the environment, and 3) be socially equitable.
On social equity, certain jurisdictions in this country have said we want a mix of incomes in our neighborhoods, and I believe this is the proper approach. The price premiums telling the real estate industry to build more also portend an inability for working- and even middle-class buyers to live in walkable urban places.
A new article in the journal Shelterforce (the publication of the National Housing Institute) by Marjorie Paloma, MPH, senior adviser and senior program officer for the Health Group at the Robert Wood Johnson Foundation (RWJF), looks at collaboration among varied sectors—such as community development and health —to help create healthier housing options for diverse populations. Improvements have ranged from reducing allergens in low-income housing to improve asthma symptoms among children, to a new model of nursing home that groups just a few people in smaller facilities, resulting in better, longer and healthier lives.
Paloma says many of these collaborations are just a few years old and bring together groups such as RWJF and Federal Reserve Banks working on parallel tracks toward improving people’s lives. “These changes to housing are far less about bricks and mortar and more about creating stability for people, especially the most vulnerable,” Paloma says.
In an interview, Paloma pointed to a 2009 article, published in the Community Development Investment Review, about the Foundation’s Commission to Build a Healthier America and on the factors outside the health sector. “At that point,” says Paloma, “all of us saw that to create healthier, more vibrant communities, these sectors need to connect and collaborate with each other.”
AARP: Foreclosures Increase for Older Americans
A new study from the AARP Public Policy Institute has found that more than 1.5 million older Americans have lost their homes since 2007. In addition, the percentage of seriously delinquent loans—those in foreclosure and loans 90 or more days delinquent—increased from 1.1 percent in 2007 to 6.0 percent as of December 2011 for people age 50 and older, a more than five-fold increase. Unstable housing can put people at greater risk for many health issues. Read more on housing.
New York State Reports Increased Number of Pertussis Cases
Because of an increased number of pertussis (whooping cough) cases in New York State, the state’s health commissioner, Nirav R. Shah, MD, MPH, is urging state residents who are un-immunized and under-immunized to get vaccinated against the disease.
Preliminary figures for New York State report 970 cases so far in 2012, compared with 931 cases in all of 2011. There were 722 total cases reported in 2010, and 265 in 2009. Through June 4, 2012, the Centers for Disease Control and Prevention (CDC) reported that the number of cases in the U.S. was nearly 44 percent higher than the number reported in the same period the prior year. In 2011 three infants died from complications of pertussis in New York. Later today, the CDC will issue an update on pertussis cases in Washington State, which has seen a significant rise in cases so far this year. Read more on infectious disease.
Continuing Drought Leads to 39 Additional Counties in 8 States Declared Natural Disaster Areas
The USDA this week designated 39 additional counties in eight states as natural disaster areas due to damage and losses caused by drought and excessive heat. During the 2012 crop year, the Department of Agriculture designated 1,297 counties across 29 states as disaster areas. The additional counties are in Arkansas, Georgia, Indiana, Mississippi, New Mexico, Tennessee, Utah and Wyoming, and the USDA is currently reporting that 61 percent of the continental United States is in a moderate to exceptional drought.
Hot and dry conditions around the nation have damaged or slowed maturation of crops such as corn and land. Read more news from USDA.
The U.S. Departments of Housing and Urban Development (HUD) and Health and Human Services (HHS), as well as health advocate groups have launched tool kits to help private owners of federally assisted multifamily housing and public housing authorities adopt smoke-free policies.
The owner’s toolkit includes a guide to implementing no-smoking policies, a sample resident survey and frequently asked questions sheet. The residents’ kit includes a going smoke-free guide, a home smoke-free pledge kit, and additional education materials about second-hand smoke. Read more on tobacco.
Hospitalizations for children with high blood pressure increased between 1996 and 2006, according to a study in the journal Hypertension. Researchers reached their conclusions based on discharge records from the Healthcare Cost and Utilization Project (HCUP) Kids’ Inpatient Database from 1997, 2000, 2003 and 2006.
- Pediatric hypertension-related hospitalizations in the United States nearly doubled, from 12,661 in 1997 to 24,602 in 2006.
- Charges for inpatient care for hypertensive children increased by 50 percent, to about $3.1 billion.
- The average length of stay for children with hypertension was double that of children with other illnesses, eight days compared to four days.
The researchers say the increased hypertensions hospitalizations may be linked to the rise in childhood obesity, and that children hospitalized with hypertension were more likely to be older than 9 years, male and African-American. Read more on children's health.
The National Prevention and Health Promotion Strategy offers a comprehensive plan to increase the number of Americans who are healthy at every stage of life. A cornerstone of the Strategy is that it recognizes that good health comes not just from quality medical care, but also from the conditions we face where we live, learn, work and play—such as healthy homes, clean water and air and safe worksites. The strategy was developed by the National Prevention Council, which is composed of 17 federal agencies including the Department of Education, the Department of Housing and Urban Development and others.
As the Strategy is rolled out, NewPublicHealth will be speaking with Cabinet Secretaries, Agency directors and their designees to the Prevention Council about their prevention initiatives. Follow the series here.
This week, NewPublicHealth spoke with Estelle Richman, Senior Advisor to the Secretary of the Department of Housing and Urban Development.
NewPublicHealth: Why was it important for the Department of Housing and Urban Development (HUD) to be involved in the development of National Prevention Strategy?
Estelle Richman: HUD’s mission is to create strong, sustainable, inclusive communities and affordable housing for everyone. HUD is more than bricks and mortar. We need to get away from thinking that housing is just about putting a roof over your head. It’s your home, and your family’s health and safety and your children’s education are all dependent on where that home is. HUD views housing as a platform for improving a wide range of outcomes.
That’s what makes HUD dovetail perfectly with the National Prevention Strategy; the whole concept of affordability of housing and the quality of neighborhoods and the understanding of that influence on health. HUD invests about $50 billion annually on affordable housing and community development and these investments impact health. We don’t do it alone and none of our partners can do it alone. But together we can bring significant experience and expertise to the table so that we can truly mitigate and help prevent health hazards.
NPH: What approach is HUD taking to address the challenges of health related to housing?
Estelle Richman: One of the most obvious places where we make a substantial difference is the physical environment of housing, including a focus on lead-based paint hazards, mold and pests and all the many things that contribute to respiratory disease, allergies and other illnesses.
Another factor not always immediately connected is housing affordability and health. Many households are now paying more than 60 percent of their income in order to remain in their homes. And if you’re paying a huge amount of your income just to pay your rent or your mortgage, then you’re cutting something else—such as food, health care, medicine and transportation. That puts people at risk for both physical and mental health problems. Children in families that have been behind on rent are more likely to be in poor health, have increased risk of developmental delays and suffer from food insecurity than children whose families are stably housed.
NPH: What are some of HUD’s key initiatives in helping to foster sustainable, healthy communities?
Estelle Richman: We know that physical and mental health depends on sustainable and economically vital neighborhoods where we have access to transportation, good schools, safe places for children to play and places to go shopping for healthy and wholesome foods.
HUD’s Moving to Opportunity for Fair Housing Demonstration Program has shown that moving to better neighborhood environments is associated with improved mental and physical health for adults, lower rates of extreme obesity, lower rates of diabetes, less psychological stress and less major depression for adult women. So being able to stabilize where you live and the quality of your housing can make a difference.
We’re trying to reach some of these same goals through our Choice Neighborhoods Program, which is part of a partnership between HUD, the Department of Education, the Department of Justice, the Department of Health and Human Services and the Department of the Treasury. Choice Neighborhoods actually builds on the success of Hope VI, which was begun in the 1990s and was set up to transform some of the worst public housing by developing mixed-income communities. In Philadelphia, for example, when they were able to switch to Hope VI, you saw a distinctive change in those neighborhoods. Schools got better, neighborhood stores moved in, transportation became more accessible. When we talk about Choice Neighborhoods now, we consider employment assets, quality education, and a wider range of stakeholders, including nonprofits, private firms, local government and public housing authorities.
NPH: What changes can be made to housing and home standards to help improve home and neighborhood safety?
Estelle Richman: We believe the home environment is a major influence on health and well-being and that threats to housing quality include everything from excess moisture, mold, allergens, and poor indoor air quality, to structural deficiencies and lead contamination.
NPH: And what is the approach to minimizing risks such as lead poising from lead-based paint?
Estelle Richman: Our Office of Healthy Homes and Lead Hazard Control is looking at this. We know that housing that was built before 1978 may have lead-based paint, with homes built before 1940 having the highest levels of lead in paint. So it really doesn’t matter if you make a million dollars—if you’re living in a house built before 1978, the odds that there’s lead somewhere in that house is high enough that everyone needs to be concerned about their children. So the standard has to be set high enough that we protect everyone.
NPH: What is HUD doing in the area of secondhand smoke in homes and who are your partners?
Estelle Richman: That is a big agenda items for many divisions of the Department.
Our partners in this are the Housing Authorities, some of the landlords, and just about anyone else who’ll talk to us. My best example of this is the Boston Housing Authority, which is on track to now to implement a total smoke-free policy this fall. They found that their asthma rates were twice as high as those for residents living in non-subsidized housing. They have done a lot of work over the last several years educating themselves, their clients, and offering folks as much support as possible to stop smoking, and now they’re ready to implement a smoke-free policy.
There are several other cities that have announced that they are looking at instituting smoke-free policies—San Antonio, Minneapolis, Portland, Oregon and all of the housing authorities in the State of Maine are among them. We’re offering whatever technical assistance we can to help them do it. We’re working in partnership with HHS, the American Academy of Pediatrics and the American Lung Association and trying to gather many other community supporters.
As we push, I think we will always find folks who believe that they want to continue to smoke, but we’re also finding that there are many people who are ready for smoke-free policies in their housing.
NPH: What are some current efforts of working across sectors to improve housing and better health in that housing?
Estelle Richman: Our Section 811 Project Rental Assistance Demonstration Program is a rental demonstration program to provide housing for people who have disabilities. It provides $85 million in funding to state housing agencies and other appropriate entities to provide long-term housing rental assistance for approximately 2,800 people. Many of these folks will have physical disabilities and will often need assistant care or assistive technology in order to live in the housing, which means that most of them will also be involved with the state Medicaid Agency, as well as their state Health and Human Services Agency.
To develop the program we worked hand in hand with the Centers for Medicare and Medicaid Services. I can’t tell you the number of positive emails I received. People were anxiously awaiting it. It is fully integrated with non-disabled populations, which was critical to the disabled community. To be a part of the program, a state housing agency must partner with the state Medicaid agency to submit a grant. So this is a true partnership. It’s integrated housing, it’s supportive housing and it helps get people out of institutions.
NPH: What are examples of partnerships you have within the Federal government?
Estelle Richman: We meet with our partners at HHS every week. We talk about our joint projects and about projects that we would like to work on together. We’re also a very strong partner with the Department of Veterans Affairs (VA). You may know that we’re working with the VA around eliminating veterans' homelessness by 2015. There is also an HHS part of it so that we can know that our veterans who are coming home not only have good health care, but they also have a place to live. As I’ve said, we all have to have partners and it is, in essence, the core of that partnership that helps us make progress. The National Prevention Council has actually brought these partners together and I credit them for being part of what keeps us working together. It’s very easy in some of these very large bureaucracies to drift off and do your own mission and I think one of the things the National Prevention Council does is help us all realize that we all share prevention, we all work on it together.
NPH: What are some of the other critical partners in communities?
Estelle Richman: In any level of government, the level you need to get to is the level of where the people are. So you need to get down to neighborhoods, you need to get to communities and when you go down in communities, you really need to talk to your hospital and health care systems, community neighborhood groups, schools and PTAs. Also what rises to the top of the page real quickly is transportation. If you have not figured out how to get transportation as a partner then you’re going to have a hard time getting prevention, promotion and health care to work outside the city center.
Each community is different. You need to talk to the folks and get a feel for what’s going to make a difference in that particular community.
NPH: Tell us about the Partnership for Sustainable Communities.
Estelle Richman: It is a multi-partner collaboration among HUD, the Department of Transportation and the Environmental Protection Agency. These two agencies have not always been traditional partners for HUD. Through the Partnership, we are coordinating federal housing, transportation, and environmental investments and looking at things like water infrastructure, roads, sidewalks, transit lines, and job creation opportunities as all of those things are necessary for a healthy and vibrant community life. Several of the Sustainable Communities grant recipients are partnering with the public health sector, including in conducting health impact assessments, increasing access to fresh foods, and encouraging active living that includes opportunities for exercise in one's daily commute and routine. They’re realizing that to improve public health, it’s critical to actually support and create the communities that are not only going to be economically sustainable, but that also maximize environmental, energy-efficient and socially sustainable design and development strategies.
NPH: What had the National Prevention Council brought to the table that was not there before?
Estelle Richman: When you have an initiative like the National Prevention Council, you set goals, you set measurable outcomes and you also have skin in the game of what the big group is doing. You’re held accountable, but you’re asking to be held accountable. And it’s not accountable to your silo, it’s accountable to the larger group.
And I think it’s that choice of accountability to the larger group for health care that affects all of us. The concern about health care is not an issue just for struggling families or folks in foreclosure or families that are in the lower incomes. Health care is something we are all concerned about. In the end, it holds us all accountable for better communities.
>>Catch up on the rest of the National Prevention Strategy series on NewPublicHealth.