More than 6 million families in the United States live in substandard housing conditions and millions more live in homes with hazards that could be easily addressed. Additional resources are critically needed to improve housing conditions and protect families and the nation's economy against the consequences of unhealthy housing.

Principles for Action

The Alliance for Healthy Homes and the National Center for Healthy Housing call on leadership from all levels of government and the private sector to create healthful housing for all families in America through the following policy approaches:

• Targeting the highest risk housing stock (i.e. low-income housing in substandard condition). This approach will yield the greatest improvements in health and reduce disparities borne by low-income and minority families.
• Providing incentives, including need-based subsidies as appropriate, for property owners and tenants, financial institutions, contractors, and builders to integrate health considerations into housing maintenance, finance, and construction.
• Eliminating disparities in health and housing through practical and evidence-based regulatory actions.
• Empowering communities to address and respond to local needs.

Federal Action

1) Promoting Holistic Programs: Federal programs should serve as models for integrating health considerations into housing programs. Congress should authorize flexibility for categorical federal grant programs to enable grantees to efficiently and effectively address client needs. New funding should beauthorized to enable greater coordination among housing, health, and energy programs.
2) Federal Standards: Congress should require rental properties to meet a minimum healthy housing code.
3) Voluntary Program: The federal agencies should develop and market a national “Healthy Homes Seal of Approval” labeling program for existing homes.
4) Housing Funding: The President and Congress should increase funding for affordable healthy, sustainable housing and ensure all people can afford quality housing including, for example, providing tax incentives and funding to offset the marginal costs of integrating healthy homes considerations into existing housing programs.
5) Capacity Building: Congress should require federal agencies to coordinate efforts to develop and deliver training for architects, builders, contractors, code inspectors, home inspectors, property owners, other housing providers, and community- and faith-based organizations. Congress should require federal agencies to provide technical assistance, training, and grants to equip state and local health departments, health care providers, code agencies, and community-based organizations to build local capacity to prevent, identify, and respond to housing-related health hazards.
6) Medical Reimbursements: The Medicaid and Medicare programs should pay for environmental investigations and interventions for housing-related illnesses including but not limited to asthma, lead poisoning, carbon monoxide poisoning, and residential injuries.
7) Indoor Environmental Action Levels: Congress should require EPA to set and enforce widespread adherence to health-based standards for indoor exposures including, but not limited to lead, carbon monoxide, radon, and formaldehyde.
8) TSCA Reform: Congress should reform the Toxic Substances Control Act to ensure that EPA has the information and resources it needs to properly assess health threats posed by building materials and home products.
9) Education: Congress should authorize a new grant program to provide funding for proven health education programs for low-income and hard-to-reach audiences. A coordinated federally-supported social marketing campaign should be created to raise the visibility of healthy homes and build broad support for it.
10) Data Collection: Congress should direct federal agencies to collect and report indicators of healthy housing at the national, state and top 50 municipal levels. Federal agencies should support the development and implementation of integrated health and housing data collection systems and use the data to evaluate the cost-effectiveness healthy homes interventions.

State and Local Governments

1) Code Enactment and Enforcement: Local and state governments should adopt and enforce the International Property Maintenance Code and ultimately the federal healthy homes minimum property standard.
2) Direct Service Programs: Public and private agencies conducting in-home visits should be cross-trained to provide healthy homes visual assessments and referrals for their clients.
3) Tax Benefits and Funding: State and local governments should offer tax incentives, home repair grants (e.g. through the Neighborhood Stabilization Program), and favorable financing for property owners to correct health hazards and conduct preventive maintenance. States should reimburse the cost of environmental investigations and interventions for housing related health problems including CO poisoning, asthma lead poisoning, and residential injuries through its Medicaid/SCHIP funds or other resources.
4) State Insurance Regulators: Require property insurance carriers to provide coverage for environmental health hazards and provide incentives to property owners who achieve the Healthy Homes Seal of Approval.

Private Sector

1) Pest Control Companies: Adopt and market Integrated Pest Management (IPM) as a superior approach to preventing and controlling pest infestation.
2) Property Owners: Apply maintenance practices that prevent health hazards and improve durability and energy efficiency, and at minimum remedy any potential health hazards
3) Consensus Standards: Consensus Standards Organizations: The International Code Council should strengthen its model codes to include key health and safety considerations.
4) Builders and Affordable Housing Providers: Meet USGBC LEED-H or Enterprise Green Communities Criteria (or regional or local equivalent) for newly constructed or substantially rehabilitated homes. Asset managers and developers should incorporate integrated pest management and smoke-free policies in multi-family housing.
5) Financial Institutions: Offer low-interest loans and other favorable financing terms for housing rehabilitation and health hazard mitigation.
6) Health Care Providers: When patients may be affected by hazards in the home environment, health care providers should take environmental health histories and recommend appropriate follow-up home assessments and home interventions.
7) Health Insurers: Provide reimbursement for appropriate hazard investigations and interventions for patients with housing-related illnesses.
8) Property and Casualty Insurers: Provide coverage for environmental health hazards and incentivize adherence to the Healthy Homes Seal of Approval and meeting Green Building criteria for new construction and substantial rehabilitation programs.
9) Home Inspectors and Realtors: Comprehensively check homes for health and safety hazards and educate buyers about potential health hazards and how to address them. Home inspectors should serve as third-party verifiers for the Healthy Homes Seal of Approval.

Alliance Action Agenda 2005-2008