| Linking Public Health, Housing, and Indoor Environmental Policy: Successes and Challenges at Local and Federal Agencies in the United States David E. Jacobs,1 Tom Kelly,2 and John Sobolewski3 1National Center for Healthy Housing, Columbia, Maryland, USA; 2U.S. Environmental Protection Agency, Washington, DC, USA; 3Cuyahoga County Board of Health, Cleveland, Ohio, USA Abstract
We describe the successes and challenges faced by federal and local government agencies in the United States as they have attempted in recent years to connect public and environmental health, housing, community development, and building design with environmental, housing, and building laws, codes, and policies. These policies can either contribute to or adversely affect human physical and mental health, with important implications for economic viability, research, policy development, and overall social stability and progress. Policy impediments include tension between housing affordability and health investment that causes inefficient cost-shifting, privacy issues, unclear statutory authority, and resulting gaps in responsibility for housing, indoor air, and the built environment. We contrast this with other environmental frameworks such as ambient air and water quality statutes where the concept of "shared commons" and the "polluter pays" is more robust. The U.S. experiences in childhood lead poisoning prevention, indoor air, and mold provide useful policy insights. Local programs can effectively build healthy homes capacity through local laws and housing codes. The experience of coordinating remediation for mold, asthma triggers, weatherization, and other healthy housing improvements in Cuyahoga County, Ohio, is highlighted. The U.S. experience shows that policymakers should adopt a prevention-oriented, comprehensive multidisciplinary approach at all levels of government to prevent unhealthy buildings, houses, and communities. Key words: built environment, healthy housing, housing, indoor air quality, indoor environmental quality, policy, public health. Environ Health Perspect 115:976–982 (2007) . doi:10.1289/ehp.8990 available via http://dx.doi.org/ [Online 25 January 2007]
This article is part of the mini-monograph "Developing Policies to Improve Indoor Environmental Quality." Address correspondence to D.E. Jacobs, National Center for Healthy Housing, 10320 Little Patuxent Parkway, Suite 500, Columbia, MD 21044 USA. Telephone: (443) 539-4157. Fax: (443) 539-4150. E-mail: djacobs@nchh.org The findings and opinions expressed in this paper are solely those of the authors, not of any government agency. The authors declare they have no competing financial interests. Received 9 January 2006 ; accepted 19 April 2006.
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