Healthier homes can produce healthier Americans and a healthier U.S. economy.

That was the message in Washington Tuesday, where officials from the Centers for Disease Control and the U.S. Department of Housing and Urban Development (HUD) laid out some of the ways housing can affect public health, challenging the nation’s builders, healthcare providers, community organizers, and citizens to play a more proactive role in reducing preventable diseases and accidents in the home.

Acting Surgeon General Steven K. Galson issued an official call to action to promote healthy homes, asserting that poorly constructed and ill-maintained residences can contribute to endemic health problems such as asthma and lead poisoning. It’s a stance similar to former surgeon general C. Everett Koop’s 1982 battle cry publicizing the link between smoking and cancer.

"In the United States today, the leading preventable causes of death, disease, and disability are asthma, lead poisoning, deaths in house fires, falls on stairs and from windows, burns and scald injuries, and drowning in bathtubs and pools," Galson said during a press conference at the National Building Museum.

During that same event, HUD Deputy Secretary Ron Sims unveiled HUD’s new Healthy Homes Strategic Plan, a blueprint for housing reform stressing the need to keep homes dry, clean, well-ventilated, pest- and contaminant-free, safe, and well maintained. The document places particular emphasis on protecting the health of children and other sensitive populations in low-income households through improved construction practices and home safety precautions.

“Our homes ought to be a place where we can raise our children without fear of making them sick,” said Sims. “As a nation, we must think smarter about how we design, build, renovate and maintain our homes in a way that protects the health and safety of those who ultimately live in them.”

In 2007, asthma took a toll on the U.S. economy, representing $19.7 billion in direct medical costs and indirect costs associated with lost work and school days, according to estimates by the National Heart, Blood and Lung Institute. One in five cases of asthma are linked to mold and moisture in the home.

Radon, another common hazard at home--including newly constructed residences--is the leading cause of lung cancer among nonsmokers.

“We must continue to work together across communities and the nation to ensure our homes are sited, designed, built, renovated and maintained in ways that support the health of residents,” Sims said, noting that green construction and rehabilitation practices are integral to the ambitious agenda that has been set forth by both agencies.

HUD’s strategic plan lays out four main goals:  to build a national framework for implementing the healthy homes agenda; to support research on links between housing and health; to mainstream healthy homes practices and programs through grants, stricter regulations, and other measures; and to empower communities to build sustainable, local healthy homes programs.

During the event, officials stressed that negative issues linking substandard housing and public health problems must be addressed holistically. “For example, dealing with uncontrolled moisture can alleviate conditions associated with allergies and asthma (mold and pests), unintentional injuries (structural safety) and poisoning (lead paint deterioration),” authors noted in the executive summary of HUD's strategic plan.

The surgeon general’s call to action seeks to mobilize the country on several levels. Citizens are urged to make their homes safer through simple measures such as installing radon and carbon monoxide detectors, setting hot  water heaters at 120 degrees to prevent burns, installing handrails and non-slip mats to prevent falls, and proper use of other safety devices and household products.

At the same time, the call to action recommends specific actions for lenders, developers, home builders and inspectors. Those include:

  • Training and implementation of healthy home and green building practices. (Click here for rankings of various green building certification programs by the National Center for Healthy Housing.)

  • Consideration of health and safety issues in the selection of building sites, construction materials and building systems.

  • The application of smart growth principals at the neighborhood or community development level.

  • Lending instruments that consider the financial benefits of healthy homes.

  • Dedicating funds from the Community Reinvestment Act to support the development of safe and healthy homes.

  • Training of home inspectors to identify and report on safety and health hazards.

Proposed government actions include using housing subsidies to promote mixed-income neighborhoods, enforcing healthy home code requirements, and modeling incentives for healthy homes on existing incentives for energy efficient products.
Many of the recommended actions could mean new business and new jobs for the home building and remodeling industries, notes Rebecca Morley, executive director of the National Center for Healthy Housing (NCHH), one of several nonprofit advocacy organizations supporting the surgeon general's entreaty. Some 5.7 million U.S. homes are in need of professional repairs, and roughly 24 million homes have lead-based paint hazards that need to be remedied, according to NCHH figures.  

But health and safety problems aren't limited to older housing stock. New homes can also harbor health hazards, Morley warns. “New construction is equally prone (sometimes more so) to high radon levels, ventilation problems, and moisture issues," she said. "A new home is typically sealed more tightly than an older home. This is great for increasing energy efficiency, keeping out pests, and reducing drafts. However, if the design of the home does not provide for a way to replace existing air with fresh air, it creates an environment where airborne toxins and irritants, moisture, and radioactive radon gas seeping in through the home’s foundation can all build up.”

Jenny Sullivan is senior editor, design, at BUILDER magazine.

How to Build a Healthier Home

The National Center for Healthy Housing recommends the following practices for builders who want to construct healthier homes.

Make sure homes meet the American Society of Heating, Refrigerating, and Air-Conditioning Engineers standard 62.2 (ASHRAE 62.2, 2007). This is an industry standard for ventilation for buildings of four stories or less. Mechanical ventilation helps ensure contaminants and humidity are exhausted to the outside and that the home receives clean, fresh air. Additionally, it can benefit occupant health by increasing comfort and reducing unplanned airflows which can result in moisture problems.

Install proper smoke and CO2 alarms in all new homes. Carbon monoxide causes 450 deaths and 15,000 emergency room visits per year, and death in a house fire is 50% more likely in homes without smoke alarms. Carbon monoxide and smoke alarms often cost less than $25, a small price to pay for safety. 

Add ducting for an active sub-slab soil depressurization radon reduction (fan-powered) system. If tests determine that radon is a problem, the fans for the system can be added and activated. Radon is a tasteless, colorless, and odorless gas that is a decay product of uranium and occurs naturally in soil and rock. The main source of high-level radon pollution in buildings is surrounding uranium-containing soil such as granite, shale, phosphate, and pitchblende. Radon enters a home through cracks in walls, basement floors, foundations, and other openings.