Pilot study indicates your home may be making you sick; but there’s help
Can changing the curtains, carpets and other factors in the homes of people who have chronic respiratory illnesses help to reduce the number of hospital visits? That’s one of the things a pilot study conducted by the BUILD Health Challenge – which MetroHealth is a part of – aimed to find out.
As of 2011, Cleveland had one of the highest rates of childhood lead poisoning in the United States. Many also suffered exacerbations of their asthma or chronic obstructive pulmonary disease (COPD) due to unhealthy housing. The BUILD Health Challenge is a collaborative that works to reduce the occurrence of lead poisoning, and exacerbations of asthma and COPD in the community by tackling unhealthy housing conditions and advancing supportive local policies.
The challenge focused on three neighborhoods near the MetroHealth Medical Center: Clark-Fulton, Brooklyn Centre and the Stockyards. The Cleveland Department of Public Health and Environmental Health Watch (EHW) gathered data on housing violations and other building inspection data. Using Epic, MetroHealth matched that data with the health records of patients with COPD or asthma who lived in those homes.
J. Daryl Thornton, MD, MPH and researchers in the Center for Reducing Health Disparities contacted the patients and asked if they’d like to enroll in the Healthy Homes, Healthy Lungs housing rehab program; 38 consented. EHW sent an inspector to look at those houses to determine what easily remediable environmental issues were present. In collaboration with home owners, assistance was provided to improve the home environment.
Although some of the housing factors involved larger repairs, such as water leaks and peeling paint, others were easier fixes, such as regular vacuuming, removing old carpeting and draperies, changing furnace filters, and installing pillowcases and mattress covers. Other recommendations involved behavioral changes, including recommending that no one smoke in the home.
“For most people, these simple interventions don’t seem like a big deal, but regular exposure to unhealthy conditions over time can exacerbate health issues,” explains Dr. Thornton. “People spend most of their time indoors, especially in the winter, and are being constantly exposed to these harmful allergens.”
Dr. Thornton’s team reviewed the data on admissions to the emergency department and hospital six months before the BUILD Challenge and six months after. Before the intervention, the average was about 1.2 ED visits in 6 months; after the BUILD intervention, it decreased to 0.5. Hospitalizations prior to the challenge were 0.32; after the BUILD intervention, they were 0.22.
Dr. Thornton is seeking funding to replicate these findings among a larger group of patients.
You can read the complete BUILD Challenge study here.
The MetroHealth System is redefining health care by going beyond medical treatment to improve the foundations of community health and well-being: affordable housing, a cleaner environment, economic opportunity and access to fresh food, convenient transportation, legal help and other services. The system strives to become as good at preventing disease as it is at treating it.
The system’s more than 600 doctors, 1,700 nurses and 7,800 employees go to work each day with a mission of service, to their patients and to the community. As Cuyahoga County’s safety-net health system, MetroHealth plays an essential role in the region, caring for anyone and everyone, regardless of an ability to pay.
Founded in 1837, MetroHealth operates four hospitals, four emergency departments and more than 20 health centers and 40 additional sites throughout Cuyahoga County. The system serves more than 300,000 patients, two-thirds of whom are uninsured or covered by Medicare or Medicaid.
MetroHealth is home to Cuyahoga County’s most experienced Level I Adult Trauma Center, verified since 1992, and Ohio’s only adult and pediatric trauma and burn center.
As an academic medical center, MetroHealth is committed to research and to teaching and training tomorrow’s caregivers. Each active staff physician holds a faculty appointment at Case Western Reserve University School of Medicine. Its main campus hospital houses the Cleveland Metropolitan School District’s Lincoln-West School of Science & Health, the only high school in America located inside a hospital.
Knowing that good health is about much more than good medical care, MetroHealth has launched the Institute for H.O.P.E.™ (Health, Opportunity, Partnership, Empowerment), which uses a coordinated, collaborative and strategic approach to help patients with non-medical needs such as healthy food, stable housing and job training.
The MetroHealth Glick Center, a new 11-floor hospital, is under construction on the system’s main campus in Cleveland and is scheduled to welcome its first patients in October 2022. The billion-dollar project is the cornerstone of a wider neighborhood revitalization effort led by the system and its partners in the community.
For more information, visit metrohealth.org.