Rationale

People in the United States spend 50% or more of every day inside their homes (Centers for Disease Control and Prevention and U.S. Department of Housing and Urban Development 2006). A healthy, safe, affordable, and accessible home supports residents’ fundamental physical and psychological needs and protects them from illness and injury.

Challenges

The risk for serious injury, toxic exposures, and illness is increased among those who are least able to find and afford healthy homes. Steps must be taken to eliminate disparities in housing conditions arising from social and economic disadvantage so that people in the United States from all walks of life, ages, and racial and ethnic backgrounds will share the opportunity to have homes that promote and protect health.

Actions

For some residential hazards, evidence-based interventions already exist to reduce exposures that cause disease and to prevent injuries. Now these interventions must be made available to all who need them. All levels of society, from single persons and families to government organizations, can begin to implement strategies that will make safe, healthy, affordable, and accessible homes a central component of the nation’s public health architecture. Home modifications should be attractive, appropriate for home setting, easy to implement, straightforward to use, affordable, and effective.

Rationale

There is a need to improve the public’s understanding of the connection between housing and health. Health literacy, including an understanding of the concepts and terms related to healthy homes, helps people take actions that foster healthy and safe homes. Stakeholders, including educators, community-based organizations, and others have key roles in improving housing-health literacy.

Challenges

Rental property owners, tenants, and single-family homeowners should receive information and tools that could help them make homes safer, healthier, and more environmentally friendly. Because many of these practices must be adopted and maintained by the residents themselves, educational efforts must both provide information and encourage behavior modifications. Educational materials must include guidance about specific steps people can take to reduce health hazards in their homes and strongly promote the benefits of taking such actions. Great care must be taken to develop messages that are inclusive, culturally sensitive, and linguistically appropriate to meet the needs of the socially, economically, and ethnically diverse U.S. population. A broad range of stakeholders should be engaged in crafting these messages.

Actions

Rationale

Although in the last decade research demonstrating the link between specific housing conditions and health has matured, significant knowledge gaps remain. Addressing these gaps will require research that links housing conditions with specific health outcomes while accounting for personal, home unit, neighborhood, and community-level factors and the impact of disparate access to safe, healthy, affordable, and accessible homes. Research is also necessary to evaluate the effectiveness of comprehensive housing improvements, regulatory policies, and voluntary initiatives. Unless healthy housing is carefully studied in methodologically appropriate ways, the risk remains that families, property owners, and government agencies responsible for providing housing assistance will undertake expensive but ineffective interventions. Progress toward promoting healthy homes also depends on demonstrating that healthy homes is feasible, cost-efficient, and beneficial (Proscio 2004).

Challenges

To advance public health actions that will have a significant impact on health, the nation needs a more holistic understanding of how housing affects people’s health (U.S. Department of Health and Human Services 2005a). Such research requires a broad approach involving many disciplines such as fire prevention, safety science, engineering, psychology, home design, epidemiology, exposure assessment, medicine, risk management, environmental science, and public policy science.

Actions

Rationale

To improve human health, research discoveries must be translated into practical applications. Both basic research, in which scientists study disease at a molecular or cellular level, and applied research, in which scientists study whether proposed interventions are effective, need to be brought to the reality of people’s lives.

Challenges

The barriers between the scientific research community and the sectors of society that can benefit most directly from their work as well as the ever-increasing complexities involved in conducting scientific research make it difficult to move new knowledge from research to action in a timely way. The barriers and complexities also slow down information from the field that would help stimulate new research questions. Opportunities for communication between scientists and those in the field are few: limited rewards exist for scientists who pursue translation research and training opportunities are scarce. These challenges limit professional interest in the field and hamper the conduct of translation research at a time when it should be expanding.

Actions

Once the best practices for prevention are identified, successfully translating them into actual practice should take two approaches: an approach that focuses on constructing and maintaining housing in ways that promote and protect health and an approach that addresses changing individual and community behaviors. Open collaboration among professionals involved in constructing and maintaining homes and scientists, government agencies, and housing advocacy organizations would ensure that each group has up-to-date information and access to resources.