Photo: Adam Weiss

Many low-income people in the region live in homes that are detrimental to their health

The tri-state area has the oldest housing stock in the nation, with more than half of all homes built before 1960. While some older homes are still in good condition, a combination of disinvestment, absentee landlords, the deterioration of facilities, and lax housing code enforcement have led to high levels of indoor air pollutants, heavy metals, and mold. These conditions can contribute to diseases, such as asthma and lead poisoning—one in 50 children tested in the region suffer from high lead levels—which are more prevalent in low income communities.

Unfortunately, addressing health hazards in homes is done reactively. Remediation often occurs only after an individual health condition has been identified—that is, after renters have complained or gotten sick. Even worse is when renters fail to complain, despite a hazardous condition, because of a language barrier, or because they fear angering their landlord and compromising their housing situation.

Addressing health hazards in the home is also hampered by the fact that responsibility for housing issues and funding are divided among agencies. Buildings departments are typically responsible for overall building conditions. Tracking health data like blood lead levels is the responsibility of public health agencies. And energy efficiency programs, which can improve health conditions, are frequently led by state energy agencies.

Well over half the homes in the region are more than 50 years old. Older homes in high-poverty areas are far more likely to have a range of health hazards, from lead paint and mold to indoor air pollutants. Sources: EPA EJSCREEN, Displacement Index, FHEA Race Poverty Typologies

Proactive monitoring of hazards can significantly improve people’s health and reduce costs

Improving housing quality can bring enormous benefits to residents health as well as the economy. One study estimates that replacing lead-paint windows in the estimated one million U.S. homes that need it would cost between $1.2 billion and $11 billion. But the avoided health impacts would save the overall economy between $181 billion and $269 billion. For that to happen, however, requires moving from haphazard to regular and more frequent monitoring.

Routinely inspect homes in at-risk neighborhoods

States or counties should provide the tools and technical assistance for localities to implement Proactive Rental Inspection (PRI) programs in at-risk neighborhoods—neighborhoods with older housing stock and low market rents, where landlords may not have many incentives to keep their properties in good upkeep. By periodically inspecting all rental properties, PRI programs relieve renters from initiating complaints, and avoid problems with absentee landlords. PRIs can also make inspections more efficient by combining inspection types, and collecting data on housing stock. In New York State, the Integrated Property Needs Assessment provides a model for integrating inspections for energy efficiency improvements and health hazards. Establishing a PRI program should involve renter organizations and landlords to make sure all needs are being accommodated.

Update technology and sensors to alert health departments and maintain up-to-date information

Health inspectors should follow a standard format for documenting the health and safety history of housing units in order to facilitate comparison over time and across city boundaries, and data should be published online. Sensors installed in homes can make inspections more accurate by continually monitoring air and water quality, and ensuring that problems are addressed before a health problem arises. Investment in sensor technology is crucial to develop low-cost, accurate models to monitor hazards such as mold, for which no technology now exists.

Build health requirements into city, state and federal housing grants and streamline the application process for remediating health hazards

Healthy home standards should be built into requirements for low income housing tax credits, tax exemptions for residential developments, and other housing grants and subsidies. Hospitals submitting community benefit plans under the Affordable Care Act should also be evaluated for how these plans improve housing quality. In addition, application requirements for remediation should be made more flexible to make it easier for landlords and tenants to apply for funding to remediate hazards. Standardized requirements for healthy homes will help establish codes and inspections that cover all key health components rather than singular hazards.


In the short term, streamlined inspection processes will produce better data that will enable more effective identification of the most burdened households, and as a result, more housing improvements. In the longer term, up to date inspection systems will make it easier to identify hazards and quickly reduce exposure to unhealthy conditions.

By 2040, lead and other leading health hazards should be eliminated from the region’s housing stock, with priority placed on the neighborhoods with the highest rates of related disease and health conditions. Just as states and municipalities set goals for carbon emissions, traffic deaths and other environmental and health conditions, they should set and meet targets for the eliminating residential health hazards.

Paying for It

Streamlining inspection processes can result in better use of existing funding, but routine inspections will likely require some additional funding. Upfront investments in sensors and technology could reduce long-term remediation needs. A more holistic approach to housing quality can also create a better business case for increasing funding, whether from municipal budgets, hospital community benefits or energy efficiency grants.