National Public Health Week Part 2: Green & Healthy Homes

Now if there is one overarching theme that everyone should understand regarding public health, it's that one's health is profoundly influenced by one's environment.  It's not just a matter of individual choices - I choose to be healthy, therefore I am - but a complex manifestation of multiple factors, both internal and external, that lead to one's health status:

One concrete example of a public health initiative that strives to improve individuals' health by impacting their environment is the Green and Healthy Homes Initiative (GHHI) which focuses on efforts such as lead hazard reduction, energy efficiency, and weatherization of homes.

According to the GHHI rep who spoke at the public health conference,

Lead-poisoned children are 7 times more likely to drop out of school and 6 times more likely to enter the juvenile justice system.  

Now clearly, there are confounding factors that could falsely inflate these statistics.  One would surmise that children who are lead-exposed are certainly more likely to live in impoverished areas, with substandard housing, crime, and poor school systems - but that does not take away from the fact that lead has demonstrable negative biopsychosocial effects on children.  In fact, the CDC has been advocating to lower the blood lead level threshold for intervention from 10 to 5 mg/dL, as studies like this one have suggested that lead levels of even 5 mg/dL have been found to have adverse educational, developmental, and behavioral effects.

Another target issue through GHHI is controlling environmental factors related to asthma.  Believe it or not, 40% of asthma triggers are in the home, so this is a key area of intervention where a huge impact can be made.  And research has shown that it has been successful-- there has been a 70% decrease in ER visits in those who have benefited from these services!  GHHI has estimated that a $70 million investment through these outreach programs has paid off several-fold through almost $640 million in health care savings.

While efforts to remove lead exposure and asthma triggers from homes are commendable, programs like GHHI are realizing that much more needs to be done to promote successful outcomes for these children.  Conducting post-remediation education with families is an important follow-up measure to ensure the sustainability of these interventions.  Furthermore, there is a new service model of funneling similar programs together to create one portal of entry via GHHI.  In this way, there is dialogue between programs that offer overlapping and/or complementary services so that clients don't have to lose several work days but can instead have a one-stop shop where they can plug into all these environmental services that improve the health of their families.  Seems a bit reminiscent of the patient-centered medical home, which is a comprehensive, coordinated system of care that is very near and dear to my heart.  Just goes to show you that the model works!

Next time--the intersection of race/culture and health...