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GREEN AND HEALTHY HOUSINGAsthma in Low-Income Communities

Written by Rachel Goldman

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Improving Resident Health through Building Practices and Materiality The correlation between building materials and occupant health has become undeniable over the past twenty years. As time goes on, it is clear the lower income population in the United States bears the brunt of the damage. On average, Americans spend 90% of their time indoors.1 Besides the obvious health benefits of spending time outdoors (such as natural Vitamin D exposure, mood enhancement, and outdoor exercise), too much time inside can be dangerous if one occupies a space with poor Indoor Air Quality (IAQ). According to the Environmental Protection Agency, indoor levels of pollutants may be two to five times higher, and occasionally more than 100 times higher, than outdoor levels.2 Exposure to indoor air pollutants has been linked to life threatening diseases, the most common of which is asthma. One in five people have asthma. Every day, asthma in the United States causes:

• 40,000 people to miss school or work• 5,000 people to visit the emergency room • 1,000 people to be admitted to the hospital for an average of 3 days• 11 people to die3

The annual cost of asthma in the United States is estimated to be nearly $18 billion, $10 billion of which is the direct cost of hospitalization.4 With healthcare costs as high as they are, those who are truly burdened by this disease are the low-income population. According to a UCLA study, a low-income individual is twice as likely to visit the emergency department due to asthma when compared to higher-income individuals, and once there, they are six times as likely to be hospitalized.5 “The poorest among us suffer most because they lack quality health care and live in high-risk environments,” said Ying-Ying Meng, a senior research scientist with the UCLA Center for Health Policy Research. “That disparity also burdens our health system with costly emergency care and hospitalizations and extracts the additional high cost of millions of lost days of work and school.” Meng added, “Asthma has the potential to be debilitating, but it can be effectively controlled through appropriate medical care and avoidance of triggers.”6 The Center for the Greater Good is dedicated to solving the problem of poor health in communities, instead of simply treating the condition. We have spent countless hours alongside our developer partners identifying the best practices in affordable housing building design, with the objective of reducing the effects of asthma and other health concerns caused by poor IAQ.

The Air we Breathe is Slowly Poisoning Us It is easy to identify the source of poor IAQ in buildings and to recognize how pollutants affect the resident’s overall quality of life; the difficult part is eliminating them. Sources of indoor air pollution may include: combustion sources; building materials and furnishings; household cleaning, maintenance, personal care, and hobby products; central heating and cooling systems and

1 The Inside Story: A Guide to Indoor Air Quality. U.S. EPA/Office of Air and Radiation. Office of Radiation and Indoor Air (6609J) Cosponsored with the Consumer Product Safety Commission, EPA 402-K-93-007.

2 The Inside Story3 AsthmaandAllergyFoundationofAmerica-InformationAboutAsthma,Allergies,FoodAllergiesandMore! Web. 13 Nov.

2011. <http://www.aafa.org/display.cfm?id=8>.4 AsthmaandAllergyFoundationofAmerica5 Driscoll, Gwendolyn. “Asthma Disproportionately Affects Low-income Populations | UCLA Center for Health Policy Research.”

UCLACenterforHealthPolicyResearch. UCLA, 10 Dec. 2010. Web. 13 Nov. 2011. <http://www.healthpolicy.ucla.edu/NewsReleaseDetails.aspx?id=71>.

6 Asthma Disproportionately Affects Low-income Populations

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humidification devices; and outdoor sources such as radon, pesticides, and outdoor air pollution.7 The Center for Disease Control warns that indoor contaminants such as dust mites, molds, cockroaches, pet dander, secondhand smoke and some chemicals can trigger asthma attacks.8 Moving forward there are strategies to improving IAQ that have the potential to decrease the burden of asthma and other preventable health concerns for communities; the greatest challenge is completing renovation and demolition of existing structures without releasing harmful chemicals and dust particles into the air and soil.

The Center for the Greater Good Promotes Best Practices in Healthy Building Design and Construction The Center for the Greater Good works with foundations and investors to build communities in a financially innovative way with innovation extending to every aspect of the projects we fund. Our buildings are designed with the resident’s health in mind. Our Best Practices in design center around passive methods for improved materiality, increased natural light and improved air circulation. The Center for the Greater Good encourages developers to invest in natural, durable building materials that do not off gas. Ideal building materials meet the following requirements. They: contain recycled content; come from natural, plentiful or renewable sources; have a resource efficient manufacturing process; are locally available; are salvaged, refurbished or remanufactured; are recyclable or reusable; durable; are low or non toxic, output minimal chemical emissions; have a low VOC assembly, are moisture resistant; and are healthfully maintained. The Center for the Greater Good also incentivizes developers to design buildings with maximum indoor exposure to natural light. It is part of our commitment to further improve resident health and reduce energy costs associated with lighting. Benefits to natural light include: reduced energy consumption; reduction of mildew or mold built-up; natural vitamin D exposure; increased productivity experienced for occupants; and improved interior visual appeal.9 It is also important to circulate fresh, outdoor air to remove stale air and move pollutants out, as well as filter mechanically circulated air in order to cut down on the distribution of mold, mildew, dust, allergens, pet dander, and other potentially health impactful particles. The Center for the Greater Good not only strives to build better quality buildings, we also encourage the healthiest possible strategies to construction, maintenance and eventual demolition. Our developer partners work with only the highest quality construction firms to ensure two concepts on the job site: the proper installation and implementation of new building materials and strategies; and the best practices for building construction, renovation and demolition. Many approaches with the purpose of improving building efficiency and occupant health (such as the use of new materials and construction methods) require special installation. It is important that time and care be taken during the strategy implementation process to ensure the building functions as planned. The best practices for building construction, renovation and demolition must also be followed to preserve IAQ by reducing the release of contaminates into the air. Examples of practices include: the isolation of construction work areas from occupied areas through the use of appropriate containment barriers; the negative pressurization of construction work areas and/or the positive pressurization of occupied areas to prevent the migration of air contaminants; and maintenance of an adequate unoccupied buffer zone around the work areas to allow for construction or renovation traffic.

7 “Indoor Air Home | Air.” USEnvironmentalProtectionAgency. Web. 13 Nov. 2011. <http://www.epa.gov/iaq/>.8 Asthma Prevalence, Health Care Use and Mortality: United States, 2003-05, http://www.cdc.gov/nchs/products/pubs/pubd/

hestats/ashtma03-05/asthma03-05.htm9 “Natural Lighting Strategies and Benefits | One Green Planet.” OneGreenPlanet|OneGreenPlanet|OneGreenPlanetIsan

OnlineEcosystemThatDrawsLinksbetweentheWorldofEcology,theEnvironment,AnimalsandVeganLiving. Web. 13 Nov. 2011. <http://www.onegreenplanet.org/lifestyle/natural-lighting/>.

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Improve the Quality of the Air, Improve the Quality of the Life Asthma affects one out of five Americans, but it affects the low-income population at a far higher rate, partially due to hazardous living conditions. Society will benefit from a reduction in asthma among the low income population because it can recover some of the $18 Billion spent annually on asthma treatment. Individuals and society will also benefit financially by missing work less due to asthma symptoms. Children living an asthma free life will develop more active lifestyles, and miss school less often. The Center for the Greater Good, alongside our developer partners and foundations, is investing in proactive solutions to poor health in communities.