RESEARCH REPORT Urban Blight and Public Health

NEIGHBORHOODS, CITIES, AND METROS

RESEARCH REPORT

Urban Blight and Public Health

Addressing the Impact of Substandard Housing, Abandoned Buildings, and Vacant Lots

Erwin de Leon

COLUMBIA UNIVERSITY

April 2017

Joseph Schilling

URBAN INSTITUTE

ABOUT THE URBAN INSTITUTE

The nonprofit Urban Institute is dedicated to elevating the debate on social and economic policy. For nearly five decades, Urban scholars have conducted research and offered evidence-based solutions that improve lives and strengthen communities across a rapidly urbanizing world. Their objective research helps expand opportunities for all, reduce hardship among the most vulnerable, and strengthen the effectiveness of the public sector.

ABOUT THE VACANT PROPERTY RESEARCH NETWORK

Since 2011, with generous support from the Ford Foundation, the Vacant Property Research Network (VPR Network) has brought people together to share knowledge and connections between academia and the field on the subject of vacancy, blight, and abandonment in cities. The VPR Network creates and supports partnerships between researchers, academic institutions, policy makers, and practitioners to define the magnitude and dimensions of blight, understand neighborhood change, and track the latest innovations to reclaim vacant properties and foster neighborhood revitalization, in such areas as real property information systems, strategic code enforcement, land banking, urban greening, and community development and planning. For more information about the network's research translation activities and resources, please explore .

Copyright ? April 2017. Urban Institute. Permission is granted for reproduction of this file, with attribution to the Urban Institute. Cover image by Brandon Dill/Neighborhood Preservation, Inc.

Contents

Acknowledgments

iv

Urban Blight and Public Health

1

Overview of Social Determinants of Health

3

Housing and Health

4

Impact of Blight on Health

6

Substandard Housing

8

Abandoned Buildings and Vacant Lots

11

Interventions to Mitigate Blight

14

Substandard Housing

14

Vacant Homes and Abandoned Buildings

16

Vacant Lots

20

Observations and Recommendations

22

Take Comprehensive and Coordinated Place-Based Approaches to

Address Blight and Health

23

Expand the Application and Use of Health Impact Assessments

24

Track and Assess Health Outcomes from Code Enforcement and

Other Vacant Property Policies and Programs

25

Enhance the Capacity and Expectations for Collaboration between

Community Organizations and Public Health Researchers

26

Infuse Public Health into Housing Policy, Codes, and Practice

28

Conclusion

29

Notes

30

References

33

About the Authors

38

Statement of Independence

39

Acknowledgments

This report was funded by the Ford Foundation's Equitable Development (formerly the Metropolitan Opportunities) program and was completed in part through a fellowship of the Robert Wood Johnson Foundation--the Interdisciplinary Leadership Program. We are grateful to them and to all our funders, who make it possible for Urban to advance its mission.

The views expressed are those of the authors and should not be attributed to the Urban Institute, its trustees, or its funders. Funders do not determine research findings or the insights and recommendations of Urban experts. Further information on the Urban Institute's funding principles is available at support.

The Vacant Property Research Network's (VPR Network's) research and policy brief series bridges the traditional divide between research and practice by synthesizing the latest research on vacant properties through different disciplines and fields. Each report highlights relevant findings and explains the methods behind recent research so that practitioners and community leaders can better understand what the research says, what the research does not say, and how it might be relevant to these leaders' respective initiatives to prevent, abate, and reclaim vacant properties. By understanding how current research may or may not apply to local efforts, we believe practitioners and policymakers will be better equipped to make effective decisions, improve policy and program implementation, and ultimately facilitate the regeneration of their communities. The initial series includes policy and research translation briefs on urban greening, neighborhood change, basics of blight, information systems, and strategic code enforcement. This ongoing effort in research translation was made possible with the support of the Ford Foundation.

IV

ACKNOWLEDGMENTS

Urban Blight and Public Health

We spend more than two-thirds of our time where we live, and the state of our homes and neighborhoods invariably affects our individual and family's well-being (Klepeis et al. 2001). Studies have shown that the conditions within our residences, the surrounding neighborhood, and the cost of housing affect our health (Braverman et al. 2011; National Center for Healthy Housing 2016; Shaw 2004).

The quality of housing can contribute to general well-being or cause poor health. Exposure to poor indoor air quality, mold, lead, and rodent and cockroach infestations can lead to asthma and other respiratory illnesses, lead poisoning, learning and behavioral problems, and other serious health issues. Asthma is often cited as a key outcome of poor housing conditions. Mudarri and Fisk (2007) estimate that about 20 percent (4.6 million) of the 21.8 million people reported to have asthma in the United States can attribute their condition to dampness and mold exposure in their homes. They also calculate the national annual costs of asthma due to dampness and mold exposure in the home to be $3.5 billion. Structural hazards and unsafe conditions can also result in physical injuries and mental stress.

The federal Healthy Homes Work Group1 reports that millions of Americans suffer from poor housing conditions, including dilapidated structures; roofing problems; heating, plumbing, and electrical deficiencies; water leaks and intrusion; pests; damaged paint; and radon gas (US Department of Housing and Urban Development 2013).2 Estimates suggest that more than 30 million housing units have significant physical or health hazards, such as dilapidated structures, poor heating, damaged plumbing, and lead pipes (Ross, Parsons, and Vallas 2016). The Healthy Homes Work Group notes further that substandard and inadequate housing disproportionately affects poor and low-income individuals, children, people of color, and people with disabilities and chronic medical conditions (US Department of Housing and Urban Development 2013). Studies have shown, for example, that poor children, particularly children of color living in dilapidated urban housing, have dangerously high blood lead levels that can lead to irreparable harm to their health and impede their development (Bashir 2002).

The proximity of our residence to our jobs, our children's schools, and public services and amenities, along with access to public transportation, also affects our health. The natural and built environment in our neighborhood can likewise determine our general well-being. Finally, access to affordable housing not only ensures that we have adequate shelter, but that we have enough left over after rent for other necessities such as food, utilities, and medical care. Figure 1 illustrates how these aspects of our lives are linked to health.

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