What the HHST Will Do

Healthy Homes Screening Tool (HHST) We wish to acknowledge the assistance of Jane Nickert from the City of Detroit Department of Health and Wellness Promotion, Robert Scott from MDCH, and many work-study students who helped with this survey. 2012 1 What the HHST Will Do The Healthy Homes Screening Tool (HHST) will: Examine the health risks in surveyed homes by assessing the presence of a wide range of risk factors that may increase the potential for sickness, injuries, and death among a home s inhabitants. Provide a consumer and paraprofessional screening tool as a companion to the Healthy Homes Rating System (HHRS). Evaluate differences in resident responses regarding health and safety hazards in comparison with actual findings determined through the HHRS. 2012 2 1

HHST Targets & Versions The first version of the HHST was used for face-to-face interviews with residents at the door. The second version of the HHST is being used by nonhousing professionals to make observations about the household.* A third two-page version of the HHST is currently being developed to be used by non-housing professionals and paraprofessionals to make observations within the home. *Residents are being given the option of allowing non-housing professionals into the home to make observations or to complete the survey by a face-to-face interview at the door. 2012 3 HHST vs. HHRS The HHST is a screening tool intended for use within households by paraprofessionals and others. The HHRS is a system of assessment of hazards and the potential effect of conditions to be used by trained housing professionals. [1] [1] Healthy Homes Rating System Operating Guidance 2012 4 2

Healthy Homes Risks Asthma/Allergy In homes where allergens are present, including dust mites, cockroaches, mold, furry pets, tobacco smoke, air fresheners, and certain chemicals, children may experience severe and frequent asthma attacks from high airborne concentrations of these allergens. [1] Moisture/Water Damage Moisture and water damage can cause mold and fungus growth, leading to the development of asthma and allergies and triggering allergic symptoms such as rhinitis, conjunctivitis, eczema, cough and wheeze. [2] Lead Lead-based materials, such as lead-based paint and water pipes, can cause lead poisoning and have toxic effects on the nervous system, cognitive development and blood production. [2] [1] National Institute of Environmental Health Sciences - www.niehs.nih.gov/airborne/asthma.html [2] Healthy Homes Rating System Operating Guidance 2012 5 Healthy Homes Risks Housing Characteristics: House Overall housing conditions such as excess noise, risk of entry by intruders, lack of adequate living space, improper food preparation appliances and lack of proper personal hygiene and sanitation facilities can have multiple negative physical and psychological impacts on residents. Housing Characteristics: Stairs Falling on stairs can be caused by poor structural condition, inadequate lighting and absence of handrails, leading to bruising, fractures, head, brain and spinal injuries and even death. [1] Housing Characteristics: Bath Falls within a bath can be caused by lack of slip-proof surfaces and grab bars, often resulting in cuts or lacerations, swelling or bruising, or fractures. [1] Housing Characteristics: Fire/Electrical Smoke detectors, fire extinguishers, multiple exits and fire exit strategies can help to reduce the risk of death by burns or gas or smoke inhalation in the case of a fire. Exposed wiring and improperly vented appliances can increase the risk of fire and electrical shock. [1] Healthy Homes Rating System Operating Guidance 2012 6 3

Carbon Monoxide Healthy Homes Risks Improperly vented gas appliances such as dryers and stoves can lead to increased levels of carbon monoxide, leading to headaches, dizziness, weakness, nausea, confusion, disorientation, fatigue, and even unconsciousness and death. [1] Poisoning: Other Substances such as medication, pesticides, cleaning products and others can be potentially hazardous to children especially if stored in accessible locations. Radon Significant exposure to ionizing radiation can damage DNA and cause genetic mutation. [1] Because radon is a gas, it can leak into homes through the basement or crawl space, cracks in concrete floors and walls, floor drains and sump holes, or through well water. The Environmental Protection Agency (EPA) estimates that radon is the number one cause of lung cancer in non-smokers, responsible for as many as 21,000 cancer deaths each year. The combination of smoking and the presence of radon in the home can significantly increase the risk of lung cancer. [1] Healthy Homes Rating System Operating Guidance 2012 7 HHST Target Area Working from west to east, the northernmost boundary from Linwood to Woodward is Webb/Woodland. From Woodward to Oakland it is Holbrook, and from Oakland to I-75 it is Clay. Working from north to south, the easternmost boundary from Atkinson to Holbrook is Woodward. From Holbrook to Clay, it is Oakland, and from Clay to Mack it is I-75. The southernmost border, from west to east, is West Grand Blvd between Linwood and 14 th. From 14 th to Rosa Parks Blvd, it is I- 94. Between Rosa Parks Blvd and Trumbull, it is Grand River, and between Trumbull and I-75 it is Mack/Martin Luther King Blvd. Between Atkinson and West Grand Blvd, the westernmost boundary is Linwood. Between West Grand Blvd and I-94, it is 14 th, and between I-94 and Grand River, it is Rosa Parks Blvd. 2012 8 4

Smoking Does anyone in your home smoke? Does anyone in your home smoke? n=301 44.7% 3 51.1% n=371 55.1% 2 48.9% 0.2% 2012 9 Smoking Number of people who smoke Number of people who smoke 1 60 59.5% 1 n=5 26.3% 2 n=69 25.7% 2 n=9 47.4% 3 3 8.6% 3 n=3 15.8% 4 4.8% 3 5 1.1% n=3 6 0.4% 10 0. 4 5.3% 5 6 10 5.3% 2012 10 5

Fire/Burns Are smoke detectors present in your home? n=534 64 23.4% 0.3% 76.3% Are smoke detectors present in your home? n=52 10.2% 1.7% n=6 88.1% Is a fire extinguisher present? n=387 99 1.6% 1 55.5% 42.9% Is a fire extinguisher present? n=34 3 3.4% 57.6% 39. Does your family sleep with the bedroom doors closed? n=335 n=338 0.6% n=4 49.5% 49.9% Does your family sleep with the bedroom doors closed? n=34 9 1.9% 63. 35.2% 2012 11 Fire/Burns Are there multiple exits from the building in the event of a fire? Has everyone in your household discussed how to get out in case of a fire? 96.3% n=670 n=57 Are there multiple exits 3.7% from the building in the 1.7% 6 0. event of a fire? 21 n=63 2.1% n=4 33.5% 64.4% Has everyone in your household discussed how to get out in case of a fire? n=39 4 26.4% 98.3% 73.6% 2012 12 6

Fire/Burns Do you use any appliances other than a furnace to provide heat? (wood stove, fireplace, space heater) Do you use any appliances other than a furnace to provide heat? (wood stove, fireplace, space heater) 78 39.2% 5 42.4% n=429 60.5% n=33 55.9% 0.3% 1.7% 2012 13 Fire/Burns Are the following hot surfaces accessible to children? Are the following hot surfaces accessible to children? Radiators n=35 25.2% Radiators 3 30.2% Pipework that serve hot water to taps and water tanks n=42 27.8% Pipework that serve hot water to taps and water tanks 1 25. Pipework between Radiators 2 17.2% Pipework between Radiators n=9 24.3% 2012 14 7

Poisoning Are the following items stored out of the reach of children? Are the following items stored out of the reach of children? Medications n=556 89. Medications n=38 78% Cleaning Products Garden Supplies n=515 n=433 82.4% 82.5% Cleaning Products Garden Supplies n=36 n=32 73% 74% Pesticides n=506 84.8% Pesticides n=33 75% 2012 15 Falls Are all stairs in good condition? n=607 n=98 13.9% 0.1% 86. Are all stairs in good condition? n=55 3.5% 96.5% Are there handrails present in all stairways? Do you have working lights above or near all stariways? n=553 51 21.4% 0.1% n=625 n=83 11.7% 0. 78.4% 88.3% Are there handrails present in all stairways? Do you have working lights above or near all stariways? n=54 6.9% n=4 n=57 1.7% 93.1% 98.3% 2012 16 8

Falls Are grab bars present in bathtub(s) and/or showers? Is there a slip-proof surface in bathtub and/or showers? 58 22.3% n=551 77.6% 0.1% n=341 48.1% n=367 51.8% 0.1% Are grab bars present in bathtub(s) and/or showers? Is there a slip-proof surface in bathtub and/or showers? 5 n=41 n=31 5 26.8% 73.2% 55.4% 44.6% 2012 17 Asthma/Allergies Have any persons living here (under 18) been told by a doctor or other medical professional that they have asthma? 00 n=381 1.2% n=6 20.5% 78.2% Have any persons living here (under 18) been told by a doctor or other medical professional that they have asthma? n=9 23.7% 7 71.1% Have any adults living here been told by a doctor or other medical professional that they have asthma? 97 n=502 1.1% n=8 27.9% 71. Have any adults living here been told by a doctor or other medical professional that they have asthma? 8 n=41 30.5% 69.5% Do any of the persons living here have chronic problems breathing? 03 22.5% n=352 0.4% 77. Do any of the persons living here have chronic problems breathing? 8 n=40 31. 69. 2012 18 9

Asthma/Allergies Would you say [this person] limits [his/her] usual activities due to asthma? Would you say [this person] limits [his/her] usual activities due to asthma? t at All 26 46.2% t at All 4 46.7% A Little n=71 26. A Little 0 33.3% A Moderate Amount n=48 17.6% A Moderate Amount 6.7% Alot 8 10.3% Alot n=4 13.3% 2012 19 Asthma/Allergies Do you have any of the following pets living in your home? Do you have any of the following pets living in your home? Dogs 39 34. Dogs 2 21.1% Cats 41 20.3% Cats 4 23.7% Birds 1.6% Birds 0. 1 2012 20 10

Asthma/Allergies Do you use the following air freshener products in your home? Do you use the following air freshener products in your home? Candles n=396 56.2% Candles n=40 67.8% Incense 87 40.9% Incense 8 47.5% Plug-Ins n=305 43.5% Plug-Ins 7 45.8% 2012 21 Asthma/Allergies Do you use the following cleaning products in your home? Do you use the following cleaning products in your home? Bleach n=654 91.9% Bleach n=50 84.8% Lysol n=558 79.2% Lysol n=45 76.3% Pine-Sol 25 65.8% Pine-Sol n=44 74.6% 2012 22 11

Mold/Water Damage Has water leaked into your home from outdoors in the past year? (exclude plumbing or other inside leaks) 65 n=441 0.3% 37.4% 62.3% Has water leaked into your home from outdoors in the past year? (exclude plumbing or other inside leaks) 0 n=38 1.7% 33.9% 64.4% Have there been water leaks in the house from INSIDE the building in the past year? 25 n=477 0.7% 31.8% 67.5% Have there been water leaks in the house from INSIDE the building in the past year? 2 n=34 5.1% 37.3% 57.6% n=5 n=3 2012 23 Mold/Water Damage Have you seen mold in your home? Have you smelled mold in your home? 16 17.2% n=555 0.5% n=3 8 14.7% 58 2.6% n=5 82.3% 82.7% Have you seen mold in your home? Have you smelled mold in your home? 0 37. n=33 61.1% 1.9% 3 24.1% n=38 70.4% 5.6% n=3 2012 24 12

Pests Is there visible evidence of the following in or around your home? Is there visible evidence of the following in or around your home? Mice/Rats 72 24.3% Mice/Rats 3 39.7% Insects 96 27.9% Insects 5 42.4% Bed Bugs 6. n=42 Bed Bugs n=8 13.6% Cockroaches 5.1% n=36 Cockroaches n=6 10.2% 2012 25 Pests If yes to any of the above, do you use pesticides to get rid of or prevent them? If yes to any of the above, do you use pesticides to get rid of or prevent them? 81 45.3% 1 29. 17 54.3% 7 71.1% 0.5% 2012 26 13

Lead Poisoning (If children present) Have your children been tested for lead poisoning? 00 06 2.9% 2 47.9% 49.3% (If children present) Have your children been tested for lead poisoning? 3 9 3. 39.4% 57.6% Is there chipping or peeling paint inside or outside of your home? n=417 87 0.3% 59.1% 40.7% Is there chipping or peeling paint inside or outside of your home? n=34 5 0. 57.6% 42.4% Was your house built before 1978? n=600 5.3% n=35 3.4% 2 91.3% Was your house built before 1978? n=37 n=8 n=9 14.8% 16.7% 68.5% 2012 27 Entry by Intruders Do all your windows have locks? 62 8 14.5% 83.9% Do all your windows have locks? n=50 n=9 15.3% 84.8% Do you have deadbolts on all your external doors? 61 n=34 17.4% 82.6% Do you have deadbolts on all your external doors? n=48 0 17.2% 82.8% 2012 28 14

Carbon Monoxide Do you have a carbon monoxide detector in your home? 83 n=404 41.2% 58.8% Do you have a carbon monoxide detector in your home? 5 n=33 42.4% 55.9% Are they working? 76 n=51 15.6% 84.4% Are they working? 4 n=4 14.3% 85.7% 2012 29 Carbon Monoxide 0 1 2 3 4 5 6 7 10 1.9% n=5 62 n=64 1 3.4% n=9 1.1% n=3 0.8% 0.4% 0.4% How many? (Carbon Monoxide Detectors) 7.8% 23.9% 60.5% 0 1 2 3 4 5 6 7 10 4. 5 n=5 n=3 4. How many? (Carbon Monoxide Detectors) 12. 20. 60. 2012 30 15

Carbon Monoxide Is an unvented gas stove used in the home? 05 15.4% n=572 0.7% n=5 83.9% Is an unvented gas stove used in the home? 5 n=44 25.4% 74.6% Is an unvented gas fireplace used in the home? 7 9.2% 66 1.1% 89.7% Is an unvented gas fireplace used in the home? n=5 8.6% n=53 91.4% Was your furnace inspected in the past year? n=360 52 0. 58.8% 41.2% Was your furnace inspected in the past year? 5 9 2.2% 55.6% 42.2% 2012 31 Radiation Do you know what radon is? Has any work been done on your home to reduce the level of radon? 14 n=73 3.1% n=6 4.5% 83 5 n=38 11.3% 37.8% 59.1% 84.2% Do you know what radon is? Has any work been done on your home to reduce the level of radon? n=39 9 1.7% 0. 7 1 66.1% 32.2% 60.7% 39.3% 2012 32 16

Crowding & Space Does your home include a recreation space? 49 n=43 22.4% 77.6% Does your home include a recreation space? n=45 4 23.7% 76.3% Is it fenced in or wellguarded? 26 n=46 26.7% 73.3% Is it fenced in or wellguarded? n=38 4 26.9% 73.1% Is the space visible from the home? 35 5 15.6% 84.4% Is the space visible from the home? n=39 0 20.4% 79.6% 2012 33 Crowding & Space Are all bedroom doors working? 86.8% Are all bedroom doors 65 n=46 13.2% working? 14.8% 5 n=8 85.2% Do all bedroom doors have locks? n=67 20 35.8% 64.2% Do all bedroom doors have locks? 2 n=32 40.7% 59.3% Are all bathroom doors working? 86 4.1% n=8 95.9% Are all bathroom doors working? n=58 1.7% 98.3% Do all bathroom doors have locks? 06 n=84 55.8% 44.2% Do all bathroom doors have locks? n=35 2 61.4% 38.6% 2012 34 17

ise Is your home located near an airport, major highway, or train station? Is your home located near an airport, major highway, or train station? 51 78.2% n=48 82.8% n=42 21.8% 0 17.2% 2012 35 Food Safety Does your kitchen include the following appliances/amenities? Does your kitchen include the following appliances/amenities? Refrigerator 98.4% Refrigerator 89 n=58 100. Freezer 59 84.1% Freezer n=53 93. Oven 87 97.9% Oven n=58 98.3% Sink 90 98.4% Sink n=59 100. 2012 36 18

Water Supply Does your home have running water? 94 0.5% 99.5% Does your home have running water? n=59 0. 100. Are both hot and cold water options available? 92 1. 99. Are both hot and cold water options available? n=58 1.7% 98.3% 2012 37 Electrical Hazards Is all the wiring in the finished areas of your home concealed either in walls or behind metal coverings? Is all the wiring in the finished areas of your home concealed either in walls or behind metal coverings? n=603 85.7% n=49 83.1% 00 14.2% n=9 15.3% 0.1% 1.7% 2012 38 19

Electrical Hazards Have you experienced any problems with your major appliances (stove, furnace, etc.) over the past year? Have you experienced any problems with your major appliances (stove, furnace, etc.) over the past year? n=61 31.6% 8 30.5% 30 67.4% n=41 69.5% 1. 2012 39 Next Steps The Center is in the process of piloting a grant from MDCH to work with health professionals and others to prepare a one-page version of the HHST, pilot it, and identify steps for its implementation as part of regular home visitation processes. 2012 40 20

Center for Urban Studies Lyke Thompson Director (313) 577-5209 ad5122@wayne.edu Ramona Washington Research Assistant (313) 577-0979 r.r.washington@wayne.edu Angie Sarb Research Assistant (313) 993-8045 angela.sarb@wayne.edu 2012 41 21