Summary of Healthy Homes and Neighborhoods Literature

Healthy Homes & Neighborhoods

A Review of Scholarly Literature

The Center for Housing and Community Studies

of the University of North Carolina at Greensboro

Conducted and Edited by Andrew Byrum and Lynn Cochran

Summary provided by Rebecca Harrelson

This literature review was conducted over a two-month period in early 2015, by Andrew Byrum and Lynn Cochran, research assistants working with the UNCG Center for Housing and Community Studies. It focuses on key variables involved in the complex dynamics of housing, neighborhoods, communities and health. Areas of focus include childhood asthma, lead exposure, cancers, the negative effects of living in proximity to vacant lots, boarded homes, and high-density traffic areas, and premature death. In reviewing more than twenty scholarly academic research articles within these focus areas, the reviewers found repeated correlations between poor housing conditions and health outcomes. What follow are highlighted points of the research findings which demonstrate how the spaces and places in which we live directly affect our health.     

Jacobs (2011) identified several statistically significant correlations between housing conditions and childhood asthma. In New York City, hospitalizations for children with asthma were associated with residence in the Census tracts with the highest proportion of crowded housing conditions, the largest number of racial minorities and high levels of neighborhood-level poverty. Jacobs (2011) also cites Centers for Disease Control and Prevention data from 2007 which indicated that racial and economic residential segregation was significantly associated with substandard housing conditions and negative health outcomes. Additionally, racial minorities, ethnic minorities, and families living below the federal poverty line were found more likely to live substandard housing conditions than Whites and more affluent Americans.

Read and Tsvetkova (2012) conducted an interdisciplinary review of existing literature concerning the larger contexts of housing affordability and its links to educational attainment, crime rates and health care. Their goal was to identify innovative ways in which affordable housing can promote education, safety and health, as well as profits for developers and the general real estate industry. The authors concluded that housing affordability is a multidimensional concept, one that includes facets of home and neighborhood quality, private home ownership, the public housing domain and homelessness, each with identifiable links to educational success, crime/safety, and health. On the basis of their findings, they argue for increased awareness and action at the policy and institutional levels regarding health and housing in the public sector, as well as greater awareness and efforts in the private sector to produce and maintain more affordable housing.

In 2006, Turyk et al. set out to investigate associations between parental-reported asthma morbidity in children and the presence of specific bedroom allergens (mold, cockroaches, dust mites, and cat allergens) in the homes of low-income families. The households surveyed were largely those of racial and ethnic minorities (Black and Puerto Rican families). The researchers collected allergen samples from the bedrooms of 61 asthmatic children, aged 3-13 and compared the presence of the triggers with self-reported asthma morbidity. Specifically, the researchers found that bedroom cockroach allergens corresponded with a higher number of asthma symptoms, while bedroom mold (specifically Penicillium) allergens corresponded with increased frequency of asthma symptoms.

In a later study, Garvin et al. (2013) explored how the prevalence of vacant lots and vacant homes impacts three domains of neighborhood health – physical, psychological and community well-being. Their goals included identifying what might be the most effective community-based intervention methods for dealing with blighted properties. They conducted 50 incentivized, semi-structured interviews in Philadelphia, gaining insight into local perspectives on both the character of vacant neighborhood lots as well their perceived consequences for physical and mental health. The researchers found that vacant spaces adversely impacted neighbors’ health by serving as unofficial dump sites (rotting trash build-up) that attracted rodent, animal and insect pests and by posing physical dangers (building collapse or fire). Participants also described heightened fears of crime and generalized anxiety. Participants offered numerous suggestions for eliminating vacant spaces – building subsidized housing on vacant lots, creating homeless shelters, playgrounds, and community gardens, among others. Importantly, community members expressed a strong desire to take responsibility for cleaning up their own neighborhoods, but felt they need support from local governments to be empowered to do so.

Regarding the links between ethnic and racial minority status, Apelberg at al. (2005) evaluated the racial and socioeconomic make-up of cancer risk disparities resulting from differing amounts of air toxin exposure in Maryland. The researchers conducted secondary data analysis using risk estimates from the U.S. Environmental Protection Agency’s National Air Toxics Assessment (NATA) paired with racial and socioeconomic characteristics of census tracts in Maryland (from the 2000 Census) to search for any socio-demographic correlation or association to cancer risk. They found that residents of Census tracts in the most segregated, predominantly African-American locales were three times more likely to be at high risk than those in more integrated areas. Indeed, cancer risk sharply decreased as the proportion of white residents in the census tract increased.  

In exploring the problem of childhood lead poisoning, Kim et al. (2002) researched potential associations between housing age, housing value and blood lead levels in children in Jefferson County, Kentucky. Employing secondary data analysis of blood lead level incidence reports provided by the Kentucky lead poisoning registry, the authors mapped the data by address, relating it to property ages and values recorded in the Jefferson county tax database. They found that children living in older homes and/or in homes valued less than $50,000 were statistically more likely to have elevated blood lead levels. Strikingly, home and property value was more strongly associated with lead poisoning risks than was the age of local housing stock.

There now exists a growing narrative on the complex and multidimensional relationships between socioeconomic status, race and ethnicity, housing and neighborhood conditions, and individual health. This research review summarizes but a snapshot of these relationships. Yet, when considering these in an even larger perspective, one that also accounts for transportation limitations and barriers to local health care access, the evidence for cyclical and systemic health inequities across large sectors of the American populace, living in a diversity of spaces and places is overwhelming.

To read the full literature review visit Health and Housing Literature Review