As public health and housing activists recognized a century ago when they fought for stronger sanitation and health codes, poorly maintained housing causes serious health problems. Today, with a better understanding of the scientific link between housing conditions and health, advocates for decent and affordable housing are building a new grassroots healthy housing movement. These advocates are discovering that documenting actual health hazards in homes can provide powerful leverage to help them win both building-by-building repairs as well as larger policy solutions.
Childhood lead poisoning and asthma are just two of the most prevalent and devastating illnesses caused or exacerbated by substandard housing conditions. Radon and carbon monoxide kill tens of thousands and sicken many more each year. Pesticides – even when used as directed – can cause cancers, reproductive problems, neurotoxic effects and other serious illnesses. Many housing-related health hazards have shared causes and solutions. Thus, multiple hazards can often be remedied simultaneously – and cost effectively. Not only are health care costs reduced by preventing illnesses associated with these hazards, long-term housing costs also are lowered because repairs to prevent or control hazards also can increase the durability of homes and of their major systems.
To support this new movement, the Alliance for Healthy Homes, a national policy and advocacy organization, has developed a model for advocacy that focuses directly on environmental hazards in homes to point the attention of officials and other policy makers toward real prevention. The most glaring shortcoming of most state and local lead poisoning and asthma programs is their failure to identify and address hazards in the home environment before children become sick. By documenting hazards in specific homes, advocates can get policy makers to acknowledge the connection between health hazards and substandard housing conditions and reshape local priorities to address housing-related hazards before occupants get sick.
Over the past 21⁄2 years, the Alliance’s Community Environmental Health Resource Center (CEHRC) has trained 200 community members in nine cities and regions across the country as hazard investigators. CEHRC has also provided funding, ongoing technical and strategy assistance, support for project evaluation and mechanisms (meetings, phone conferences, a listserv) to allow peer-to-peer support among these groups. These projects, in turn, have checked more than 2,500 homes for hazards and used the results of their own hazard investigations in high-risk homes to press for community-wide solutions for lead poisoning and other healthy housing problems.
The following vignettes highlight the successes of three local CEHRC projects that motivated landlords to repair serious problems in individual buildings and won significant improvements in law, code enforcement and funding to address substandard housing and associated health hazards.
Cleveland Tenants Organization and Environmental Health Watch
In Cleveland, Environmental Health Watch (EHW), an environmental policy nonprofit, and Cleveland Tenants Organization (CTO) began working closely together four years ago because of a growing awareness about lead poisoning and other health consequences of substandard housing. Together they visited more than 250 homes in the past two years, documenting lead and asthma-related environmental health hazards and identifying numerous landlords violating the federal lead disclosure law. Through this work, these organizations won a new municipal ordinance that addresses lead paint dangers and strengthened their policy advocacy concerning housing measures to reduce asthma.
The two groups documented lead paint hazards in about half of the units they checked. They found that most landlords in these buildings failed to comply with the federal law that requires them to disclose known information about lead hazards to tenants before they move in and provide tenants with the required EPA lead safety pamphlet. They also used a visual survey and a tenant questionnaire to document environmental factors associated with asthma including mold, moisture problems (leaks, visible water damage) and cockroach and rodent infestation.
“It’s no mystery that Cleveland has a lead paint problem,” says Mike Foley, CTO’s executive director. “But documenting lead hazards in hundreds of homes and collecting more than 50 affidavits from tenants who never received federally required lead disclosure really helped convince officials that new legislation was needed.” CTO and EHW members provided input about the law’s content to city health officials and testified at a City Council hearing to support the proposal. After many landlords and their associations vehemently opposed the measure based on their understanding of its provisions, the Council convened a work group that included housing court officials, landlords and EHW’s executive director. The work group addressed landlord concerns and clarified the ordinance’s provisions. Ultimately, the Council passed the ordinance unanimously in August 2004.
The ordinance makes lead paint hazards in residences, schools and day care facilities a “nuisance” subject to city code enforcement; creates a voluntary property certificate program as an incentive for property owners to eliminate lead hazards; and allows the city to regulate exterior paint removal through its permitting process for most properties built before 1978. If a property owner fails to act, the city can send a contractor to abate the hazard and assess the costs to the owner by placing a lien on the property. The ordinance also incorporates the federal disclosure requirement into city code. It gives individuals harmed by the property owner the ability to recover triple damages and authorizes nonprofit groups to pursue damages on behalf of individuals. In addition, the city now has authority to pursue criminal penalties (up to $5,000 per violation) against property owners who fail to fulfill their duties under the federal law.
The project has also strengthened EHW’s efforts to convince the Cleveland Metropolitan Housing Authority to control pests more safely and effectively through the use of integrated pest management, or IPM. IPM emphasizes maintaining physical barriers to pest entry, removing sources of food and water and reducing resident exposure to dangerous pesticides that can be potent asthma triggers, cause neurological damage in children and lead to a variety of cancers.
Collaborating on healthy homes work helped strengthen a partnership between an organization with expertise about technical lead poisoning and asthma issues and another with experience and credibility in working with low-income tenants – to the benefit of both organizations. “The project allowed us to get inside hundreds of homes, see conditions first-hand and talk with tenants about their health and housing problems and their rights under Ohio tenant-landlord law,” says EHW’s health educator, Kimberly Foreman. Both organizations believe their collaboration also enhanced their reputations and helped them win significant new funding from foundations and government agencies.
“We’ve always understood on some level that bad housing has health consequences,” says Foley. “But actually checking hundreds of homes for lead hazards and asthma triggers made this connection more real for us. Water leaks and cockroaches are not only nuisances; they’re dangerous, too. Health impacts add another color to our palette of ways we can talk about substandard housing and inform tenants about the deeper consequences of these conditions.”
Northern Manhattan Improvement Corporation and the Unión Comunal de Washington Heights e Inwood
Northern Manhattan Improvement Corporation (NMIC) is a multi-service nonprofit organization working to improve housing conditions and stabilize low-income communities in Manhattan’s Washington Heights and Inwood neighborhoods. NMIC tenant organizers provide technical assistance and training to the Unión Comunal de Washington Heights e Inwood (Unión Comunal), a separate organization led by community tenant leaders that has for many years worked to organize tenants and improve housing code enforcement.
During the past three years, NMIC provided training to eight members of the Unión Comunal and some NMIC staff on how to conduct home hazard investigations, educate tenants about lead and other hazards and organize tenant associations in buildings where hazards are documented. Hazard investigators also learned to conduct visual assessments to document other health-related conditions, including mold, rodents and cockroaches. All of these problems constitute emergency violations under city codes.
NMIC and the Unión Comunal used their hazard investigation findings to support efforts by a citywide coalition to win enactment of a strong municipal lead poisoning prevention ordinance, Local Law 1. The law was fiercely contested by some political leaders, landlords and even a few affordable housing developers who feared the costs of lead paint removal. Still, the law was enacted in January 2004 and became effective in August after the City Council overrode a mayoral veto. It requires peeling paint and lead dust to be safely removed by trained personnel in pre-1960 apartments with children under age seven. Cited violations must be fixed within 45 days, and the city must inspect landlords’ repairs within 14 days. Local Law 1 also increased the number of housing code inspectors citywide.
In the weeks leading up to the final Council vote on the ordinance in late 2003, NMIC and the Unión Comunal released a report on their lead hazard investigation findings for some 200 apartments at a press conference covered extensively by TV, radio and newspapers. “Our report, showing that at least one out of four apartments had lead hazards, drove home the point that lead is still a serious problem in our neighborhood,” notes NMIC organizer Jennifer Welles. “At a critical point in the campaign, we helped sustain the momentum needed to get the law passed and prevent last minute City Council defections. It’s hard to say you’re against the law, when there’s been video on TV of a young child standing next to a gaping hole in their bedroom wall.”
Address-specific, quantitative information proved to be especially potent for getting individual landlords to repair violations. Welles says there was a noticeable improvement in landlord responsiveness to tenants’ repair request letters when they included lab reports on lead dust wipe samples, and the improved response became dramatic after Local Law 1 was enacted and copies of tenant letters were sent to the code enforcement agency. An NMIC housing attorney has also used the federal lead disclosure law to win damages and relocation assistance for tenants living in two lead-contaminated apartments.
Building on their legislative victory, NMIC and the Unión Comunal are now part of a broader coalition, the Coalition for Slumlord Accountability, campaigning to enact a municipal “Healthy Homes Act” that would strengthen enforcement of Local Law 1. The Unión Comunal is also campaigning for increased funding for legal aid lawyers to represent tenants and to fund the City’s Emergency Repair Unit, which steps in to repair dangerous code violations when the landlord fails to act promptly.
The hazard investigator training was an invaluable leadership development tool for the Unión Comunal and has kept key leaders involved in the issue for the long haul, says Welles. “They really are our strongest and most effective leaders, and they get real satisfaction from being able to help their fellow tenants tackle bad housing and landlords,” she says.
The Environmental Health Coalition, San Diego
The Environmental Health Coalition (EHC) a 25-year-old, grassroots environmental justice organization, was one of the first environmental groups in the country to recognize the major health implications of substandard housing. EHC adapted its SALTA (Salud Ambiental Latinas Tomando Acción or Environmental Health, Latinas Taking Action) training program for community health promoters (promotoras) for its 21⁄2-year CEHRC project. The promotoras, volunteers who live in the affected communities, investigated more than 250 homes for lead and asthma hazards, using lead dust wipe and paint chip testing, visual surveys, resident questionnaires, cockroach traps (to quantify infestations) and moisture meters (to detect hidden moisture problems).
The promotoras reported their hazard investigation results to residents, offered to help them get needed repairs and worked to involve interested residents in their larger Campaign to Eliminate Childhood Lead Poisoning. EHC then used the promotoras’ documentation of hazards to convince city agencies in San Diego and nearby National City to partner with them to improve housing code enforcement and lead paint policies, and to win two lead hazard control grants worth nearly $5 million from HUD.
After documenting lead paint hazards in 77 percent of the homes checked by their promotoras in National City, EHC worked to educate the city’s housing inspectors about the hazards, and in return, the inspectors explained the city’s code enforcement process to the promotoras. EHC and the inspectors then worked together to identify high-risk properties and inspect them for hazards. Their collaboration resulted in a jointly written funding proposal that won a $3 million HUD lead hazard control grant for National City. This grant is subsidizing lead hazard control interventions and additional rehab and weatherization services in 110 high-risk homes and funding efforts to make another 300 homes lead-safe through improved code enforcement.
In San Diego, EHC’s lead hazard investigation results convinced housing department officials to create a pilot project in 2002 to reduce lead hazards in five homes in the Sherman Heights neighborhood. The pilot project led to a successful $1.9 million HUD Lead Hazard Control grant that is being supplemented by more than $700,000 in local matching funds. This will allow lead hazards to be reduced in more than 170 homes and increase the number of low-income children tested for lead exposure.
EHC’s work has enhanced the organization’s reputation as local experts on healthy homes, allowing them to play a leadership role in a mayoral task force created two years ago to develop a new municipal lead poisoning prevention ordinance. The ordinance, which was approved unanimously by the San Diego City Council’s Land Use and Housing Committee in August 2004 and which is scheduled for consideration by the full Council this spring, would make it unlawful to create or fail to correct a lead hazard and require the use of lead-safe work practices by workers disturbing paint on dwelling units built before 1979. The ordinance would also require pre-1979 housing to be made lead-safe at the point of sale and require owners of pre-1979 rental units to conduct visual inspections for deteriorated paint and make repairs prior to re-occupancy at rental turnover.
Letitia Ayala, director of EHC’s anti-lead campaign, says the organization found that collecting hard data about hazards was key to driving policy changes. Ayala has seen many other benefits to EHC from the project, including new and strengthened relationships with community and government agencies. But she feels that EHC’s increased leadership capacity is the most important outcome of this work. “Learning how to check homes for hazards, explain the problems to residents in ways they can understand, help tenants understand and exercise their rights and work on policy changes were certainly challenges for our promotoras,” says Ayala. “But doing all this really solidified their skills and turned them into incredibly strong leaders.”
The first step in solving a problem is recognizing its existence. Community-based home hazard assessments provide vivid documentation of the extent and severity of health hazards in high-risk homes. They also help engage tenants in common cause, put pressure on landlords, engage the media and move policy makers to help local organizations win needed changes for their communities.