The relationship between housing and health is strong and some evidence suggests that many of our exposures and stresses in the home can be avoided, alleviated, or reduced. The quality of a home may also be influenced by an individual or family’s ability to understand potential hazards and their capacity to address those hazards. This Research Topic welcomes articles that address innovative strategies to improve the quality of homes and thereby positively influence health. These strategies could include community, educational, policy, technological, or engineering approaches to all hazards encountered in the home. Housing hazards can include but are not limited to biological, chemical, physical, and/or emotional, where there is evidence of the connection with health.

North Carolina Agricultural and Technical State University

Frontiers in Public Health

Environmental Health and Exposome

Frontiers in Environmental Science

Housing and Health: Finding Innovative Solutions to Improve the Quality and Condition of the Home

How important is having a healthy home for individuals, families, and communities across world? One must question the understanding of the concept of a healthy home and also the understanding of its importance to health. The concept of a healthy home may not be shared from individual to individual or from leader to leader within a country or community, and may be driven by historical and economic factors, along with current and demanding needs/drivers within a community.There are some obvious factors that affect achieving a healthy home that we can all easily understand. Aging homes, for example, present more problems as ventilations systems fail and structural damage grows. Location of a home also plays a part, where for example, more humid and hot climates create more of a challenge in managing pests that frequent homes and threaten health (e.g., cockroaches, rats). The condition of the home can be transient due to external factors. For example, it is devastating to communities and individuals when homes are destroyed due to extreme flooding and wind events from storms. The economics of an area can change, especially in the short term making it difficult to maintain healthy homes to some reasonable standard. We can also see how the quality and standard of a home is affected by the wealth and knowledge of an individual and the community. There are steps that homeowners can take to promote a healthy home where some require few resources (e.g., clean, unclogging drains, keeping shrubs low), while others steps require substantial financial investment (e.g., properly sized and efficient heating and cooling system, roof repairs). Homeowners on various economic scales must be motivated however to see the benefit of various inexpensive and expensive steps as valuable to comfort and health. Renters are also additionally challenged by modifications and repairs that are the Landlord&apos;s responsibility.Communities may also question how much of a role governments play in encouraging healthy homes by driving the adoption of and compliance with updated building, sanitation, and renovation codes, and in providing assistance to those in need.This research topic received four article submissions. “Community mobilization for slum upgrading through sanitation in Roma informal settlements in the Paris region” by author <a href="https://doi.org/10.3389/fpubh.2017.00213">Chaudhuri</a> explored the social, economic, and political drivers that influence the availability and condition of housing and ultimately its health effects for community members of this informal settlement in Europe. We are reminded by reading this article of desperate conditions of marginalized groups even in wealthy communities, where basic sanitation (i.e., availability of a proper functioning toilet and hot water) can lead to immediate health outcomes such as infections and various levels of discomfort.<a href="https://doi.org/10.3389/fpubh.2016.00263">Bachelder et al.</a> present results of a survey delivered to over 1,000 renters in a State without an explicit landlord implied warranty of habitability. Over one quarter of the tenants self-report health problems due to substandard housing. <a href="https://doi.org/10.3389/fpubh.2018.00180">Horwitz-Wills</a> offers a perspective on this article by encouraging leaders to include Landlords in state public health systems in order to improve the Landlord-Tenant relationship and renter health. There is again a recognition of the challenges brought on by sociopolitical factors in a community where marginalized renters are challenged to not only find, but to maintain a healthy home.<a href="https://doi.org/10.3389/fpubh.2016.00048">Ferguson and Yates</a> offer a solution to substandard housing here in the United States which can be duplicated elsewhere and that is a “Federal Enactment of Healthy Homes Legislation in the United States to Improve Health” forcing local governments to put some effort forth in ensuring healthy homes in their communities. Governments must invest in basic standards for homes for individuals and families tailored to meet geographic and local challenges that may impact housing quality. These standards must go beyond a roof and a bed and consider the elements that lead to discomfort, respiratory, and dermal diseases and accidents in and around the home (i.e., proper ventilation, smoke and carbon monoxide detectors, avoidance of trip/fall hazards). The community as a whole pays the price in health care cost for poor and inadequate housing for its most in-need members.In conclusion, the papers on this research topic explored only a few concepts having to do with healthy homes and innovative solutions. In the future we hope to obtain more articles on this topic exploring strategies to impact homes and achieve some basic and reasonable standard for a broader set of individuals. There are strategies explored and yet to be explored that can take advantage of community, educational, technological, and engineering approaches to reducing biological, chemical, physical, and emotional hazards in housing. The transient nature of housing and home due to family changing economics and natural and manmade disasters also calls on more advanced innovative strategies that will build more permanent and structural sound housing to last and withstand the elements in a cost-effective manner. Climate change (i.e., extremes of hot and cold and more damaging storms) will challenge how we interact with the earth and how we build to shelter more efficiently from the elements.The author confirms being the sole contributor of this work and has approved it for publication.The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.Thank you to the authors that submitted their articles to the research topic.

Editorial: Housing and Health: Finding Innovative Solutions to Improve the Quality and Condition of the Home

This is a review of an existing article that surveyed the perceived health of renters' in Arkansas. As a first in the field of public health it was able to provide ground-level insight through tenant interviews about housing and health in the state. This review illuminates how the state's sociopolitical characteristics may affect marginalized Arkansas renters. Marginalized renters may include persons living below the poverty line, people of color, and women who are the head of household. This article seeks to elucidate how the upstream factor, habitability law, may impact tenant health in the state. With a novel public health approach, the article contributes to the existing housing and health literature with its invaluable insight of stakeholders' perspectives relating to how habitability law may impact their health outcomes. Now is an opportune time for public health practitioners, researchers, and policymakers to facilitate incremental change to include landlords in their state public health system. Such inclusion may improve housing while promoting, improving, and protecting health outcomes for Arkansas renters.

This is a review of an existing article that surveyed the perceived health of renters&apos; in Arkansas. As a first in the field of public health it was able to provide ground-level insight through tenant interviews about housing and health in the state. This review illuminates how the state&apos;s sociopolitical characteristics may affect marginalized Arkansas renters. Marginalized renters may include persons living below the poverty line, people of color, and women who are the head of household. This article seeks to elucidate how the upstream factor, habitability law, may impact tenant health in the state. With a novel public health approach, the article contributes to the existing housing and health literature with its invaluable insight of stakeholders&apos; perspectives relating to how habitability law may impact their health outcomes. Now is an opportune time for public health practitioners, researchers, and policymakers to facilitate incremental change to include landlords in their state public health system. Such inclusion may improve housing while promoting, improving, and protecting health outcomes for Arkansas renters.

Health Complaints Associated With Poor Rental Housing Conditions in Arkansas: The Only State Without a Landlord's Implied Warranty of Habitability

BackgroundCommunity-based processes addressing environment, housing, and health issues may decrease health inequities by addressing social, economic, and political health determinants more effectively. Yet little analysis of their effectiveness has been undertaken and their potential transfer to marginalized groups in rich country settings. In Europe, stark health inequalities are seen among the Roma, Europe’s most impoverished community who often reside in informal settlements suffering from illiteracy, inadequate housing, and lack of water and sanitation. This paper assesses a dry sanitation project in a Roma informal settlement in the Paris region to improve their living conditions.</sec>MethodsBetween 2014 and 2017, multiple stakeholders were involved in a participatory process of design, construction, and maintenance of toilets. Interviews, mapping, model construction, and facilitated discussion were used to identify design features and follow-up indicators. Field notes, videos, questionnaires, and observation provided data for monitoring and evaluation. For questionnaires delivered to women in the community, a cross section time series was conducted to due to migration.</sec>ResultsDespite issues related to maintenance, the overall quality of life of women improved after toilet construction. This included indicators for comfort, cleanliness, practicality, privacy, security, and menstrual hygiene management. Furthermore, fewer women restrained themselves from relieving themselves or from drinking less water to avoid urinating. Odors continued to be an issue. Self-reporting of illnesses, such as diarrhea and urinary tract infections, were not reliable due to the vague description of these illnesses and the potential recall bias. Appropriate sanitation in informal settlements is a necessity as shown by feedback from Roma women and the literature. However, a more sustainable toilet project would have required an adequate budget, good quality materials, accountability, and buy in from all inhabitants as well as good relationships between the chief and all stakeholders in the settlement. Furthermore, provision should have been made for vulnerable and less autonomous inhabitants to ensure proper follow-up and maintenance.</sec>Conclusion/recommendationsSafe water and sanitation is essential to decrease health inequities. Formative research, identifying natural leaders, sanitation committee formation, outcome indicator and baseline questionnaire development, appropriate messages and toilet design and placement, long-term follow-up, and political support are elements for effective interventions with the Roma. Potential attrition and reporting bias should be considered in monitoring and evaluation.</sec>

Background: Community-based processes addressing environment, housing, and health issues may decrease health inequities by addressing social, economic, and political health determinants more effectively. Yet little analysis of their effectiveness has been undertaken and their potential transfer to marginalized groups in rich country settings. In Europe, stark health inequalities are seen among the Roma, Europe’s most impoverished community who often reside in informal settlements suffering from illiteracy, inadequate housing, and lack of water and sanitation. This paper assesses a dry sanitation project in a Roma informal settlement in the Paris region to improve their living conditions.Methods: Between 2014 and 2017, multiple stakeholders were involved in a participatory process of design, construction, and maintenance of toilets. Interviews, mapping, model construction, and facilitated discussion were used to identify design features and follow-up indicators. Field notes, videos, questionnaires, and observation provided data for monitoring and evaluation. For questionnaires delivered to women in the community, a cross section time series was conducted to due to migration.Results: Despite issues related to maintenance, the overall quality of life of women improved after toilet construction. This included indicators for comfort, cleanliness, practicality, privacy, security, and menstrual hygiene management. Furthermore, fewer women restrained themselves from relieving themselves or from drinking less water to avoid urinating. Odors continued to be an issue. Self-reporting of illnesses, such as diarrhea and urinary tract infections, were not reliable due to the vague description of these illnesses and the potential recall bias. Appropriate sanitation in informal settlements is a necessity as shown by feedback from Roma women and the literature. However, a more sustainable toilet project would have required an adequate budget, good quality materials, accountability, and buy in from all inhabitants as well as good relationships between the chief and all stakeholders in the settlement. Furthermore, provision should have been made for vulnerable and less autonomous inhabitants to ensure proper follow-up and maintenance.Conclusion/recommendations: Safe water and sanitation is essential to decrease health inequities. Formative research, identifying natural leaders, sanitation committee formation, outcome indicator and baseline questionnaire development, appropriate messages and toilet design and placement, long-term follow-up, and political support are elements for effective interventions with the Roma. Potential attrition and reporting bias should be considered in monitoring and evaluation.

Community Mobilization for Slum Upgrading through Sanitation in Roma Informal Settlements in the Paris Region

Arkansas is the only U.S. state that does not have a landlord’s implied warranty of habitability, meaning tenants have a requirement for maintaining their rental properties at certain habitability standards, but landlords are not legally required to contribute to those minimum health and safety standards. This project assessed the possibility that this lack of landlord responsibility affects tenants’ perceived health. Using surveys and interviews, we collected self-reported data on the prevalence and description of problems faced by renters who needed household repairs from their landlords. Of almost 1,000 renters, one-third of them had experienced a problem with their landlord making needed repairs; and one-quarter of those had a health issue they attributed to their housing conditions. Common issues included problems with plumbing, heating, or cooling systems, and pest or rodent control. Reported health problems included elevated stress levels, breathing problems, headaches, high blood pressure, and bites or infections. Hispanic respondents and those with less than a high school education were both significantly more likely to report problems with their landlords not making repairs as requested. These data suggest that the lack of landlord requirements may negatively impact the condition of rental properties and, therefore, may negatively impact the health of Arkansas renters.

Arkansas is the only U.S. state that does not have a landlord&#x2019;s implied warranty of habitability, meaning tenants have a requirement for maintaining their rental properties at certain habitability standards, but landlords are not legally required to contribute to those minimum health and safety standards. This project assessed the possibility that this lack of landlord responsibility affects tenants&#x2019; perceived health. Using surveys and interviews, we collected self-reported data on the prevalence and description of problems faced by renters who needed household repairs from their landlords. Of almost 1,000 renters, one-third of them had experienced a problem with their landlord making needed repairs; and one-quarter of those had a health issue they attributed to their housing conditions. Common issues included problems with plumbing, heating, or cooling systems, and pest or rodent control. Reported health problems included elevated stress levels, breathing problems, headaches, high blood pressure, and bites or infections. Hispanic respondents and those with less than a high school education were both significantly more likely to report problems with their landlords not making repairs as requested. These data suggest that the lack of landlord requirements may negatively impact the condition of rental properties and, therefore, may negatively impact the health of Arkansas renters.

Health Complaints Associated with Poor Rental Housing Conditions in Arkansas: The Only State without a Landlord’s Implied Warranty of Habitability

Not all homes across America are “healthy” homes. This contributes to the poor health of Americans and exacerbates existing health conditions costing millions each year in health-care cost. Newer research is being conducted into strategies to alleviate biological, chemical, and physical hazards in the home, and various programs exist to assist the homeowner in making improvements in the quality of their home. Not every homeowner or renter nationwide or within community localities has access to these strategies or programs that could potentially improve their home environment and therefore the health of their family. The objective of this article is to propose elements of a policy to address this inconsistency and variation. This proposal centers around the federal enactment of a national policy demanding that each state implements a healthy homes program tailored to fit their specific state housing and health needs. Members of Congress from States that have successfully implemented healthy home programs should champion this policy. Organizations that recognize the impact of housing on health should support the development of a national healthy homes strategy. This article will discuss the need, outcomes, stakeholders, and minimum requirements of such a policy.

Not all homes across America are &#x201c;healthy&#x201d; homes. This contributes to the poor health of Americans and exacerbates existing health conditions costing millions each year in health-care cost. Newer research is being conducted into strategies to alleviate biological, chemical, and physical hazards in the home, and various programs exist to assist the homeowner in making improvements in the quality of their home. Not every homeowner or renter nationwide or within community localities has access to these strategies or programs that could potentially improve their home environment and therefore the health of their family. The objective of this article is to propose elements of a policy to address this inconsistency and variation. This proposal centers around the federal enactment of a national policy demanding that each state implements a healthy homes program tailored to fit their specific state housing and health needs. Members of Congress from States that have successfully implemented healthy home programs should champion this policy. Organizations that recognize the impact of housing on health should support the development of a national healthy homes strategy. This article will discuss the need, outcomes, stakeholders, and minimum requirements of such a policy.