Lifting the Burden of Energy-Inefficient and Unhealthy Homes

March 01, 2012
March/April 2012
A version of this article appears in the March/April 2012 issue of Home Energy Magazine.
Click here to read more articles about Healthy Homes

American taxpayers needlessly lose hundreds of millions of dollars every year in medical bills, skyrocketing energy costs, and lost wages due to inefficient and unhealthy housing conditions. Thanks to years of disinvestment in low-income neighborhoods, combined with a fractured system of program delivery and coordination, six million families have been confined to unhealthy and energy inefficient homes, placing them at risk for illnesses and injuries, including asthma, trip-and-fall accidents, and respiratory illnesses. (Data from the American Housing Survey, U.S. Department of Commerce, Bureau of the Census, 2007.) Hardest hit by environmental health hazards in the home are children and the elderly.

Lead Safety(Charles Wright)
Drainage Pipe(WAPTAC)
Carbon Monoxide DetectorWAPTAC
Furnace Detector(WAPTAC)
FamilyLead safety, proper drainage, healthy indoor air, and a properly functioning furnace create healthy families. (WAPTAC)

As home energy professionals are well aware, far too many American homes don’t meet basic healthy-homes principles—dry, clean, well ventilated, free from pests and contaminants, well maintained, and safe. This costs the United States billions of dollars annually in housing-related health care expenses for asthma, lead-based paint poisoning, injuries, and lost productivity in the labor force (see “The Cost of Asthma, Lead Poisoning, and Unsafe Housing”). Besides the physical health toll an at-risk home can take on its inhabitants, the monetary costs of unhealthy homes are enormous. They are estimated at $54.9 billion annually for childhood environmental diseases alone.

In addition to eliminating many health hazards, improving energy efficiency provides much-needed financial relief to low-income families. This makes it easier for them to meet such basic needs as rent or mortgage payments, and to maintain their property:

  • Families eligible for federal home energy assistance spend 20% of their income on home energy bills—6 times more than average.
  • Improving efficiency in very low-income housing would deliver 25–40% energy savings in up to 25 million residential units.
  • Air sealing homes and adding insulation in attics, floors over crawl spaces, and accessible rim joists would save up to 20% of heating-and-cooling costs, or up to 10% of total energy costs.

Although great strides have been made in revamping housing policies to address unhealthy and energy-inefficient conditions, it is critical that government agencies coordinate programs and resources in the way that best leverages both health and energy benefits. People with low incomes should no longer have to choose between paying their utility bills and keeping themselves and their families healthy and safe.

The coordination of weatherization and energy efficiency measures with health and safety interventions, in both low-income and market-rate homes, can improve the residents’ quality of life and also maximize savings for service providers. This in turn will enable providers to leverage additional resources, expand their business opportunities, and reach more clients.

The Green & Healthy Homes Initiative (GHHI) is a collaborative effort of the Coalition to End Childhood Lead Poisoning and various philanthropic groups, federal agencies, and local jurisdictions. The initiative is designed to maximize the public health and energy benefits of addressing many deficiencies in a given house simultaneously. Through an innovative set of practices and smart investments, GHHI breaks the cycle of deferred housing investments that result in higher medical bills, higher energy costs, and higher housing maintenance costs.

Currently, the benefits of health-based housing investments go largely unrecognized. As a result, residents of many homes are faced with excessive and avoidable costs; the health care sector, the taxpayers, and the residents themselves absorb these costs. GHHI addresses substandard housing by coordinating, or “braiding,” the work of programs that are funded and managed by different agencies but have similar missions; and by leveraging federal, state, local, and philanthropic investment. The goal of GHHI is to eliminate health, safety, and energy inefficiencies in the home through simultaneous, and integrated, interventions.

The Cost of Asthma, Lead Poisoning, and Unsafe Housing

Lead poisoning costs $43.4 billion a year. This sum represents court costs and the costs of medical treatment, special
education, and lost earnings.

There are 22.9 million Americans with asthma. Of these, 6.8 million are children. Asthma costs $20.7 billion a year for 2 million ER visits and 500,000 hospitalizations. Each year, 14 million school days are missed due to asthma.

Trip-and-fall injuries for seniors cost taxpayers over $19 billion per year.

GHHI takes a whole-house approach that coordinates weatherization, energy efficiency, and health and safety programs with relevant funding streams. This approach yields healthier, safer, and more energy-efficient homes; more-stable communities; better health outcomes for children; and improved financial well-being for families. The program streamlines service delivery and maximizes the impact of diverse funding streams for local and federal governmental agencies. The integration of energy and health programs eliminates overlapping costs.

Since 2010, GHHI has launched in 15 American cities and 2 Native American communities (see “Program Launch Sites”). These 17 sites are expected to renovate a minimum of 3,500 housing units using GHHI’s integrated approach by the end of 2012. We plan to renovate 500,000 units over the next three to five years as more cities come online. Each GHHI project site is expected to renovate 250–500 units during this period, using a comprehensive assessment and single-stream intervention process to reduce lead hazards, indoor allergens, safety hazards, and energy consumption through weatherization and energy efficiency interventions.

Program Launch Sites

GHHI is a social innovation designed to improve government efficiency and capitalize on investments in energy efficiency to deliver green, healthy, and safe homes in low- and middle-income communities. GHHI has been launched in the 15 cities and 2 Native American communities below and has quickly become a national movement, with 44 additional communities seeking GHHI designation in 2012.

Atlanta, GA
Baltimore, MD
Buffalo, NY
Chicago, IL
Cleveland, OH
Cowlitz Tribe, WA
Denver, CO
Detroit, MI
Dubuque, IA
Flint, MI Jackson, MS
New Haven, CT
Oakland, CA
Philadelphia, PA
Providence, RI
San Antonio, TX
Spirit Lake Nation, SD

GHHI’s first 3,500 homes are expected to produce the following benefits:

  • Each home is estimated to realize energy savings of $350 per year, for a total of $1,225,000.
  • Health and safety improvements for homes with asthmatics are estimated to create an average health care savings of $247,300,000 per year.
  • Health and safety improvements related to lead poisoning are estimated to create an average health care savings of $68,400,000 per year.
  • Health and safety improvements related to injury prevention for children, especially with respect to improving stairs, steps, and floors, are estimated to create an average health care savings of $2,865,625 per year.
  • More wealth will be created by the development of a tangible career pathway that produces 1,400 direct high-quality green jobs, through GHHI training and certification of unemployed or underemployed workers. These jobs will ensure better wages, benefits, and long-term opportunities for these workers. GHHI will build upon existing training resources.

GHHI is a new way of looking at housing—a smarter way of doing housing intervention work that recognizes that housing serves as a platform for improving health outcomes (see “Case Study: Smith Family”). GHHI will help to change policy and system practices in the following ways:

Case Study Smith Family—Baltimore, Maryland

The Smiths are a family of five, including a son who has severe asthma and a history of repeated asthma episodes resulting in hospitalizations. He has gone to the hospital an average of three times per year since birth; the average stay is 1 week each time. The Smiths' average annual asthma-related medical costs are $48,300 per year.

  • The Smith home had multiple health and safety issues that triggered asthma episodes for their son—rodent infestation, dust mites, excessive moisture, lack of weatherization, and poor indoor air quality.
  • GHHI performed a comprehensive, whole-house audit and assessment and then used an integrated intervention approach to address all issues in the home. The total cost was $8,826.
  • HUD Healthy Homes & Lead Hazard Control, Maryland Energy Administration, Community Development Block Grant, Community Service Block Grant, and philanthropic foundations all provided funding and support for the intervention.
  • Had the work been done without the GHHI integrated approach, the cost would have been $10,615.

Results. The Smiths’ son was not hospitalized due to asthma triggers in the home in the 12 months following the intervention. The family saved $48,300 in avoided medical costs in the first year alone and they saved nearly $1,900 on the whole-house audit and retrofit measures.

  • It will transform these practices from silo-based processes to horizontal-based programs;
  • make use of integrated interagency intervention modules;
  • leverage private investment;
  • implement single-portal client intake systems;
  • employ comprehensive, single-inspector audit and assessment processes;
  • develop common data metrics and reporting templates; and
  • condense and streamline training and accreditation standards across varying fields of green expertise.

GHHI has the strong support of the White House Office of Recovery, and the GHHI approach has been championed by many national organizations. These include the U.S. Conference of Mayors, which passed a resolution in June 2011 encouraging communities nationwide to adopt GHHI standards, practices, and principles. GHHI is also a model for other programs, such as HUD’s recently announced Safe and Healthy Homes Investment Partnership (SHHIP) designation, which will award two points on federal funding applications for communities that formalize relationships among health, housing, and energy programs to provide many housing-based interventions, and to leverage nonfederal resources. The criteria for SHHIP are based on GHHI, and the GHHI staff served on the HUD advisory committee that developed the program.

The GHHI gives home energy service providers opportunities to engage in home-based environmental health work. With the end of the Recovery Act just weeks away, and future federal funding for WAP and other energy programs uncertain, it becomes increasingly important to explore innovative program resources to fill financing gaps. GHHI provides a sustainable model for collaboration and public-private partnerships that can make health-based housing programs more efficient, and that can improve social, economic, and health outcomes for residents of low-income housing.


Ruth Ann Norton is the executive director of the Coalition to End Childhood Lead Poisoning.

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