Finding Upstream Solutions to Childhood Asthma Triggers in the Home
by Jana Rieker, PR/Communications Director, Healthy Homes Des Moines
Often, partnering across sectors can be bumpy, even with aligned goals. In our work around Des Moines, Iowa, we used an upstream approach to bridge the gap between housing and health stakeholders. Our mission? To reduce childhood asthma. Our method? Strategic collaboration every step of the way.
Healthy Homes Des Moines (HHDSM) is a partnership that brought together members of the housing, medical, government, and education communities to determine whether mediating risks that trigger asthma attacks in the home could reduce children’s acute asthma attacks. Collaborators included the following:
- Polk County Housing Trust Fund
- Polk County Health Department
- Mercy Medical Center
- Broadlawns Medical Center
- UnityPoint Health
- City of Des Moines
- Viva East Bank
- Mid-Iowa Health Foundation
- Visiting Nurse Services of Iowa
- Polk County Public Works
- Des Moines Public Schools
To fund the program, we raised nearly $165,000 in kind and in cash from three hospitals, received $70,000 from the Mid-Iowa Health Foundation, and received $250,000 from the BUILD Health Challenge. The Polk County Health Department and the Housing Trust Fund contributed additional resources in cash and in kind, resulting in a $900,000 total value for the two-year project. We then launched and began building the infrastructure and processes to create and track the program’s progress.
How It Works
Phase 1: Referrals
When a child has a history of asthma issues, including school absences and multiple doctor visits or emergency room visits, a physician or school nurse can refer the child to HHDSM. For families to qualify, they must earn less than 80 percent of the area’s median income (about $60,000 for a family of four). Once referred, HHDSM schedules a visit and assesses risks in the family’s home—such as mold, dust, chemicals, and pests—that trigger asthma attacks (children with developing lungs are particularly vulnerable to experiencing asthma symptoms when exposed to such triggers). The assessment is done by a third-party partner who is trained and certified in healthy homes and uses a checklist that includes environmental risks, behavioral patterns, and situational risks (e.g., Is there smoking in the home? Are there cracks in the windows or leaks in the roof?). Once the risks are assessed, the partner provides a report to determine what the family needs to reduce the child’s risks of asthma.
After the assessment is completed, the family receives a report and HHDSM debriefs, teaching them how to identify potential risks. The education is intended to help families self-manage and mitigate risks that might trigger asthma and to help them maintain a healthy home.
Phase 2: Home Supplies
Phase 2 is to equip the family with supplies to keep their home healthy. These supplies include cleaning supplies, a vacuum cleaner, bed and pillow covers, furnace filters, window sealant, and other items to keep the child from being exposed to triggers. This is beneficial to the family and a cost-efficient way to provide products or materials to maintain a clean, trigger-free home. The work and supplies would have cost the family nearly $10,000.
Phase 3: Home Remediation
When something in the home is assessed to be a potential risk or trigger for the child’s asthma, bids to repair the home are gathered and reported into the system at no cost to the family. Thirty-eight of the 137 homes received remediation during the program’s pilot phase. The average cost of a full home remediation was $3,250, a fraction of the cost of a hospital visit.
Successful Pilot Program Expands to 2.0
The HHDSM program received 137 referrals in its first two-year pilot program, with a 100 percent completion rate on referrals through one phase of the program or another. Though this was short of our goal of 150, we count it as a success because HHDSM can use the knowledge gained to expand and serve even more families.
The program received several accolades, including a prize from the CEOs for Cities Healthiest Cities & Counties Challenge and the BUILD Health Challenge 2.0 grant. Healthy Homes Des Moines will continue to improve the lives of children in the Des Moines area and has added discussions with local experts on creating a proactive and sustainable future for this program and the families it serves. More information on the HHDSM program can be found on its website and Facebook page.