Creating Healthy Buildings for Asthma Patients

BPHC’s Innovation Fund initiative is helping to expand a program to create healthier housing for Bronx community members living with asthma.

Bronx residents visit the emergency department (ED) for asthma at nearly twice the New York City rate and triple the state rate with up to 20% of children in some Bronx neighborhoods living with asthma, according to the most recent Community Health Survey (CHS). The Bronx also has the highest proportion of homes with mold and pests, according to NYC Housing and Vacancy Survey data, and the greatest percentage of reported second-hand smoke (CHS).

The program, called Healthy Buildings, is a project of the Northwest Bronx Community & Clergy Coalition (NWBCCC) that addresses the high rates of asthma in our borough by making our buildings healthier to live in.

BPHC began an Innovation Fund initiative with NWBCCC in October 2017 to bring the Healthy Buildings program to additional multi-family buildings in the northwest and central Bronx. Through housing and hospital admissions data, the program identifies buildings referred to as asthma “hot spots” — areas with high rates of asthma and asthma-related ED and hospital admissions.

“Our Healthy Buildings Teams work with landlords and building management to identify and reduce asthma triggers present in buildings and engage tenants to advocate and take control of their health,” says Sandra Lobo, NWBCCC Executive Director. “It’s a multi-pronged approach that addresses the disproportionate rate of asthma in our borough and fosters community empowerment.”

Team members, comprised of community health workers and community organizers, conduct a building assessment looking at general structural needs, energy usage and efficiency, presence of pests and mold, overall air quality, and tenant-identified improvements. Recommendations on the scope of work can include structural repairs, energy efficient upgrades, integrated pest management (IPM), and “green” cleaning training for building staff. The Team can connect owners with local, certified contractors and provide support with acquiring financing needed for major improvements.

Focus is also given to the economic benefits of the program including energy savings, financing options for making improvements, and reduced tenant turnover.

The Healthy Buildings Team also meets with tenants to assess their apartments and make referrals for in-home asthma visits if needed.

They help form tenant associations and engage residents to become “building leaders” by training them on the social determinants of health, in particular the relationship between environmental triggers and asthma, as well as green cleaning, local resources, and tenant rights. Building leaders become trainers themselves, informing and empowering fellow residents to manage their asthma and advocate for building improvements.

Progress is measured by evaluating building improvements and energy savings, surveying building residents, and comparing healthcare utilization before and after the interventions began.

Through the BPHC Innovation Fund project, the Healthy Buildings program reached landlords and tenants in six buildings, securing IPM in three buildings, training more than 300 people about their housing rights, and making more than 140 referrals to in-home asthma assessments.

NWBCCC’s assessment report conducted on one housing development – Bailey Houses – also drove the allocation of $3 million in capital funding to the NYC Housing Authority to repair significant leaks in the roof.

“We are very excited to be expanding this Innovation Fund initiative to a new set of buildings,” said Dr. J. Robin Moon, BPHC Senior Director of System Integration. “The Healthy Buildings program underscores the essential role of addressing environmental and social issues to improve our community’s health. Community action and clinical care need to work hand-in-hand for healthcare to be effective. This is what DSRIP is working to achieve.”

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