Post on 26-Dec-2015
transcript
Baltimore’s Transition to Healthy Homes
Structuring a comprehensive, community-based healthy homes
effort
Genevieve Birkby, MPH, MA
Baltimore City Health Department
Healthy Homes & Communities Division
Overview
Describe Baltimore’s transition to healthy homes
Convey opportunities, resources & barriers
Discuss expansion to community-based initiatives which support healthy housing
87 square miles; 650,000 people 55,000 children under 6 65% African American Median family income – $37,000 Limited affordable, healthy housing Goal - Clean, Green, Healthy
Baltimore
Healthy Homes & Communities Division
Created in May 2006 Deputy Commissioner, Dr. Madeleine Shea Mission: The Baltimore City Health Department -- in
collaboration with community, city, state and national partners -- will improve the health and well being of children and their families by developing and targeting resources to make Baltimore homes lead safe, reduce home-based asthma triggers, reduce carbon monoxide poisoning, and decrease preventable home injuries.
Baltimore’s Housing
24% leaking roofs 53% peeling paint 38% mouse droppings 31% roaches present
50 years old on average (US is 30 yrs) 75% of rental units estimated to have lead Studies of low income housing show:
Lead Exposure in Baltimore
0
500
1000
1500
2000
2500
2000 2001 2002 2003 2004 2005 2006 2007
The number of lead-poisoned children under age 6 in Baltimore decreased from 2,189 in the year 2000 to 626 in 2007.
Why Transition from Lead to HH?
Declining lead cases Unmet needs in asthma prevention
and control, and injury prevention Staff capacity in inspections, health
education and case management Opportunity to expand public health
services and impact New funding and partnership
opportunities
Healthy Homes Demonstration Project
CDC-funded; piloted in 2007 Goal to develop, implement and
evaluate a model to expand an urban childhood lead poisoning prevention program into a comprehensive healthy housing program
100 initial home assessments 50 three-month follow up assessments
HH Demonstration Project
Significant staff training (healthy homes 101; IPM; fire safety; CO etc.)
Developed forms, assessments and protocols
Identified relevant healthy housing resources
Evaluation, evaluation, evaluation
Population - Renters
56% live in rental properties 65% of renters have a written lease Average monthly rent is $328
Population - Asthma
40% of households have someone with asthma or other respiratory problem
32% have child with asthma
Kitchens without a trash can: 28% Households reporting any pest
problem: 79.5% 44% with no working smoke alarms Asthma reported: 43% No working heat: 17% Indoor smoking: 36%
Results: What did we find?
Lessons Learned: HH Pilot
One-size fits all approach? Need to weigh “comprehensive” assessment
with “actionable” interventions Priority intervention areas?
Asthma? IPM? Staff
Training Morale
How? Resources & Opportunities
City Agencies – (DHCD, HABC, FD, PD, Health Programs, Quasi Orgs, School System)
State Agencies (DHMH, MDE, DHCD) Universities (public health, nursing, psychiatry,
urban planning, community law, social work, forestry, etc.)
Primary Care Providers Federal Agencies (CDC, HUD, EPA) Community Based Orgs (Coalition to End Childhood
Lead Poisoning, community groups, etc) National Advocacy and Training Orgs (NCHH, AHH)
How? Resources & Opportunities
City-wide initiatives Baltimore City Sustainability Commission Mayor’s Cleaner, Greener Initiative Food Policy Task Force
Barriers to Transition
Taking programs to scale Requires increased staff, training and
supplies Lack of public investment in housing
for low-income families Families “in crisis” – social issues
beyond housing Resource constraints
Current Division Structure
Four Bureaus Lead Inspections &
Enforcement LAAP (Lead
Abatement Action Program)
Asthma Community
Planning & Initiatives
Lead Inspections & Enforcement
Registered sanitarians inspect all homes of children with elevated blood lead levels with a healthy homes approach.
Issue violation notices to those homes with lead hazards
2009: Bed bug response
Lead Inspections & Enforcement
Case management for children with an EBL or with significant lead risks
Provide integrated healthy homes assessment and risk-specific advice
Link families to resources needed to improve the health and safety of their housing
Lead Abatement Action Program
Health intervention program geared towards interim control treatments of lead poisoning hazards in the home.
Have completed lead hazard intervention work in over 2,500 units throughout the City.
Asthma Home visiting asthma programs
Enroll children ages 2- 18 who have moderate to severe asthma
Home visits from nurses and trained community health workers to assess medical and environmental needs.
Utilize a healthy homes approach.
Community Planning & Initiatives
Community-based initiatives and evaluation Outreach and training Lead Safe Work Practices Initiative Promotores program Community Environmental Health
Planning Initiative Safe Pest Management for Health
Initiative
Community Approaches
Response to both identified priorities and emerging needs
Promotores program – need for better engagement with the Latino community
Safe Pest Management for Health Bed bugs! New and creative approaches (MICA) Asthma community education groups
Community Approaches
Support other city-wide initiatives Weatherization + health Baltimore City Sustainability Commission Redline Project
Safe Pest Management for Health
Baltimore Housing, BCPSS Augment our IPM response within the
division 35 site assessments Recommendations for city IPM
contracts Bed bug subsidization program Peer education in public housing
Weatherization
Broad-based partnership Housing; CECLP; MD Rehab.,
Civicworks, Rebuilding Baltimore Together
Weatherization + healthy housing