Addressing Health Impacts of Poor Housing and Vacant Lots in Urban Areas

Considering people spend two-thirds of their lives where they live, the quality of housing and the state of their neighborhood can play a large role in well-being and cause poor health. A new report from Urban Institute took a look at the impact of blighted properties, such as substandard housing, abandoned buildings, and vacant lots, and policy and program recommendations that can help communities make housing and neighborhoods healthier.

Previous studies have found that dampness and mold exposure in the home has helped contribute to asthma for 20% of Americans with the condition. In addition, proximity to work, school, and public services can affect health, according to the report.

“Housing is a key social determinant of public health,” authors Erwin de Leon, PhD, of Columbia University, and Joseph Schilling, JD, of Urban Institute, wrote. “The condition of our homes, from the indoor air we breathe to the tap water we drink, and the neighborhoods where we live, from green space to amenities, can lead to better or worse health outcomes.”

The report reviewed current interventions in place to mitigate blight:

• Substandard housing. Many communities have policies in place to prevent lead poisoning and decrease fatal fires and fire deaths through smoke alarm laws. The US Department of Housing and Urban Development has awarded grants through the Healthy Homes Initiative, such as to the Seattle—King County Health Homes II Project, which found that access to community health workers decreased the number of children who used urgent health services for their asthma.
• Vacant homes and abandoned buildings. Cities such as Baltimore, Cleveland, and Detroit have launched initiatives to inventory, assess, and demolish vacant homes. Philadelphia enforced an ordinance that required owners to secure openings on a vacant property or face penalties. The strategy increased home sale prices by about 31% in neighborhoods that were targeted and reduced violent gun crimes in the city.
• Vacant lots. Cities have contended with vacant lots through property acquisition, site clearance and demolition, and redevelopment. Baltimore turned 640 vacant lots into green spaces, which has improved community pride to the point that drug dealers respect the space.

Successful interventions should be place-based, according to the authors. To implement that strategy, there are 5 core principles to follow:

1. Connect with citywide and regional opportunities and assets while expanding opportunities within target neighborhoods
2. Work both by integrating efforts across policy domains within a neighborhood and by engaging city, state, and federal policy makers
3. Integrate the work of multiple organizations with complementary missions
4. Define, measure, and track progress to shared goals while continuously adapting and improving strategies
5. Consider and plan for the challenges of residential mobility

“We can learn from some of the interventions initiated by cities to mitigate and remediate the negative impact of blight,” de Leon and Schilling concluded. “Moreover, more can be done, including taking a place-based approach to tacking blight; expanding the use of HIAs; learning from code enforcement and other policies; engaging the community in public health studies; and infusing health into codes, policies and practices.”