A white paper on Asthma by Center for the Greater Good.

1. GREEN AND HEALTHY HOUSING
Asthma in Low-Income Communities
Written by Rachel Goldman
www.CenterforGreaterGood.com | contact@centergg.com | 410 East State Street Eagle, ID 83616

2. Improving Resident Health through Building Practices and Materiality
The correlation between building materials and occupant health has become undeniable over
the past twenty years. As time goes on, it is clear the lower income population in the United States
bears the brunt of the damage. On average, Americans spend 90% of their time indoors.1 Besides
the obvious health benefits of spending time outdoors (such as natural Vitamin D exposure, mood
enhancement, and outdoor exercise), too much time inside can be dangerous if one occupies a space
with poor Indoor Air Quality (IAQ). According to the Environmental Protection Agency, indoor levels
of pollutants may be two to five times higher, and occasionally more than 100 times higher, than outdoor
levels.2 Exposure to indoor air pollutants has been linked to life threatening diseases, the most
common of which is asthma. One in five people have asthma. Every day, asthma in the United States
causes:
• 40,000 people to miss school or work
• 5,000 people to visit the emergency room
• 1,000 people to be admitted to the hospital for an average of 3 days
• 11 people to die3
The annual cost of asthma in the United States is estimated to be nearly $18 billion, $10 billion
of which is the direct cost of hospitalization.4 With healthcare costs as high as they are, those who
are truly burdened by this disease are the low-income population. According to a UCLA study, a low-
income individual is twice as likely to visit the emergency department due to asthma when compared
to higher-income individuals, and once there, they are six times as likely to be hospitalized.5
“The poorest among us suffer most because they lack quality health care and live in high-
risk environments,” said Ying-Ying Meng, a senior research scientist with the UCLA Center for Health
Policy Research. “That disparity also burdens our health system with costly emergency care and
hospitalizations and extracts the additional high cost of millions of lost days of work and school.”
Meng added, “Asthma has the potential to be debilitating, but it can be effectively controlled through
appropriate medical care and avoidance of triggers.”6 The Center for the Greater Good is dedicated to
solving the problem of poor health in communities, instead of simply treating the condition. We have
spent countless hours alongside our developer partners identifying the best practices in affordable
housing building design, with the objective of reducing the effects of asthma and other health
concerns caused by poor IAQ.
The Air we Breathe is Slowly Poisoning Us
It is easy to identify the source of poor IAQ in buildings and to recognize how pollutants
affect the resident’s overall quality of life; the difficult part is eliminating them. Sources of indoor
air pollution may include: combustion sources; building materials and furnishings; household
cleaning, maintenance, personal care, and hobby products; central heating and cooling systems and
1 The Inside Story: A Guide to Indoor Air Quality. U.S. EPA/Office of Air and Radiation. Office of Radiation and Indoor Air (6609J)
Cosponsored with the Consumer Product Safety Commission, EPA 402-K-93-007.
2 The Inside Story
3 Asthma and Allergy Foundation of America - Information About Asthma, Allergies, Food Allergies and More! Web. 13 Nov.
2011. <http://www.aafa.org/display.cfm?id=8>.
4 Asthma and Allergy Foundation of America
5 Driscoll, Gwendolyn. “Asthma Disproportionately Affects Low-income Populations | UCLA Center for Health Policy Research.”
UCLA Center for Health Policy Research. UCLA, 10 Dec. 2010. Web. 13 Nov. 2011. <http://www.healthpolicy.ucla.edu/
NewsReleaseDetails.aspx?id=71>.
6 Asthma Disproportionately Affects Low-income Populations
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3. humidification devices; and outdoor sources such as radon, pesticides, and outdoor air pollution.7 The
Center for Disease Control warns that indoor contaminants such as dust mites, molds, cockroaches,
pet dander, secondhand smoke and some chemicals can trigger asthma attacks.8 Moving forward
there are strategies to improving IAQ that have the potential to decrease the burden of asthma and
other preventable health concerns for communities; the greatest challenge is completing renovation
and demolition of existing structures without releasing harmful chemicals and dust particles into the
air and soil.
The Center for the Greater Good Promotes Best Practices in Healthy Building Design
and Construction
The Center for the Greater Good works with foundations and investors to build communities
in a financially innovative way with innovation extending to every aspect of the projects we fund. Our
buildings are designed with the resident’s health in mind. Our Best Practices in design center around
passive methods for improved materiality, increased natural light and improved air circulation. The
Center for the Greater Good encourages developers to invest in natural, durable building materials
that do not off gas. Ideal building materials meet the following requirements. They: contain recycled
content; come from natural, plentiful or renewable sources; have a resource efficient manufacturing
process; are locally available; are salvaged, refurbished or remanufactured; are recyclable or reusable;
durable; are low or non toxic, output minimal chemical emissions; have a low VOC assembly, are
moisture resistant; and are healthfully maintained. The Center for the Greater Good also incentivizes
developers to design buildings with maximum indoor exposure to natural light. It is part of our
commitment to further improve resident health and reduce energy costs associated with lighting.
Benefits to natural light include: reduced energy consumption; reduction of mildew or mold built-
up; natural vitamin D exposure; increased productivity experienced for occupants; and improved
interior visual appeal.9 It is also important to circulate fresh, outdoor air to remove stale air and move
pollutants out, as well as filter mechanically circulated air in order to cut down on the distribution of
mold, mildew, dust, allergens, pet dander, and other potentially health impactful particles.
The Center for the Greater Good not only strives to build better quality buildings, we also
encourage the healthiest possible strategies to construction, maintenance and eventual demolition.
Our developer partners work with only the highest quality construction firms to ensure two concepts
on the job site: the proper installation and implementation of new building materials and strategies;
and the best practices for building construction, renovation and demolition. Many approaches with
the purpose of improving building efficiency and occupant health (such as the use of new materials
and construction methods) require special installation. It is important that time and care be taken
during the strategy implementation process to ensure the building functions as planned. The best
practices for building construction, renovation and demolition must also be followed to preserve IAQ
by reducing the release of contaminates into the air. Examples of practices include: the isolation of
construction work areas from occupied areas through the use of appropriate containment barriers;
the negative pressurization of construction work areas and/or the positive pressurization of occupied
areas to prevent the migration of air contaminants; and maintenance of an adequate unoccupied
buffer zone around the work areas to allow for construction or renovation traffic.
7 “Indoor Air Home | Air.” US Environmental Protection Agency. Web. 13 Nov. 2011. <http://www.epa.gov/iaq/>.
8 Asthma Prevalence, Health Care Use and Mortality: United States, 2003-05, http://www.cdc.gov/nchs/products/pubs/pubd/
hestats/ashtma03-05/asthma03-05.htm
9 “Natural Lighting Strategies and Benefits | One Green Planet.” One Green Planet | One Green Planet | One Green Planet Is an
Online Ecosystem That Draws Links between the World of Ecology, the Environment, Animals and Vegan Living. Web. 13 Nov.
2011. <http://www.onegreenplanet.org/lifestyle/natural-lighting/>.
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4. Improve the Quality of the Air, Improve the Quality of the Life
Asthma affects one out of five Americans, but it affects the low-income population at a far
higher rate, partially due to hazardous living conditions. Society will benefit from a reduction in
asthma among the low income population because it can recover some of the $18 Billion spent
annually on asthma treatment. Individuals and society will also benefit financially by missing work
less due to asthma symptoms. Children living an asthma free life will develop more active lifestyles,
and miss school less often. The Center for the Greater Good, alongside our developer partners and
foundations, is investing in proactive solutions to poor health in communities.
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