Chapter 6: SPECIAL HOUSING ISSUES - National Low ...
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
Chapter 6: SPECIAL HOUSING ISSUES
Lead Hazard Control and Healthy Homes
By Sarah Goodwin, Policy Analyst, On October 28, 2021, the Centers for Disease
National Center for Healthy Housing and Control and Prevention (CDC) updated its blood
David Jacobs, PhD, CIH, Chief Scientist, lead reference value (BLRV) from 5 µg/dL to
3.5 µg/dL, which will increase the number of
National Center for Healthy Housing
children deemed to have an elevated blood
Administering Agency: HUD’s Office of Lead lead level. BLRV is used by public health
Hazard Control and Healthy Homes (OLHCHH) agencies and healthcare providers to help guide
Year Started: Lead Hazard Control, 1992; interventions for children following blood lead
Healthy Homes Initiative, 1999 tests and prioritize primary prevention efforts in
communities. Read more here: https://www.cdc.
Population Targeted: Low-income and very
gov/mmwr/volumes/70/wr/mm7043a4.htm?s_
low-income families who reside in worst-quality
cid=mm7043a4_w.
private housing where children under six years of
age reside or are likely to reside On January 15, 2021, the Environmental
Protection Agency (EPA) promulgated a final
FY21 Funding: $360 million, including $60
version of their updated drinking water lead
million for the Healthy Homes Initiative
and copper rule. The effective date of the rule
FY22 Funding: $415 million, $55 million more has been extended to December 16, 2021, and
than the FY 2021 enacted level. water utilities will have until October 16, 2024
to achieve compliance. Read more here: https://
Children spend as much as 90% of their time
www.epa.gov/ground-water-and-drinking-water/
indoors, and toxic substances can reach more
proposed-revisions-lead-and-copper-rule.
concentrated levels indoors than they do outside.
Older, dilapidated housing with lead-based paint, The Biden Administration is considering an
and the settled interior dust and exterior bare executive order: “Ensuring Healthy Homes:
soil it generates, are the biggest sources of lead Eliminating Lead and Other Housing Hazards.”
exposure for children (lead in drinking water The urgent need for homes that support good
and other sources can also be a problem). Often health has never been clearer: the COVID-19
these units have a combination of health dangers pandemic has meant more time in our
that include dust mites, mold (fungi), and pests residences, bringing healthy housing to the
that can trigger asthma; carcinogens, such as fore as a national priority. This Executive Order
asbestos, radon, and pesticides; and other deadly establishes a cabinet-level Presidential Task
toxins such as carbon monoxide. Force on Lead Poisoning Prevention and Healthy
Housing to coordinate the nation’s response to
RECENT DEVELOPMENTS lead paint and other housing-related diseases
The Bipartisan Infrastructure Bill as signed into and injuries under the Biden Administration.
law included $15 billion for removal of lead Led by the Secretary of Housing and Urban
drinking water service lines. The November Development, this Task Force will recommend
2021 House Build Back Better Bill included $5 new strategies, regulations, incentives, and other
billion for addressing lead paint hazards and actions that promise to conquer these avoidable
other healthy homes issues to be funded through problems. With strategic leadership and
OLHCHH, as well as an additional $9 billion for concerted action, the Task Force can eliminate
lead in water (through EPA) and $970 million for childhood lead poisoning as a major public health
lead service line removal in rural areas through problem and ensure that all American families
USDA. have healthy homes.
NATIONAL LOW INCOME HOUSING COALITION 6–1The draft executive order was written by the safety hazards. The goal of this program is
National Center for Healthy Housing and is a comprehensive, integrated approach to
available here: https://twitter.com/Day1Project/ housing hazards through grants that create
status/1338593971069734913?s=20. and demonstrate effective, low-cost methods of
addressing mold, lead, allergens, asthma, carbon
The National Safe and Healthy Housing Coalition
monoxide, home safety, pesticides, radon and
tracks appropriations for these two programs
other housing-related health and safety hazards.
and regularly circulates sign-on letters. See:
These grant programs are housed in HUD’s
www.nchh.org and: http://www.nchh.org/
OLHCHH.
Policy/National-Policy/Federal-Appropriations.
aspx. In addition, healthy housing fact sheets The beneficiaries of both the lead and healthy
are now available for all 50 states and five homes programs are low-income households and
major territories (https://nchh.org/who-we-are/ the broader public through education campaigns.
nchh-publications/fact-sheets/state-hh-fact- Assisted rental units served must be affirmatively
sheets/) and agency fact sheets summarizing marketed for at least three years for families
the activities, funding, and impact of key federal with children under age six. Ninety percent of
programs related to healthy housing (https:// owner-occupied units served must house or be
nchh.org/who-we-are/nchh-publications/fact- regularly visited by a child under age six. Because
sheets/agency-fact-sheets/). the funds do not cover all housing eligible under
federal policy, each grantee develops its local
The World Health Organization released new
plan and is permitted to target investment
International Housing and Health Guidelines
of grant funds based on factors such as the
in December 2018. See: http://www.who.int/
presence of a lead-poisoned child and location in
sustainable-development/publications/housing-
a high-risk neighborhood. The programs’ funds
health-guidelines/en/.
are awarded via competitive Notices of Fund
HISTORY AND PURPOSE Availability.
Lead Hazard Control ISSUE SUMMARY
The “Residential Lead-Based Paint Hazard Recent research confirms that housing policy
Reduction Act,” or Title X of the “Housing and has a profound impact on public health, and for
Community Development Act of 1992,” was any public health agenda to be effective, it must
enacted to focus the nation on making housing include a housing component. The statistics and
safe for children by preventing exposure to lead- key findings regarding the long-term effects of
based paint hazards (the statute defines this as housing-related health hazards are alarming.
deteriorated lead-based paint, lead contaminated At least 500,000 children aged one to five in the
settled house dust, and lead contaminated bare US have elevated blood lead levels above the
soil). The law authorized the HUD Lead Hazard current CDC reference value of 3.5 micrograms
Control Grant Program and related programs per deciliter. Childhood exposure to lead can
at the EPA and CDC to provide grants to local have lifelong consequences including decreased
jurisdictions to identify and control lead-based cognitive function, developmental delays,
paint hazards in privately owned, low-income, behavior problems, and, at very high levels can
owner-occupied, and rental housing and conduct cause seizures, coma, and even death. Asthma
training and public health surveillance and other is one of the most common chronic conditions
duties. among children in the U.S.; over 25 million people
Healthy Homes Initiative in the U.S. have asthma, including 7% of children
under 18.
The Healthy Homes Initiative was established
by Congress in 1999 to protect children and The burden of housing-related health hazards
their families from residential health and falls disproportionately on the most vulnerable
6–2 2022 ADVOCATES’ GUIDEchildren and communities, contributing greatly measures. Healthy Homes and weatherization/
to U.S. health disparities. African American building performance are described in a
children are twice as likely to have asthma and report from the Department of Energy and the
are six times more likely to die from it than National Center for Healthy Housing: https://
white children. Households with annual incomes www.energystar.gov/campaign/improvements/
less than $30,000 and children of low-income professionals/resources_library/health_and_
families are much more likely to be lead- home_performance.
poisoned than those of higher-income families.
Children poisoned by lead are seven times more PROGRAM SUMMARY
likely to drop out of school, and six times more Healthy Homes Initiative
likely to end up in the juvenile justice system.
The Healthy Homes Demonstration Grant
There are even bigger consequences when Program develops, demonstrates, and promotes
dealing with the cumulative effects of multiple cost-effective, preventive measures for
hazards. Inadequate ventilation increases the identifying and correcting residential health
concentration of indoor air pollutants, such as and safety hazards. HUD awards Healthy
radon and carbon monoxide, and exacerbates Homes Demonstration grants to nonprofits, for-
moisture and humidity problems. Moisture profit firms located in the U.S., state and local
causes paint deterioration, which puts children governments, federally recognized Indian Tribes,
at risk of exposure to leaded dust and paint chips. and colleges and universities.
Moisture also encourages the growth of mold,
mildew, dust mites, and microbes that contribute HUD also often awards Healthy Homes
to asthma and other respiratory diseases and Supplemental funding to grantees when
structural rot, which is related to injuries. distributing lead hazard control and lead hazard
Asthma is exacerbated by allergic reaction to reduction demonstration grants to allow grantees
certain triggers such as dust, mold, pests (such to address other healthy homes issues when
as cockroaches, rats, and mice), cold air, and conducting their lead programs.
dry heat. Use of common pesticides to control Lead Hazard Control Grants
infestations can contaminate homes. Thus, a
The typical Lead Hazard Control award addresses
‘whole-house’ approach is critical, including
hazards in several hundred homes and provides
thorough inspections, air tests, and remediation
needed outreach and capacity-building services.
activities.
Grants are awarded to states, counties, and cities
Additionally, solutions and opportunities for lead hazard control in privately-owned, low-
may arise through existing weatherization, income housing. At least 65% of the grant must
rehabilitation, maintenance, and home repair be used for direct activities such as abatement,
work. Because improperly disturbing lead-based interim control, clearance, and risk assessment
paint may cause lead poisoning, it is necessary (and to a limited extent other healthy housing
to use lead-safe work practices and comply issues). Grantees are required to partner with
with the EPA’s renovation, repair, and painting community groups, typically by awarding sub-
rule (and for federally assisted housing, HUD’s grants, and to provide a match of 10% to 25%
Lead Safe Housing rule). Many weatherization from local or Community Development Block
treatments have healthy homes benefits. For Grant (CDBG) funds. More than $1 billion has
example, window replacement can help with been awarded since the program started in 1992.
lead poisoning prevention, and roof repair and
Lead Hazard Reduction Demonstration Grants
insulation may help reduce moisture intrusion
and prevent mold. Improving ventilation to The Lead Hazard Reduction Demonstration grant
ameliorate the ill effects of tightening a building program targets funds for lead hazard control to
can help ensure no harm from energy-efficiency the nation’s highest-risk cities as defined by the
NATIONAL LOW INCOME HOUSING COALITION 6–3prevalence of lead poisoning and the number of to prevent childhood lead poisoning. Due to
pre-1940 rental housing units. Grants may be consistently increased funds, this program was
as high as $3 million, but 80% of the funds must able to issue grants to 48 states and 10 cities in
be spent on direct activities, and HUD requires a 2021. This program also funds the Flint Lead
25% local match from local or CDBG funds. High- Exposure Registry.
risk cities can receive demonstration grants in
CDC National Asthma Control Program
addition to basic lead hazard control grants. HUD
now allows a portion of the lead grants to be used CDC’s National Asthma Control Program funds
for other healthy homes issues. states, localities, and others to improve asthma
surveillance, build coalitions that implement
Healthy Homes and Lead Technical Studies
interventions, translate asthma guidelines into
Grants
public health practice, collect and analyze data
Healthy Homes and Lead Technical Studies not available elsewhere, and increase asthma
grants develop and improve cost-effective awareness. This program typically funds about 30
methods for evaluating and controlling states.
residential health and safety hazards through
CDC’s Environmental Public Health Tracking
a separate competition open to academic
Program
and nonprofit institutions, state and local
governments, tribes, and for-profit and non-profit CDC’s Environmental Public Health Tracking
research organizations. Program hosts an online database and
visualization tool (the Environmental Public
OTHER FEDERAL AGENCIES Health Tracking Network) that provides 23
datasets, 124 indicators, and 449 health
Programs at CDC’s National Center for
measures on public health topics like air quality,
Environmental Health and EPA provide
water, asthma, carbon monoxide, and birth
complementary programs to HUD’s OLHCHH.
defects. The program also funds 25 states and
The EPA provides training and licensing
one city to run their own tracking programs.
programs and laboratory quality control
programs; CDC-funded programs provide EPA Lead Programs
surveillance data, education, laboratory quality EPA’s Lead Risk Reduction Program updates
control for blood lead testing, and outreach on and supports implementation of lead hazard
housing related diseases and injuries; and HUD- standards, requires lead-safe work practices,
funded programs remediate homes to remove the ensures treatment of residential drinking water,
health hazards. and ensures disclosure of known lead during rent
For more information on healthy homes work at or sale of a home. EPA’s Lead Categorical Grants
these and other federal agencies, see https://nchh. fund states that have adopted EPA regulations
org/who-we-are/nchh-publications/fact-sheets/ around lead paint hazard abatement and
agency-fact-sheets/. renovation.
CDC Childhood Lead Poisoning Prevention EPA Indoor Air Quality Programs
Program EPA’s Reduce Risk from Indoor Air program
CDC’s Childhood Lead Poisoning Prevention educates and equips individuals and
Program provides funding to state and local organizations to reduce health risks from poor
health departments to determine the extent indoor air quality, including radon, secondhand
of childhood lead poisoning by screening smoke, carbon monoxide exposure, and asthma
children for elevated blood lead levels, helping to triggers like mold, pests, and dust. EPA’s Indoor
ensure that lead-poisoned infants and children Air: Radon program and Radon Categorical
receive medical and environmental follow-up, Grants promote actions to reduce health risks
and developing neighborhood-based efforts from radon, including radon-reducing features
6–4 2022 ADVOCATES’ GUIDEin new buildings and testing and fixing radon enforcement programs, instead of a complaint-
in existing homes, and administer the National driven process. For example, many housing
Radon Action Plan. codes prohibit peeling paint, standing water,
chronic moisture, roof and plumbing leaks, and
EPA Children and Other Sensitive Populations
pest infestation. The International Residential
EPA’s Children and Other Sensitive Populations: Code requires carbon monoxide detectors
Agency Coordination program ensures that EPA in new homes with fuel-burning appliances
programs protect children’s environmental health or attached garages. Efforts are underway to
by developing regulations, improving policy, require carbon monoxide detectors in existing
implementing community-level programs, and housing and radon-resistant new construction
collecting and interpreting data. and to prohibit lead hazards and excessive
moisture that leads to mold. Increasing public
FUNDING awareness and concern about other housing-
FY22 proposed budgets: related hazards is fueling new attention to state
and local regulation of healthy homes issues.
• HUD Office of Lead Hazard Control and
Many communities have also urged strong
Healthy Homes: $415 million passed by
collaboration between departments of housing,
Congress.
health, and environment; effective utilization of
• CDC Childhood Lead Poisoning Prevention CDC surveillance data to guide HUD programs to
Program: $50 million (House), $46 million families and areas of greatest need; enforcement
(Senate). of EPA requirements; and state Medicaid
• CDC National Asthma Control Program: $34 reimbursement for environmental health
million (House), $32 million (Senate). services in the homes of lead-exposed children
and people with asthma.
• CDC National Environmental Public Health
Tracking Network: $34 million. Resources:
• EPA Lead Categorical Grants: $21 million • Technical Assistance tools on local codes, RRP
(House), $14.6 million (Senate). certification, and lead-safe demolition: https://
nchh.org/who-we-are/nchh-publications/
• EPA Radon Categorical Grants: $11 million nchh-tools-for-technical-assistance/lead-
(House), $8.9 million (Senate). legal-strategies-partnership-technical-
assistance-tool-series/.
FORECAST FOR 2022
• How to make proactive rental inspection
The FY22 appropriation passed at $415 million.
effective: https://nchh.org/resource-library/
This funding level is below the National Safe and
how-to-make-proactive-rental-inspection-
Healthy Housing Coalition’s proposal of $606
effective.pdf.
million but is a welcome increase ($55 million
more than FY21) and continues to build on the • Creating effective and efficient primary
increases seen in the past few years. Please see prevention programs: https://nchh.org/who-
this link for updates https://nchh.org/information- we-are/nchh-publications/nchh-tools-for-
and-evidence/healthy-housing-policy/national/ technical-assistance/creating-effective-and-
current-nchh-work/federal-appropriations/. efficient-primary-prevention-programs/.
• Healthcare financing of healthy homes:
TIPS FOR LOCAL SUCCESS https://nchh.org/tools-and-data/financing-
Many communities have improved the quality and-funding/healthcare-financing/.
of their housing stock through the development
of better codes, such as the National Healthy
Housing Standard, and proactive code
NATIONAL LOW INCOME HOUSING COALITION 6–5WHAT TO SAY TO LEGISLATORS Housing, Section 8 Housing Choice Vouchers,
and others.
Advocates should contact their Members of
Congress, ask to speak to the person who deals • Include lead paint funding in infrastructure-
with housing, health or environmental policy, focused efforts.
and deliver the message that funding is needed • Fully fund healthy homes programs within
to correct health and safety hazards and lead CDC’s National Center for Environmental
hazards in homes. Healthy homes interventions Health, including the Childhood Lead
prevent injury, neurological and respiratory Poisoning Prevention Program, the
diseases, cancer, and even death from toxins such National Asthma Control Program, and
as carbon monoxide and radon. Addressing these the Environmental Public Health Tracking
hazards provides economic benefits, too; for Network.
example:
• Fully fund lead and healthy homes activities
• Removing leaded drinking water service at EPA.
lines from the homes of children born in
2018 alone would protect more than 350,000 FOR MORE INFORMATION
children and yield $2.7 billion in future
National Center for Healthy Housing, 410-992-
benefits, or about $1.33 per dollar invested.
0712, http://www.nchh.org/.
• Eradicating lead paint hazards from older
National Safe and Healthy Housing Coalition,
homes of children from low-income families
www.nshhcoalition.org.
would provide at least $3.5 billion in future
benefits, or approximately $1.39 per dollar HUD’s Office of Lead Hazard Control and Healthy
invested, and protect more than 311,000 Homes, https://www.hud.gov/lead.
children born in 2018 alone. CDC’s Healthy Homes and Lead Poisoning
• For every $1 spent on home-based asthma Prevention Program, http://www.cdc.gov/nceh/
control, there is a return on investment of lead/.
$2.03.
Advocates should use the Healthy Housing Fact
Sheets for each state and five major territories at:
https://nchh.org/who-we-are/nchh-publications/
fact-sheets/state-hh-fact-sheets/ and the Healthy
Housing Agency Fact Sheets at https://nchh.
org/who-we-are/nchh-publications/fact-sheets/
agency-fact-sheets/.
Advocates should also inform legislators of the
following ways through which they can lend
support for reducing housing-related health
problems:
• Fully fund HUD’s Lead Hazard Control and
Healthy Homes Program through which
communities can fix homes with health
hazards, including lead-based paint problems.
This also requires full funding for allied
HUD programs, such as the Community
Development Block Grants, Public and Indian
6–6 2022 ADVOCATES’ GUIDEYou can also read
