Executive Summary

The State of Healthy Housing presents the only comprehensive analysis of U.S. housing conditions. The study shows that despite early success toward improving housing conditions, the Roosevelt-era goal of ensuring that every family has access to safe and decent housing remains elusive.

The study reveals that 35 million-- 40 percent – of metropolitan homes in the U.S. have one or more health and safety hazards. The physical conditions of U.S. housing have declined since the U.S. Census’ last survey in 2009. That survey found that about 30 million homes (or 35%) had health and safety hazards. The foreclosure crisis and the blighted conditions that followed may be one factor in the decline.

According to The State of Healthy Housing, the metropolitan areas of San Jose, Calif.; Indianapolis, Ind.; and Tampa-St. Petersburg-Clearwater, Fla.; rank at the top of the list for having the healthiest housing. At the bottom of the list for having the least healthy houses are the metropolitan areas of San Antonio, Texas; Birmingham, Ala; and Memphis, Tenn.
Across metropolitan areas, rental properties tend to have more problems than owner-occupied dwellings and central city housing tends to have more problems than housing outside the central city. Other community characteristics that influence the healthfulness of a jurisdiction’s housing include housing age and poverty levels.
The study found that the most common housing problems identified include water leaks, roofing problems, damaged interior walls, and signs of mice. The World Health Organization Guidelines for Indoor Air Quality (2009) found sufficient evidence of an association between damp and moldy housing conditions and asthma development and exacerbation. A study by Phipatanakul et al. (2000) concluded that mouse allergen may be an important indoor allergen in inner-city children with asthma. Another study (Matsui et al. 2006) found that for mouse-sensitized inner-city children, exposure to mouse allergen may be an important cause of asthma morbidity.

The National Center for Healthy Housing (NCHH) created the State of Healthy Housing by selecting 20 key housing factors from the American Housing Survey (AHS) that are related to health. The housing characteristics that make up the study rankings are based largely on the federal “housing quality standards,” which represent a single uniform standard for addressing the health and safety of residential dwellings. There is ample evidence that deficiencies in any one of these areas can and does lead to health deficits and safety issues.

The NCHH study uses survey data from the American Housing Survey (AHS), which is collected by the U.S. Census Bureau for the U.S. Department of Housing and Urban Development.  Before 2011, the national survey reached an average 55,000 housing units on odd numbered years. In addition, a separate set of metropolitan area surveys were conducted on a rotating basis and reached 2,700 or more housing units in each location. Beginning in 2011, AHS combined the national survey and metropolitan surveys into a pooled sample. The survey reached 190,000 housing units including about 70,000 nationally and 120,000 supplemental housing units from 29 metropolitan area surveys.  Each metropolitan area survey included an average of 4,500 housing units. AHS plans to sample 54 metropolitan areas every four years.

If you have questions about the State of Healthy Housing, please contact Jonathan Wilson (jwilson@nchh.org).