Housing Quality and Health: Revealing the Connections, Addressing the Challenges (Part 3)

Housing Quality and Health: Revealing the Connections, Addressing the Challenges (Part 3)

July 2021
Don Bianchi & Elana Brochin

Revitalize CDC in Springfield improves housing conditions by performing assessments and interventions for adults and children with asthma to safely remain in their home. (Photo credit: Revitalize CDC)


MACDC has long supported its members in their work to improve housing quality. In recent years, MACDC worked with it's members to establish health equity work as a defining characteristic of the contemporary community development movement in Massachusetts. We are now in the beginning stages of an initiative to link these two strands of our work. We would like to engage with as many stakeholders as possible in this process, and, therefore, are publishing this series of blog posts to share out ideas and get your feedback.

Part 3: Current Programs Addressing Property-Level Distress

In our prior blog, we provided a snapshot of current housing quality and safety problems that negatively impact resident and community health.  For each of these problems, we identified the unsafe housing conditions, the resulting health and safety problems, and the impact on at-risk populations.  

 We now turn to an examination of current interventions to address these housing quality problems. Because of the broad dimensions of current efforts, we will cover these efforts in two blogs, the third and fourth in our series: 

  • This blog, our third, will examine current programs focused on addressing property-level distress, including programs to confront lead hazards in homes, poor indoor air quality, and other unsafe housing conditions. 
  • Our following blog will focus on efforts to address broader factors, without which, initiatives to address property-level distress are destined to be inadequate: neighborhood disinvestment, and climate change. 


The fifth and final blog post in our series will identify gaps and advocate for increased investment in and alignment of housing quality and health programming and funding. The American Rescue Plan Act (ARPA) – which will bring more than $8 billion dollars into the Commonwealth of Massachusetts – is a once in a generation opportunity to invest in creating affordable housing, and also to invest in improvements to the quality and safety of Massachusetts existing housing stock, which is among the oldest in the nation. Through investing $100 million in healthy housing and de-leading programs, we can improve the housing stock and improve the health and well-being of residents across the Commonwealth. 


Programs to address lead hazards: 

The Massachusetts Lead Law requires the removal or covering of lead paint hazards in homes built before 1978 where any children under 6 live. A landlord can be held legally responsible if a child living in a unit they own becomes poisoned from lead.  It is illegal under MA law to evict, or refuse to rent to, a family with a young child; this is enforced by the Massachusetts Commission Against Discrimination (MCAD). Yet, 50 years after passage of the Lead Law, we have not come close to addressing the hazards, and landlords routinely discriminate against families with children- underscoring the need for new legislation. 


There are public programs, including the State’s Get the Lead Out Program (GTLO) administered by MassHousing, and the federal Department of Housing and Urban Development’s (HUD) Lead-Based Paint and Lead Hazard Reduction Demonstration Grant Programs that aim to accelerate lead removal from residences.  Local agencies, both public and nonprofit, administer these programs. For example, Worcester’s lead abatement program assists property owners with costs associated with lead abatement and conducts studies to protect children and families from health hazards in their homes. 

The Boston Public Health Commission (BPHC) offers training to build capacity to address lead hazards and ensure safe lead abatement.  It provides training for renovation, repair, and painting contractors on how to work safely in housing with lead-based paint and comply with EPA's Renovation, Repair, and Painting (RRP) Rule, and HUD's Lead Safe Housing Rule. It also provides Moderate Risk De-leading training to certify contractors, agents and property owners that want to remove lead in Massachusetts on their own.  


Programs to address poor indoor air quality: 

The Environmental Epidemiology Program (EEP) within the State’s Bureau of Environmental Health (BEH) provides information about asthma and the environment and helps to educate the public about the variety of environmental exposures that can trigger asthma attacks. BEH conducts annual asthma surveillance of children ages 5-14 by gender, grade, school, and community in Massachusetts. 


Regulations and incentives to make multi-unit buildings smoke-free can reduce exposure to secondhand smoke which causes asthma, poor blood circulation, heart disease, and lung cancer. For example, as of 2018, all Public Housing Authorities funded by the US Department of Housing and Urban Development are required to implement a smoke-free housing policy. The Massachusetts Smoke-free Housing Project provides support to tenants, landlords, and condominium owners and associations to understand the benefits and challenges of making homes smoke-free.1  


On the local level, public agencies, nonprofits, and healthcare institutions have joined forces to address indoor air quality. The Boston Public Health Commission runs a variety of programs focused on various aspects of home health and indoor air qualityThrough the Boston Asthma Home Visit Collaborative, Community Health Workers conduct home visits to assess the environment for asthma triggers, share information on resources to reduce or eliminate them, and work with the family to create an Asthma Action Plan.  BPHC also offers a training program to help landlords make their properties smoke-free. 

The Springfield Healthy Homes Program is partnership among Revitalize CDC, Baystate Medical Center, Health New England, and the Public Health Institute of Western Massachusetts. The program connects Springfield residents to services that address a variety housing quality and safety concerns that impact health, including asbestos, asthma triggers, carbon monoxide, and pests, among othersHospitals throughout Massachusetts participate in programs that aim to decrease home asthma triggers. For example, Boston Children’s Hospital’s Community Asthma Initiative conducts home visits to identify asthma triggers and provides tools for asthma mitigation, including vacuums, bedding encasement, and integrated pest management services. 


Programs to address other unsafe conditions in homes (and keep safe homes in that condition): 

Responsible Property Management: In multifamily properties, sound property management practices are essential to providing a safe living environment. One resource for property managers, the New England Affordable Housing Management Association (NEAHMA) provides training to encourage best practices. Through quality property management, proactive maintenance, and timely upgrading and replacement of building systems, properties in good condition can be maintained as such.  


Code Enforcement: Code regulations and enforcement of existing housing quality requirements are a tool for ensuring adequate housing quality and safety. Through the Massachusetts State Sanitary Code, and other laws and regulations, all homes, including those in the private market, are subject to certain minimum standards of health and safety. Tenants in Massachusetts have legal protections from landlords who are not responsive to tenant complaints, including the ability to withhold a portion of the rent or move out, even if there is a lease or rental agreement in place. These rights are described in the MA Attorney General’s Guide to Landlord and Tenant Rights 


Housing Rehabilitation Programs: Several CDCs and many municipalities administer Housing Rehabilitation Programs using public funds such as federal CDBG funding to address code violations and improve living conditions. Hilltown CDC administers its Housing Rehabilitation Program for several towns in its rural region, making funds available to property owners as zero interest deferred-payment loans, with repayment due upon sale or refinancing of the property, and forgiven over time Revitalize CDC in Springfield administers a home improvement program for veteransand others, with a focus on making their homes safe, healthy, accessible, and energy-efficient. 


MassHousing administers a Home Improvement Loan Program, with loans of up to $50,000 to address home repair needs.  MassHousing also assists first-time homebuyers to address home repair needs when their home is purchased through its Loan Program for purchase and rehabilitation. 


The Home Modification Loan Program is a state-funded program that provides loans to homeowners and small landlords to fund changes to keep people with disabilities and elderly individuals in their homes, through improvements such as installing grab bars which can allow elderly residents to safely live in their homes. 


The programs and interventions discussed in this article have addressed health and safety problems in thousands of homes, and dramatically improved the lives of countless families.  In our next blog, we’ll describe existing programs that address two broader problems that must be addressed if we are to sustain property-level improvements: neighborhood disinvestment and climate change. We will then detail the ways in which, through greater program alignment and a significant investment of ARPA dollars, we can improve housing quality and safety for current Massachusetts residents and generations to come.