Evaluating the health benefits of green affordable housing

Investigator: John Balmes, MD

Location(s): United States


Through the study, Enterprise Community Partners and NCHH will collect data on (1) the cost of implementing a standard set of healthy housing improvements, (2) various child asthma measures and caregiver quality of life, (3) other resident health outcomes, and (4) indoor environmental/ventilation data from a subset of homes. The study will recruit households living in multifamily dwellings that are scheduled to receive renovations that meet Enterprise Green Communities criteria. Households must include at least one child between the ages of 5-16 with not-well-controlled asthma and/or a recent history of unscheduled health care visits for asthma. A comparison (control) group will have the same inclusion criteria as the study group, except that their homes will not undergo renovation until after the study period concludes. An add-on cost-benefit study funded by the MacArthur Foundation will enable NCHH to document the impact of the participant’s health care utilization on Medicaid costs using standard cost-benefit analytical methods.

The study is expected to enroll over 1,200 households and retain over 700 one year after renovation. The study will take six years to complete. We hypothesize that healthy housing improvements will reduce health care costs among the study group and that reduction will be statistically significant when compared with the control group. These findings will provide the evidentiary support for investments in “housing as a vaccine,” thus aligning housing and health policies. The results of this study will be used to make the housing investment case to public and private health insurers, hospital community benefit programs, and investors in health impact bonds. In addition, the study will provide support and justification for affordable housing financiers to strengthen their criteria for green and healthy affordable housing redevelopment.