Impact of LEED-certified affordable housing on asthma in the South Bronx

Background: Green housing reduces energy costs and may mitigate indoor allergens and pollutants, improving asthma morbidity. High asthma burden is seen in low-income neighborhoods. Past studies show improvements in respiratory symptoms when living in green homes. Objective: Develop partnership with Blue Sea Development Company to determine impacts of living in Melrose Commons V (MCV), a Leadership in Energy and Environmental Design (LEED) Platinum-certified affordable housing complex, on asthma in the South Bronx. Methods: Participants completed a home-based respiratory health questionnaire before moving into MCV. Follow-up occurred at 6, 12, and 18 months post-move. A home-based educational module was delivered on indoor environmental interventions to avoid asthma triggers. A pretest was given before the module and a posttest was given 9 months later, including an evaluation of behavioral practice changes. Results: Outcomes included decreases in continuous daily respiratory symptoms (p<.001), asthma symptoms disrupting sleep in the past month (p=.028), and urgent visits to a healthcare professional for asthma in the past 3 months (p=.038). Clinically relevant outcomes included fewer days with asthma symptoms; asthma episodes; days of work, school, or daycare missed; and emergency department visits. Education changes from pretest to posttest included increased knowledge about dust mites, roaches, mold, and chemical irritants (p=.007). Common behavioral changes included using hypoallergenic mattress covers, using green cleaning products, and eliminating bedroom carpets. Conclusions: Findings support the beneficial effect of LEED Platinum-certified buildings on respiratory health. Trends may be clinically and economically relevant. Advocacy efforts should promote the expansion of green housing and emphasize the development of healthy communities.