Renovated Housing Linked to Decrease in Childhood Asthma Rate in Cincinnati Neighborhood

Published October 31, 2023

Scientists and physicians know that certain conditions in a home can impact the health of the people living there. To help protect children’s health, EPA scientists are looking at how housing conditions affect childhood asthma. Increasing scientific evidence shows that asthma starts in early childhood, and babies exposed to high levels of mold are much more likely to be diagnosed with asthma by age seven. The asthma rate is higher in children living in under-resourced, urban communities that have poor housing conditions.

Asthma is a serious respiratory disease that affects more than 25 million Americans, including about four million children. Asthma has no current cure, but medical treatment and management of environmental triggers can help control symptoms. Overall, emergency hospital trips and deaths due to asthma have decreased in recent years, but the prevalence of asthma is still very high in the U.S. today compared to earlier decades. Progress has been made in managing asthma symptoms, but additional measures could help stop children from developing asthma at all.

EPA researchers hypothesized that if infants were not living in substandard housing, they would be less likely to develop asthma. To test this theory, the scientists focused on a community in Cincinnati, Ohio, where approximately 800 families lived. The community’s deteriorated housing, originally built in the 1960s, was renovated between 2010 and 2012 with U.S. Department of Housing and Urban Development (HUD) support to meet HUD’s green building standards. Renovations included structural repairs; removal of water damage and mold; complete insulation; and installation of new windows, doors, and roofs.

EPA scientists and Cincinnati Children’s Hospital physicians collected data to determine if the frequency of asthma for infants born in the community before the renovations differed from those infants born afterwards. Before renovation, approximately 12 percent of children in the City of Cincinnati had asthma based on surveys and hospital records—which is consistent with documented rates of higher asthma in similar communities across the U.S. After the renovations were completed, researchers accessed Medicaid data to determine the prevalence of childhood asthma in the renovated community. In the first six years following the renovations (2013-2018), the prevalence of asthma among seven-year-olds in this community averaged 12.7 percent. However, for infants born in the community following the renovations (2019-2021), the average prevalence of asthma was 5.9 percent by the time these babies reached seven to nine years old. The housing renovation correlated to a 50 percent reduction in the asthma rate for seven-years-olds who were born in the community and only lived in the renovated homes.

“We didn’t see a significant reduction in asthma prevalence in the renovated apartments at first. But by the time the infants born after the renovations reached seven years old, the reduction was clear. This strengthens the hypothesis that asthma develops in infancy or very early childhood,” notes EPA scientist Stephen Vesper, a lead researcher for this effort.

The researchers determined that green building renovations are linked to reduced development of asthma for the infants that were born during this study. However, because the housing improvements were so comprehensive, it’s difficult to pinpoint which action had the most significant impact on reducing asthma rates. The research study has led to an enhanced understanding of the link between the development of asthma and housing conditions, which may lead to updated guidance for physicians, community leaders, housing authorities and policymakers, and be used to improve substandard housing conditions.

More information:

• EPA Asthma Resources
• Reduced prevalence of childhood asthma after housing renovations in an under-resourced community

This article was written by EPA’s Melissa Payne.