Homesick: Is your house impacting your health?

"LowTen-year-old Reginald Liddell and his eight-year-old brother, Jaylijah, have asthma. But when they moved into a low-income apartment complex in the Cincinnati neighborhood of Avondale, their breathing problems grew exponentially worse. Why? Housing conditions—including an apartment “creeping with mold”—were making them sick. 

"Housing is the number one predictor of human health,” Marcheta Gillam told the Cincinnati Enquirer,“If the housing is in peril, kids are going to go down the drain with the building.”

Gillam is a lawyer with the Legal Aid Society of Greater Cincinnati, and works with children living in substandard housing. She was part of a team of doctors and lawyers that formed a medical-legal partnership based at two clinics of the Cincinnati Children’s Hospital Medical Center. The team’s efforts—featured in the journal Pediatrics—focused on improving housing conditions for low-income children who had been diagnosed with asthma, development delays, behavioral disorders, and/or elevated lead levels.


Asthma remains the most common chronic condition of childhood, affecting nearly 10 percent of all U.S. children, and the air they breathe in the home plays an important role in their health. A recent study highlighted in the American Journal of Public Health demonstrated how asthma-friendly homes—when combined with caregiver education to reduce exposure to triggers—reduced urgent asthma-related clinic visits by two thirds, from 62 percent to 21 percent. The homes also contributed to a 44 percent increase in the number of asthma-symptom-free days.

An asthma-friendly home is one that is clean, dry, well-ventilated, and uses materials and finishes that do not off-gas volatile organic compounds (VOCs) and other toxic chemicals. On the flip side, water damage, mold, and peeling paint might seem like nothing more than symptoms of neglect and deferred maintenance, but they are actually sources of potentially serious health threats, especially for children like the Liddell boys.

"ChildWhen Rocky Mountain Institute established our Superefficient Housing Initiative (SHI), we understood that healthy housing needs to be part of the solution. “We look at the house as a system,” explains Alexis Karolides, co-leader of SHI. “It’s a very interconnected set of solutions that can help create a healthier home environment.”

For example, that system begins with the house envelope or shell—the walls, roof, windows, and doors. The shell is a crucial piece for tapping into energy efficiencies. But it’s also a key for managing air and moisture flow into and out of the home, which is one place where energy efficiency and healthy homes overlap.

When we create more efficient building envelopes through air-tightness and more insulation, we then need to ventilate the home by choice, rather than by chance. Ventilating a home by chance means that you might get fresh air through leaks in the building envelope when the wind blows (such as through poorly sealed doors and windows). Such leaks and other flaws in the building envelope can let in water as well as air, and water damage can then spawn mold problems and other airborne irritants that affect children and adults alike.

Ventilating a home by choice, on the other hand, involves using a low-energy heat recovery ventilation unit or other mechanical air supply system with good filtration. Superefficient homes with a tight building envelope are similarly resistant to water penetration and damage as well, and that spells good news for creating a healthy home.

Children like the Liddell boys needn’t be exposed to environmental hazards that put their health at risk just because they live in low-income/affordable housing. As the ventilation example demonstrates, energy efficiency and healthy homes can go hand-in-hand, and RMI is helping to bring those benefits into closer alignment.

RMI recently launched Residential Energy Efficiency Leaders (REEL), a working group of ten major public housing authorities in locales ranging from Washington to Massachusetts, Minnesota to Texas. By sharing lessons learned, best practices, and other solutions for superefficient affordable housing—energy efficiency designs and interventions that deliver housing 60% more efficient than today’s code at comparable cost—RMI and its REEL partners are promoting healthy, energy-thrifty housing for the people who can afford it least, and for whom the health consequences of the alternative are the highest.

Highlighted Resources


Superefficient Housing Intitiative


Residential Energy Efficiency Leaders (REEL) Working Group




Healthy Homes



HUD’s Healthy Homes Program



Some images courtesy of Shutterstock