Map of life expectancy at birth from Global Education Project.

Friday, January 06, 2006

Home not so sweet

We usually think of environmental health as having to do with the great outdoors -- air pollution and industrial waste in the water supply. But in fact, for most of us, children in particular, the most important exposures to environmental toxins are often in the home. The acute conditions of 19th century tenements and factory neighborhoods, which catalyzed public health and housing reform measures, have been ameliorated in U.S. cities. However, in recent decades economic and social forces have siphoned off resources and opportunities from older city centers: the exodus of white middle and working class people to suburbs; corporate relocation away from center cities; "redlining" of urban neighborhoods; and federal cutbacks in aid to cities. Consequently, during the latter half of this century, the urban poor have been concentrated and ghettoized in substandard housing in inner cities.

Back in 1998, the Doc-4-Kids project at Boston Medical Center documented the links between unsafe and unhealthy homes, homelessness (homeless kids do live somewhere, specifically in shelters or welfare motels), and poor children’s health crises -- asthma and respiratory diseases, lead poisoning, injuries, and malnutrition . Extrapolating from smaller studies where large data sets were lacking, the authors estimate the cumulative impact of inadequate housing on children's health in the United States -- which includes nearly 18,000 hospitalizations for asthma per year.

The overall findings of the report support public health studies which have systematically demonstrated that poorly maintained housing is strongly linked with childhood injuries and lead poisoning, and that damp, moldy indoor environments are associated with increased respiratory disease and asthma. A 1974 study of injuries to children associated with consumer products, for example, estimated that 2 out of 3 childhood injuries take place in the home. Ninety-one percent of injuries to children under 5 years of age occurred at home. Residential building conditions and design, including structural elements and defects such as faulty fire detection systems, windows without screens and window guards, steam radiators without covers, high-temperature hot water, missing balusters, and insufficient lighting were strong determinants of injuries.(Gallagher S, Hunter P, Guyer B. A home injury prevention program for children. Pediatric Clinics of North America. 1985;32(1):95-112.)

Well, that's how conditions are where most poor kids live. And there is plenty that we could do about this, for a lot less than what it's costing us to kill children with bombs in Iraq. If the president really believes the he was "elected" to keep us safe, he might consider that.

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