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Introducing NCHH's State Healthy Housing Fact Sheets: EPA Region 4

This is the third installment in a 10-part blog series. You may also be interested in reading about EPA Region 1Region 2, and Region 3.

Throughout 2018, we’re posting highlights of our state fact sheets by EPA region, one region per month. In April, we’re looking at EPA Region 4, which includes Alabama, Georgia, Florida, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee.

Highlights from these many states include:

  • Across six of the eight states (Alabama, Georgia, Kentucky, Mississippi, North Carolina, and Tennessee), 6,422 children tested with blood lead levels above 5 µg/dL in 2015.
  • The following areas in this region have average indoor radon tests above the EPA action level of 4 picocuries per liter (4 pCi/L) of air:
    • 15 counties in northern and western Alabama,
    • 30 counties in Kentucky,
    • eight counties in western North Carolina,
    • two counties in South Carolina (Oconee and Greenville),
    • 32 counties in eastern and central Tennessee.
  • There are over 800 deaths per year in Georgia due to radon-related lung cancer.
  • In 2015, unintentional falls among adults over 65 were responsible for 5,848 deaths in all eight states combined. Florida had the highest individual number at 2,603 deaths.
  • An average of 50 people die from carbon monoxide exposure in North Carolina each year (2011-2015). This is the highest average for this region; close behind are South Carolina at 47 and Florida at 40.
  • Some of the costs asthma has inflicted on this region include:
    • $1.1 billion from emergency department visits and hospitalizations in Florida (2012);
    • Over $192 million in billed charges, including 19,678 emergency department visits and 5,111 hospitalizations, in Kentucky (2014);
    • $139 million from hospitalization charges in North Carolina.
  • While the age of housing in this region is lower than in the previous regions we’ve covered, 35-52% of housing was still built before 1978 and therefore may contain lead paint.
  • Some of these states lack state-level protections for healthy housing; Alabama has no law regulating building mold standards, testing requirements, or contractor accreditation and certification, while Mississippi is without state statutes regulating carbon monoxide detectors, radon, and bed bugs.

Other NCHH Resources

  • NCHH’s 2013 State of Healthy Housing includes rankings for Charlotte, North Carolina; Memphis, Tennessee; Atlanta, Georgia; Birmingham, Alabama; and Miami and Tampa-St. Petersburg-Clearwater, Florida.
  • Use this list of building code resources to identify building codes in your state and locality.

One More Thing...

By the way, this region is one of the most underrepresented in the National Safe and Healthy Housing Coalition, and we’re missing official members from South Carolina and Alabama entirely. Interested in joining? Learn more and sign up here.

NCHH’s state fact sheets will be updated annually with current information. For questions or comments, please email Laura Fudala at

Sarah Goodwin joined NCHH as a Policy Analyst in June 2017. She previously served NCHH as a policy intern, helping to establish and run the Find It, Fix It, Fund It lead action drive and its workgroups. She holds a Bachelor of Arts degree in Interdisciplinary Studies: Communications, Legal Institutions, Economics, and Government from American University.

The FY18 Omnibus: Thank You for Your Support of Healthy Housing Programs

Over the last two days, the House and Senate passed the FY18 omnibus bill, containing milestone funding increases for lead poisoning prevention and healthy homes. And this afternoon, the president signed off on the bill.

Thanks to the collective hard work of all of you with organizations and individuals who signed on to the National Safe and Healthy Housing Coalition’s (Coalition) letters, sent messages to your members of Congress, and brought up the issue in your communities, Congress acted to provide significant support to healthy homes programs across the agencies, including the Department of Housing and Urban Development (HUD), the Centers for Disease Control and Prevention (CDC), and the Environmental Protection Agency (EPA), that help Americans ensure safer home environments. Thanks to the House and Senate members who have championed this issue over the years and have done what they can to stabilize effective programs during the years of the Budget Control Act, which provided significant restraints to growth in agencies across the federal budget. But this newly passed appropriation meets the needs you’ve been highlighting and sets us on the path to better addressing the needs of our children and all Americans.

The FY18 omnibus appropriations bill includes:

  • Huge wins for lead poisoning prevention work at HUD and CDC
    • $230 million for HUD’s Office of Lead Hazard Control and Healthy Homes, including $45 million for healthy homes programs. This is a number the National Safe and Healthy Housing Coalition has requested for years, based on the Presidential Task Force’s recommendation in 2000. It represents an $85 million increase over FY17.
    • $35 million for CDC’s Childhood Lead Poisoning Prevention Program. This is an increase of $18 million over FY17, and it restores the program to the level of funding it had before its near-elimination in FY12.
  • Level funding for CDC’s National Asthma Control Program and National Environmental Health Tracking Network.
  • Level funding for healthy homes programs at EPA, counter to presidential requests for elimination.
  • Increases for other important programs, including Community Development Block Grants (a gain of $300 million), HOME Investment Partnerships (a gain of $412 million), the Low Income Housing Energy Assistance Program (a gain of $250 million), and the Weatherization Assistance Program (a gain of $23 million). The Weatherization Assistance Program provides funding to low-income families and seniors who want to make home repairs that improve energy efficiency and health. The Building Technologies Office, which conducts research on indoor environmental quality, also received additional funding.

The Coalition has sent multiple letters to appropriators in Congress endorsing higher funding for these programs, the most recent of which was a sign-on letter to in November 2017. Many individual organizations, including NCHH, have continued to advocate for these numbers in their own communications with key members of Congress over the last month. Strong, effective advocacy has always been an important part of the healthy homes story, and today's good budgetary news is evidence of our collective impact.

So what's next? Stay tuned for a letter asking Congress to keep up its commitment in the 2019 budget!

Introducing NCHH's State Healthy Housing Fact Sheets: EPA Region 3

This is the third installment in a 10-part blog series. You may also be interested in reading about EPA Region 1 and Region 2.

How do you decide how to advocate for the programs and issues you represent? What stories and statistics do you elevate, and how do you describe what we all know are nuanced topics and problems in an understandable and engaging way? What about when you’re facing a tight time limit, like a 15-minute meeting with a congressional office? These questions should be familiar to those of you who have worked with us in the past on hill days and in district visits, and they help guide our policy team here in Columbia.

One way we’re answering these questions is in the creation of 53 state healthy housing fact sheets, covering all 50 states, the District of Columbia, Puerto Rico, and the U.S. as a whole. For each state, we highlighted eight healthy housing statistics, with covered topics including asthma prevalence and financial burden, childhood lead poisoning numbers and age of housing, radon levels, carbon monoxide fatalities, and unintentional falls among older adults. The facts illustrate the specific needs of each state, while a list of 11 programs at CDCHUD, and EPA that may be funding your state places these needs in a federal context. Most information on the fact sheets was found from federal or state governments, and each fact is hyperlinked back to the source material.

EPA Region 3

Throughout 2018, we’re posting highlights of our state fact sheets by EPA region, one region a month. In March, we’re on EPA Region 3, which includes Delaware, the District of Columbia, Maryland (home of NCHH!), Pennsylvania, Virginia, and West Virginia.

  • Among these states, asthma is responsible for:
    • $200 million in total costs per year (Delaware);
    • 8,000 emergency department visits among adults in one year (DC, 2011);
    • 45,500 emergency department visits and over 7,000 hospitalizations, costing $95.8 million and $61.1 million, respectively, in one year (Maryland, 2014);
    • Medical costs totaling over $1.9 billion, including over 18,000 hospitalizations, in one year (Pennsylvania, 2013);
    • 2,785 hospitalizations costing $31 million in one year (West Virginia, 2011);
    • 7,582 hospitalizations costing over $156.5 million in one year (Virginia, 2013).
  • At 75, Pennsylvania had the highest average number of deaths per year from carbon monoxide in the 2011-2015 period of any state. This number was 10 in Maryland, eight in Virginia, and six in West Virginia.
  • 81% of DC homes were built before 1978, and 37% before 1940. This is one of the highest percentages recorded across all our fact sheets, and has led the District to pursue a 100% lead screening rate for children ages 1 and 2.
  • In 2015, 3,143 children in Delaware, Maryland, and West Virginia tested with blood lead levels above 5 µg/dL. In 2016 in Virginia, this number was 793; in 2014 in Pennsylvania alone, it was 11,983.
  • Between Delaware, DC, Pennsylvania, and Virginia, unintentional falls were responsible for 2,310 deaths of adults over 65 in 2015. In West Virginia, this number was 243 in 2014.
  • High radon risk areas in this region include central and western Virginia, eastern West Virginia, central Maryland, and New Castle County, Delaware. In Pennsylvania, 40% of homes tested for radon have been above the EPA action level.
  • Pennsylvania is the only state in this region to have received money from all of the programs we track on the top half of these sheets since 2015.

Other NCHH Resources

NCHH’s state fact sheets will be updated annually with current information. For questions or comments, please email Laura Fudala at



Sarah Goodwin joined NCHH as a Policy Analyst in June 2017. She previously served NCHH as a policy intern, helping to establish and run the Find It, Fix It, Fund It lead action drive and its workgroups. She holds a Bachelor of Arts degree in Interdisciplinary Studies: Communications, Legal Institutions, Economics, and Government from American University.

Join NCHH for National Public Health Week (April 2-8, 2018)

National Public Health Week 2018 BannerHealthiest Nation 2030: Changing Our Future Together

The National Center for Healthy Housing joins the American Public Health Association (APHA) in inviting you to engage all communities and all sectors in a conversation about the role each of us can play to put good health within everyone’s reach. Where we live, learn, work, worship, and play impacts our health and our opportunity to ward off disease and injury. With that in mind, let’s partner across public and private spheres to create healthier people, families, communities and, eventually, the healthiest nation. We can do it — if we work together.

Partners for Public Health

NCHH is a proud National Public Health Week Partner, and we invite your organization to become anNPHW partner too. It’s fast and very simple; just fill out this quick and easy form to add your organization to the growing list of NPHW partners. 
We all have a role to play. For inspiration and information on changing our nation’s health and ensuring that everyone has an opportunity to be healthy, check out the Healthiest Nation NPHW fact sheets.

NPHW Daily Themes

Each day of NPHW 2018 will focus on a different public health topic that’s critical to creating the healthiest nation. Every day is an opportunity to showcase your organization’s mission and projects, a partner’s accomplishments, a community’s events, and recognize and honor the contributions of America’s public health workers. 

Each year, NPHW provides new tools and tips to help you effectively shape and promote activities and key messages during the week. The NPHW 2018 postcard and toolkit gives you talking points around this year's theme, activity suggestions for each day of NPHW, tips for planning a successful NPHW event, strategies for garnering media coverage and using social media and ways to advocate for public health issues. At NCHH, we have found these resources help to engage communities to celebrate and promote public health and prevention.

Check out the NPHW Toolkit (pdf), which features sample social media posts, information about engaging your community and more!

Get Social about NPHW 

How to Make Social Media Work for You - Are you new to social media, or do you want to learn how to use the tools to advance your messages? Good news! APHA has a National Public Health Week Social Media 101 and 201. We invite you to connect with NCHH on Twitter, Facebook, Instagram, and LinkedIn

Join the Twitter Chat! APHA will host its eighth annual NPHW Twitter Chat on Wednesday, April 4, at 2 p.m. EDT. The NPHW chat has grown bigger and better each year. Last year, APHA hosted nearly 900 people and organizations and brought the importance of public health to more than 68 million users! You can RSVP to participate in the 2018 chat here. You’ll see a list of other organizations and people that will be participating in the chat. This is a great way to make connections, grow your audiences, and share your organization’s story, events, and resources. 

Jo Miller, GPC, SMS, has worked as a part of the NCHH team since 2016, providing strategy, technical assistance, and training for communication and community engagement. A 20-year healthy housing and lead poisoning prevention veteran, she has worked with lead and healthy homes programs throughout the country to build stronger partnerships, innovative approaches, and secure grant funds. As a grant professional, Ms. Miller also specializes in nonprofit and community development as well as grant professional training. Ms. Miller is also a Social Media Strategist (SMS) and trainer, by the Grant Professional Certification Institute as Grant Professional Certified, and as an approved trainer by the Grant Professionals Association.

Safety's No Accident: A New Year's Resolution Has Us Buzzing about Alarms and Detectors – Part 2: Dual-Sensor Alarms

As I reported in an earlier blog, I planned to install sealed 10-year smoke alarms in our home to be in compliance with Maryland state law. I knew that I had replaced a battery-powered smoke in my home within the past 10 years. Further, also I knew that because it did not have a sealed 10-year battery, the alarm would now have to be upgraded. But as I assessed the situation, I learned two things: First, each floor of our home has been hard-wired to the electrical panel for smoke alarms. The battery-powered smoke alarm I had replaced appears to have been installed by the former owner when for some reason, they did not replace the hard-wired alarm on the second floor of our home. Second, because our home was built after 1975, I would need to replace the hard-wired alarm to be in full compliance with Maryland state law. But what alarm should I install?

Different Types of Smoke Detectors

Smoke alarms can come with two different types of smoke detectors.

  • Ionization detectors create a flow of ions within the device. When the ions are disrupted by smoke, the alarm sounds. Research has found that ionization sensors are best at responding to fast-burning, “flaming” fires.
  • Photoelectric detectors have a light source within the device. When the light is reflected by smoke particles entering the chamber, the light sensor triggers the alarm. Research has found that photoelectric sensors are best at responding to slow-burning, “smoldering” fires.

As recently as 2012, about 90% of U.S. homes had a smoke alarm with an ionization sensor, about 5% had a photoelectric sensor, and the remainder of homes had no smoke alarm at all. Having no alarm certainly poses the highest risk, but people are now realizing that having the “wrong” type of sensor in the home can also have tragic results. Today, many groups including the National Fire Protection Association (NFPA), insurers, and the publishers of Consumer Reports recommend installing both types of alarms in our homes. Manufacturers are now selling devices that have both sensors, so the most efficient way to put both sensors in a home is to install these “dual-sensor” models.

Are We Safer with Dual-Sensor Alarms?

Some observers have questioned whether the dual-sensor models will alarm as quickly as models with the individual sensors. However, a 2009 study by the National Institute of Standards and Technology (NIST) and reviewed by NFPA found that “the assumption that sensors in dual alarms are always less sensitive than those found in individual photoelectric or ionization alarms is false. Typically, dual alarms respond before ionization alarms in smoldering fires and before photoelectric alarms in flaming fires.”

Knowing that a dual sensor would effectively protect my family’s safety, I started thinking more about the idea of having just one alarm per story in our home.1 I had seen smoke alarms sold in combination with carbon monoxide (CO) detectors. Could a single alarm on the second floor address the risks of both fires and carbon monoxide poisoning? Unfortunately, the marketplace is not there just yet. Consumer Reports says it well: “Our challenge to manufacturers: Produce a single device that senses both kinds of fire and CO. Until then, combining various types of alarms offers the best protection.”

Next Steps in the Resolution for Home Safety

With this information in hand, I went ahead with purchasing and installing a dual-sensor hard-wired smoke alarm. I also decided to seize the moment and practice what my organization preaches: Every home should have a CO detector installed. In a separate blog, I’ll discuss my search for the optimal CO detector for our home.

1 We have a relatively small home with all bedrooms next to our second floor smoke alarm. Fire officials recommend placing extra smoke alarms within bedrooms if there is a risk that a hallway-based alarm might not be heard in those rooms.  

Jonathan Wilson, MPP, joined NCHH in 1993 and currently serves as Deputy Director and Chief Financial Officer. Mr. Wilson has authored more than 25 peer-reviewed research manuscripts evaluating assessment tools and interventions for healthy housing hazards. He also served as the NCHH representative to the federal Advisory Committee on Childhood Lead Poisoning Prevention from 2004 to 2010. He came to NCHH with a background in nonprofit housing development and a Master of Public Policy degree.

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