Healthy Homes Screening Tool (HHST)
description
Transcript of Healthy Homes Screening Tool (HHST)
Healthy Homes Screening Tool (HHST)
12012
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.
What the HHST Will DoThe 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
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 non-housing 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]
2012 4
[1] Healthy Homes Rating System – Operating Guidance
Healthy Homes RisksAsthma/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]
2012 5
[1] National Institute of Environmental Health Sciences - www.niehs.nih.gov/airborne/asthma.html[2] Healthy Homes Rating System – Operating Guidance
Healthy Homes RisksHousing 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.
2012 6
[1] Healthy Homes Rating System – Operating Guidance
Healthy Homes RisksCarbon Monoxide
• 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.
2012 7
[1] Healthy Homes Rating System – Operating Guidance
2012 8
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 14th. From 14th 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 14th, and between I-94 and Grand River, it is Rosa Parks Blvd.
HHST Target Area
Smoking
2012 9
Don't Know
No
Yes
0% 20% 40% 60% 80% 100%
0.2%
55.1%
44.7%
Does anyone in your home smoke?
Don't Know
No
Yes
0% 20% 40% 60% 80% 100%
0.0%
48.9%
51.1%
Does anyone in your home smoke?
Completed in house by site visitor Completed outside house by interview
n=23
n=22
n=301
n=371
n=1 n=0
Smoking
2012 10
10
6
5
4
3
2
1
0% 20% 40% 60% 80% 100%
5%
0%
0%
5%
16%
47%
26%
Number of people who smoke
10
6
5
4
3
2
1
0% 20% 40% 60% 80% 100%
0.0%
0.4%
1.1%
4.8%
8.6%
25.7%
59.5%
Number of people who smoke
Completed in house by site visitor Completed outside house by interview
n=160
n=69
n=23
n=13
n=3
n=1
n=5
n=9
n=3
n=1
n=1
n=0
n=0
n=0
Fire/Burns
2012 11
Does your family sleep with the bedroom doors closed?
Is a fire extinguisher present?
Are smoke detectors present in your home?
0% 50% 100%
1.8%
3.4%
1.7%
35.2%
39.0%
10.2%
63.0%
57.6%
88.1%
YesNoDon't Know
Does your family sleep with the bedroom doors closed?
Is a fire extinguisher present?
Are smoke detectors present in your home?
0%20%
40%60%
80%100%
0.6%
1.6%
0.3%
49.9%
42.9%
23.4%
49.5%
55.5%
76.3%
YesNoDon't Know
Completed in house by site visitor Completed outside house by interview
n=52
n=6
n=1
n=34
n=23
n=2
n=34
n=19
n=1
n=534
n=164
n=2
n=387
n=299
n=11
n=335
n=338
n=4
Fire/Burns
2012 12
Has everyone in your house-hold discussed how to get out
in case of a fire?
Are there multiple exits from the building in the event of a
fire?
0% 20% 40% 60% 80% 100%
0%
0%
26%
2%
74%
98%
YesNoDon't Know
Has everyone in your household discussed how to get out in case of a fire?
Are there multiple exits from the building in the event of a fire?
2.1%
0.0%
33.5%
3.7%
64.4%
96.3%
YesNoDon't Know
Completed in house by site visitor Completed outside house by interview
n=670
n=26
n=121
n=63
n=4
n=57
n=1
n=39
n=14
n=0 n=0
n=0
Fire/Burns
2012 13
Don't Know
No
Yes
0% 20% 40% 60% 80% 100%
1.7%
55.9%
42.4%
Do you use any appliances other than a furnace to provide heat? (wood
stove, fireplace, space heater)
Don't Know
No
Yes
0% 20% 40% 60% 80% 100%
0.3%
60.5%
39.2%
Do you use any appliances other than a furnace to provide heat? (wood
stove, fireplace, space heater)
Completed in house by site visitor Completed outside house by interview
n=278
n=429
n=2
n=25
n=33
n=1
Fire/Burns
2012 14
Pipework between Radiators
Pipework that serve hot water to taps and water tanks
Radiators
0%20%
40%60%
80%100%
24.3%
25.0%
30.2%
Are the following hot surfaces acces-sible to children?
Yes
Pipework between Radiators
Pipework that serve hot water to taps and water tanks
Radiators
0%20%
40%60%
80%100%
17.2%
27.8%
25.2%
Are the following hot surfaces acces-sible to children?
Yes
Completed in house by site visitor Completed outside house by interview
n=13
n=11
n=9
n=35
n=42
n=22
Poisoning
2012 15
Pesticides
Garden Supplies
Cleaning Products
Medications
0% 20% 40% 60% 80% 100%
75%
74%
73%
78%
Are the following items stored out of the reach of children?
Yes
Pesticides
Garden Supplies
Cleaning Products
Medications
0% 20% 40% 60% 80% 100%
84.8%
82.5%
82.4%
89.0%
Are the following items stored out of the reach of children?
Yes
Completed in house by site visitor Completed outside house by interview
n=556
n=515
n=433
n=506
n=38
n=36
n=32
n=33
Falls
2012 16
Do you have working lights above or near all stariways?
Are there handrails present in all stairways?
Are all stairs in good condition?
0%
0%
0%
2%
7%
4%
98%
93%
96%
YesNoDon't Know
Do you have working lights above or near all stariways?
Are there handrails present in all stairways?
Are all stairs in good condition?
0.0%
0.1%
0.1%
11.7%
21.4%
13.9%
88.3%
78.4%
86.0%
YesNoDon't Know
Completed in house by site visitor Completed outside house by interview
n=55
n=2
n=54
n=4
n=57
n=1
n=607
n=98
n=1
n=553
n=151
n=1
n=625
n=83
n=0
n=0
n=0
n=0
Falls
2012 17
Is there a slip-proof surface in bathtub and/or showers?
Are grab bars present in bathtub(s) and/or showers?
0%20%
40%60%
80%100%
0%
0%
45%
73%
55%
27%
YesNoDon't Know
Is there a slip-proof surface in bathtub and/or showers?
Are grab bars present in bathtub(s) and/or showers?
0%20%
40%60%
80%100%
0.1%
0.1%
51.8%
77.6%
48.1%
22.3%
YesNoDon't Know
Completed in house by site visitor Completed outside house by interview
n=341
n=367
n=1
n=158
n=551
n=1
n=31
n=25
n=15
n=41
n=0
n=0
Asthma/Allergies
2012 18
Do any of the persons living here have chronic problems breathing?
Have any adults living here been told by a doctor or other medical professional that they have asthma?
Have any persons living here (under 18) been told by a doctor or other medical professional that they have asthma?
0%
0%
0%
69%
69%
71%
31%
31%
24%
YesNoDon't Know
Do any of the persons living here have chronic problems breathing?
Have any adults living here been told by a doctor or other medical professional that they have asthma?
Have any persons living here (under 18) been told by a doctor or other medical professional that they have asthma?
0.4%
1.1%
1.2%
77.0%
71.0%
78.2%
22.5%
27.9%
20.5%
YesNoDon't Know
Completed in house by site visitor Completed outside house by interview
n=9
n=27
n=18
n=41
n=18
n=40
n=100
n=381
n=6
n=197
n=502
n=8
n=103
n=352
n=2
n=0
n=0
n=0
Asthma/Allergies
2012 19
Alot
A Moderate Amount
A Little
Not at All
0% 20% 40% 60% 80% 100%
13.3%
6.7%
33.3%
46.7%
Would you say [this person] limits [his/her] usual activities due to
asthma?
Alot
A Moderate Amount
A Little
Not at All
0% 20% 40% 60% 80% 100%
10.3%
17.6%
26.0%
46.2%
Would you say [this person] limits [his/her] usual activities due to
asthma?
Completed in house by site visitor Completed outside house by interview
n=126
n=71
n=48
n=28
n=14
n=10
n=2
n=4
Asthma/Allergies
2012 20
Birds
Cats
Dogs
0% 20% 40% 60% 80% 100%
0.0%
23.7%
21.1%
Do you have any of the following pets living in your home?
Yes
Birds
Cats
Dogs
0% 20% 40% 60% 80% 100%
1.6%
20.3%
34.0%
Do you have any of the following pets living in your home?
Yes
Completed in house by site visitor Completed outside house by interview
n=12
n=14
n=239
n=141
n=11 n=0
Asthma/Allergies
2012 21
Plug-Ins
Incense
Candles
0% 20% 40% 60% 80% 100%
45.8%
47.5%
67.8%
Do you use the following air freshener products in your home?
Yes
Plug-Ins
Incense
Candles
0% 20% 40% 60% 80% 100%
43.5%
40.9%
56.2%
Do you use the following air freshener products in your home?
Yes
Completed in house by site visitor Completed outside house by interview
n=396
n=287
n=305
n=40
n=28
n=27
Asthma/Allergies
2012 22
Pine-Sol
Lysol
Bleach
0% 20% 40% 60% 80% 100%
74.6%
76.3%
84.8%
Do you use the following cleaning products in your home?
Yes
Pine-Sol
Lysol
Bleach
0% 20% 40% 60% 80% 100%
65.8%
79.1%
91.9%
Do you use the following cleaning products in your home?
Yes
Completed in house by site visitor Completed outside house by interview
n=50
n=45
n=44
n=654
n=558
n=125
Mold/Water Damage
2012 23
Have there been water leaks in the house from INSIDE the building in the past year?
Has water leaked into your home from outdoors in the past year? (exclude plumbing or other inside leaks)
5.1%
1.7%
57.6%
64.4%
37.3%
33.9%
YesNoDon't Know
Have there been water leaks in the house from INSIDE the building in the past year?
Has water leaked into your home from outdoors in the past year? (exclude plumbing or other inside leaks)
0.7%
0.3%
67.5%
62.3%
31.8%
37.4%
YesNoDon't Know
Completed in house by site visitor Completed outside house by interview
n=20
n=38
n=1
n=22
n=34
n=3
n=265
n=441
n=2
n=225
n=477
n=5
Mold/Water Damage
2012 24
Have you smelled mold in your home?
Have you seen mold in your home?
0%20%
40%60%
80%100%
5.6%
1.8%
70.4%
61.1%
24.1%
37.0%
YesNoDon't Know
Have you smelled mold in your home?
Have you seen mold in your home?
0%20%
40%60%
80%100%
2.6%
0.4%
82.7%
82.3%
14.7%
17.2%
YesNoDon't Know
Completed in house by site visitor Completed outside house by interview
n=116
n=555
n=3
n=28
n=158
n=5
n=20
n=33
n=1
n=13
n=38
n=3
Pests
2012 25
Cockroaches
Bed Bugs
Insects
Mice/Rats
0% 20% 40% 60% 80% 100%
10.2%
13.6%
42.4%
39.7%
Is there visible evidence of the follow-ing in or around your home?
Yes
Cockroaches
Bed Bugs
Insects
Mice/Rats
0% 20% 40% 60% 80% 100%
5.1%
6.0%
27.9%
24.3%
Is there visible evidence of the follow-ing in or around your home?
Yes
Completed in house by site visitor Completed outside house by interview
n=23
n=25
n=8
n=6
n=172
n=196
n=42
n=36
Pests
2012 26
Don't Know
No
Yes
0% 20% 40% 60% 80% 100%
0.0%
71.1%
29.0%
If yes to any of the above, do you use pesticides to get rid of or prevent
them?
Don't Know
No
Yes
0% 20% 40% 60% 80% 100%
0.5%
54.3%
45.3%
If yes to any of the above, do you use pesticides to get rid of or prevent
them?
Completed in house by site visitor Completed outside house by interview
n=181
n=217
n=2
n=11
n=27
n=0
Lead Poisoning
2012 27
Was your house built before 1978?
Is there chipping or peeling paint inside or outside of your home?
(If children present) Have your children been tested for lead poisoning?
16.7%
0.0%
3.0%
14.8%
42.4%
57.6%
68.5%
57.6%
39.4%
YesNoDon't Know
Was your house built before 1978?
Is there chipping or peeling paint inside or outside of your home?
(If children present) Have your children been tested for lead poisoning?
3.4%
0.3%
2.9%
5.3%
40.7%
49.3%
91.3%
59.1%
47.9%
YesNoDon't Know
Completed in house by site visitor Completed outside house by interview
n=200
n=206
n=12
n=417
n=287
n=2
n=600
n=35
n=22
n=13
n=19
n=1
n=34
n=25
n=37
n=8
n=9
n=0
Entry by Intruders
2012 28
Do you have deadbolts on all your external doors?
Do all your windows have locks?
0%20%
40%60%
80%100%
17.2%
15.3%
82.8%
84.8%
YesNo
Do you have deadbolts on all your external doors?
Do all your windows have locks?
0%20%
40%60%
80%100%
17.4%
14.5%
82.6%
83.9%
YesNo
Completed in house by site visitor Completed outside house by interview
n=162
n=28
n=161
n=34
n=50
n=9
n=48
n=10
Carbon Monoxide
2012 29
Are they working?
Do you have a carbon monoxide detector in your home?
0%20%
40%60%
80%100%
14.3%
55.9%
85.7%
42.4%
YesNo
Are they working?
Do you have a carbon monoxide detector in your home?
0%20%
40%60%
80%100%
15.6%
58.8%
84.4%
41.2%
YesNo
Completed in house by site visitor Completed outside house by interview
n=25
n=33
n=24
n=4
n=283
n=404
n=276
n=51
Carbon Monoxide
2012 30
10
7
6
5
4
3
2
1
0
0% 20% 40% 60% 80% 100%
0.4%
0.4%
0.8%
1.1%
3.4%
7.8%
23.9%
60.5%
1.9%
How many? (Carbon Monoxide De-tectors)
10
7
6
5
4
3
2
1
0
0% 20% 40% 60% 80% 100%
0%
0%
4%
4%
0%
12%
20%
60%
0%
How many? (Carbon Monoxide De-tectors)
Completed in house by site visitor Completed outside house by interview
n=5
n=162
n=64
n=21
n=9
n=3
n=2
n=1
n=1
n=15
n=5
n=3
n=1
n=1
n=0
n=0
n=0
n=0
Was your furnace inspected in the past year?
Is an unvented gas fireplace used in the home?
Is an unvented gas stove used in the home?
0%20%
40%60%
80%100%
2%
0%
0%
42%
91%
75%
56%
9%
25%
YesNoDon't Know
Carbon Monoxide
2012 31
Was your furnace inspected in the past year?
Is an unvented gas fireplace used in the home?
Is an unvented gas stove used in the home?
0%20%
40%60%
80%100%
0.0%
1.1%
0.7%
41.2%
89.7%
83.9%
58.8%
9.2%
15.4%
YesNoDon't Know
Completed in house by site visitor Completed outside house by interview
n=15
n=44
n=5
n=53
n=25
n=19
n=1
n=105
n=572
n=5
n=17
n=166
n=2
n=360
n=252
n=0
n=0
n=0
Radiation
2012 32
Has any work been done on your home to reduce the level of radon?
Do you know what radon is?
0%20%
40%60%
80%100%
39.3%
1.7%
60.7%
32.2%
0.0%
66.1%
YesNoDon't Know
Has any work been done on your home to reduce the level of radon?
Do you know what radon is?
0%20%
40%60%
80%100%
11.3%
3.1%
84.2%
37.8%
4.5%
59.1%
YesNoDon't Know
Completed in house by site visitor Completed outside house by interview
n=39
n=19
n=1
n=17
n=11
n=114
n=73
n=6
n=15
n=283
n=38
n=0
Crowding & Space
2012 33
Is the space visible from the home?
Is it fenced in or well-guarded?
Does your home include a recreation space?
0%20%
40%60%
80%100%
20.4%
26.9%
23.7%
79.6%
73.1%
76.3%
YesNo
Is the space visible from the home?
Is it fenced in or well-guarded?
Does your home include a recreation space?
0%20%
40%60%
80%100%
15.6%
26.7%
22.4%
84.4%
73.3%
77.6%
YesNo
Completed in house by site visitor Completed outside house by interview
n=149
n=43
n=126
n=46
n=135
n=25
n=45
n=14
n=38
n=14
n=39
n=10
Crowding & Space
2012 34
Do all bathroom doors have locks?
Are all bathroom doors working?
Do all bedroom doors have locks?
Are all bedroom doors working?
0% 20% 40% 60% 80% 100%
38.6%
1.7%
59.3%
14.8%
61.4%
98.3%
40.7%
85.2%
YesNo
Do all bathroom doors have locks?
Are all bathroom doors working?
Do all bedroom doors have locks?
Are all bedroom doors working?
0% 20% 40% 60% 80% 100%
44.2%
4.1%
64.2%
13.2%
55.8%
95.9%
35.8%
86.8%
YesNo
Completed in house by site visitor Completed outside house by interview
n=165 n=46
n=8n=25
n=67
n=120
n=186
n=8
n=106
n=84
n=22
n=32
n=58
n=1
n=35
n=22
Noise
2012 35
No
Yes
0% 20% 40% 60% 80% 100%
17.2%
82.8%
Is your home located near an airport, major highway, or train station?
No
Yes
0% 20% 40% 60% 80% 100%
21.8%
78.2%
Is your home located near an airport, major highway, or train station?
Completed in house by site visitor Completed outside house by interview
n=48
n=10
n=151
n=42
Food Safety
2012 36
Sink
Oven
Freezer
Refrigerator
0% 20% 40% 60% 80% 100%
100.0%
98.3%
93.0%
100.0%
Does your kitchen include the follow-ing appliances/amenities?
Yes
Sink
Oven
Freezer
Refrigerator
0% 20% 40% 60% 80% 100%
98.4%
97.9%
84.1%
98.4%
Does your kitchen include the follow-ing appliances/amenities?
Yes
Completed in house by site visitor Completed outside house by interview
n=189 n=58
n=53
n=58
n=59
n=159
n=187
n=190
Water Supply
2012 37
Are both hot and cold water options available?
Does your home have running water?
0%20%
40%60%
80%100%
1.7%
0.0%
98.3%
100.0%
YesNo
Are both hot and cold water options available?
Does your home have running water?
0%20%
40%60%
80%100%
1.0%
0.5%
99.0%
99.5%
YesNo
Completed in house by site visitor Completed outside house by interview
n=194
n=192
n=2
n=1
n=59
n=58
n=1
n=0
Electrical Hazards
2012 38
Don't Know
No
Yes
0% 20% 40% 60% 80% 100%
1.7%
15.3%
83.1%
Is all the wiring in the finished areas of your home concealed either in walls or
behind metal coverings?
Don't Know
No
Yes
0% 20% 40% 60% 80% 100%
0.1%
14.2%
85.7%
Is all the wiring in the finished areas of your home concealed either in walls or
behind metal coverings?
Completed in house by site visitor Completed outside house by interview
n=49
n=9
n=1
n=603
n=100
n=1
Electrical Hazards
2012 39
Don't Know
No
Yes
0% 20% 40% 60% 80% 100%
1.0%
67.4%
31.6%
Have you experienced any problems with your major appliances (stove, furnace, etc.) over the past year?
Don't Know
No
Yes
0% 20% 40% 60% 80% 100%
0.0%
69.5%
30.5%
Have you experienced any problems with your major appliances (stove, furnace, etc.) over the past year?
Completed in house by site visitor Completed outside house by interview
n=18
n=41
n=61
n=130
n=2 n=0
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
2012 41
Center for Urban Studies
Lyke ThompsonDirector(313) [email protected]
Ramona WashingtonResearch Assistant(313) [email protected]
Angie SarbResearch Assistant(313) [email protected]