Baltimore takes a holistic approach to unhealthy housing
Tuesday, April 6, 2010
The house on Baltimore's Rutland Avenue wasn't charming or well-maintained -- among other things, the skylights were covered by plastic bags -- but Petrina Taylor assumed it was safe enough.
But after five years there, the 31-year-old mother of three learned that carbon monoxide had been accumulating in the house, its escape hindered by a blocked chimney. Then a blood test revealed that lead dust and paint chips had poisoned her baby daughter.
"Everywhere you could possibly touch in my house tested positive for lead," said Taylor, whose daughter A'Niah is now hyperactive and aggressive.
Taylor moved out in December 2008. Even though her next house was a marked improvement, Taylor found ratholes in the backyard, and her kitchen floor bore evidence of mice, which she learned were inflaming her family's asthma. Then came the bedbugs.
"The lead and asthma and bites due to housing, and living arrangements, it affects your life," Taylor said. "It's very frustrating."
Stories such as Taylor's are increasingly common in cities like Baltimore, where an aging housing stock, poor indoor air quality, and the resurgence of bedbugs are compounding existing health risks in the home. Substandard homes are a big part of the problem, but the renters and homeowners living in them often do not know how to manage risks. And even if help is available from local government agencies, it's often spread out across many offices with little coordination.
Baltimore is trying a new approach.
The city is the site of the Centers for Disease Control and Prevention's first Healthy Homes program, an attempt to coordinate efforts on lead abatement, asthma and injury prevention, indoor air pollution and fire safety.
"It's not unusual for a community health worker to take care of lead only to have a child die in a fire, or fall out the window," said Mary Jean Brown, chief of the Lead Poisoning Prevention branch at CDC. "The Healthy Homes approach recognizes all these things that can happen in homes. So you take your lead prevention army and equip them with tools so that they can address more than one problem at once."
The program is run by Baltimore Assistant Health Commissioner Madeleine Shea, who says her biggest challenge has been training staff members from formerly separate areas to expand their expertise.
"Lead is really complicated, but so is asthma, and we've had to work out over time how to tailor an intervention to a family without burning out our staff," Shea said.
Much of Baltimore's housing stock is nearly a century old. Lead paint and dust still coat the interiors of some homes, though strict abatement laws have resulted in a 97 percent reduction in childhood lead-poisoning cases since the 1980s. But the humid summer climate favors the growth of mold, while fissures in deteriorating structures give pests a way in. And some homes in poorer neighborhoods have no heat source but their gas stoves, which create pernicious carbon monoxide and nitrogen dioxide fumes.