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    Credit: Eli Meir Kaplan

By 2020 we will provide new and existing housing that supports good health with indoor environments that no longer contain avoidable exposures to toxins that contribute to or cause asthma, mold-induced illness, lead poisoning, carbon monoxide poisoning, mental illness, stress, and a host of other preventable diseases and injuries.

By 2020 we will have ended the practice of allowing unhealthy and unsafe building materials to enter commerce and reduced the need to provide medical care to people who have been hurt by exposure to these materials—and the related costs of correcting these conditions by retrofitting housing at great expense. Doctors will no longer be forced to treat patients and then return them to the homes that made them sick in the first place. Our now skyrocketing health care costs will be contained in part due to the establishment of clear health-based, practical housing standards based on rigorous science that protects not only the public, but our most sensitive and at-risk populations, such as children, the elderly, and low-income families. In 2020 our housing financial system will enable health-based investments to be made in much the same way other housing improvements are done. We will have credentialed, well-trained healthy housing practitioners and our National Institutes of Health will have within it a National Institute for Healthy Green Housing, spawning new housing-based interventions that are evidence-based. By 2020 improved health from green healthy housing will be the new normal, reducing costs and needless suffering.

WHAT IS A HEALTHY HOME?

In the most basic sense, houses are shelters, providing protection from weather and potentially hostile environments. But beyond the basics, housing can and should support good health. The connection between housing and health has long been recognized. The public health and housing movements have common roots planted more than a century ago in efforts to address slum housing. The first modern housing laws were established to respond to infectious disease threats to public health such as tuberculosis and typhoid. The provision of indoor plumbing improved sanitation and led to the control of cholera and other waterborne illnesses.

Why are green healthy housing improvements unlike other home improvements? For housing, there is not a consistent perceived “shared commons” for which the public feels a communal benefit and responsibility, unlike other more widely shared elements of physical infrastructure, such as water or outdoor air quality. Housing codes are almost entirely local affairs, unlike health or environmental laws, which typically have national standards of care.

So, why is an integrated approach that eliminates health hazards in housing so difficult? One answer is that the scientific evidence of harm to specific groups has not been assembled adequately, although that is beginning to change, as described below. Another is that we have had no dramatic moment of recognition of the problem to galvanize public action, although the recent mortgage crisis has shown the importance of housing to us all. A third is that responsibility for housing is diffuse, including architects, builders, maintenance personnel, designers, code and building inspectors, occupants, engineers, urban planners, public environmental health professionals, and others. A final answer has to do with economic investment and the inability of housing price to reflect health outcomes.

Despite these obstacles, there are signs that a more integrated approach is emerging in the form of green healthy housing guidelines and that such approaches do in fact improve health.