Health Outcomes Attributable to Housing Conditions in the United States

This research was a cross-sectional examination of the effects of substandard housing conditions in the United States. Air sampling and interviews were performed for 85 housing units in the Chicago metropolitan area. Air metrics included concentration levels for formaldehyde, nitrogen dioxide, particulate matter, carbon monoxide, carbon dioxide, ASHRAE 62.2 compliance. Health-related quality for occupants was assessed through the Short Form-36 scale. In addition, disease and monetary burden from pediatric asthma attributed to mold and moisture exposure in homes from the American Housing Survey. Homes that complied with the ASHRAE 62.2 standard had significantly lower levels of formaldehyde. When restricted to homes within the city limits of Chicago, there were statistically significant lower levels of formaldehyde and carbon dioxide in homes that were compliant with the standard. In general, the trend was that most contaminants were lower in ASHRAE 62.2 compliant homes. There was no statistically significant difference in self-reported occupant health-related quality of life outcomes between homes that were ASHRAE 62.2 compliant and those that were not. Modeling for physical health resulted in asthma, age, and carbon dioxide being significant variables. Modeling for mental health resulted in nicotine, carbon dioxide, carbon monoxide, and nitrogen dioxide being significant variables. However, it appeared that nicotine variable acted as a surrogate introduction of bias into the model because the directionality was opposite than expected. When the total air contaminant load was divided into tertiles there were no statistically significant differences observed. However, there was a consistent trend that increased air contamination load resulted in lower compliance with ASHRAE 62.2, lower physical health, and lower mental health. Estimates for the disease and monetary burden were calculated utilizing most recent data from 2008 and calculated in 2009 dollars. Mold accounted for 13,870 Disability Adjusted Life Years (DALYs) and 5 deaths. Leaks from interior sources accounted for 29,839 DALYs and 11 deaths. Moisture from exterior sources accounted for 36,198 DALYs and 14 deaths. A combined factor of moisture from interior and exterior sources accounted for 60,136 DALYs and 23 deaths. The total cost of asthma for those under 15 that may be attributed to mold and moisture in homes was almost 2.4 billion dollars.