摘要：Poor housing conditions are associated with a wide range of health conditions, including respiratory infections, asthma, lead poisoning, injuries, and mental health. Addressing housing issues offers public health practitioners an opportunity to address an important social determinant of health. Public health has long been involved in housing issues. In the 19th century, health officials targeted poor sanitation, crowding, and inadequate ventilation to reduce infectious diseases as well as fire hazards to decrease injuries. Today, public health departments can employ multiple strategies to improve housing, such as developing and enforcing housing guidelines and codes, implementing “Healthy Homes” programs to improve indoor environmental quality, assessing housing conditions, and advocating for healthy, affordable housing. Now is the time for public health to create healthier homes by confronting substandard housing. Housing is an important determinant of health, and substandard housing is a major public health issue. 1 Each year in the United States, 13.5 million nonfatal injuries occur in and around the home, 2 2900 people die in house fires, 3 and 2 million people make emergency room visits for asthma. 4 One million young children in the United States have blood lead levels high enough to adversely affect their intelligence, behavior, and development. 5 Two million Americans occupy homes with severe physical problems, and an additional 4.8 million live in homes with moderate problems. 6 The public health community has grown increasingly aware of the importance of social determinants of health (including housing) in recent years, 7 yet defining the role of public health practitioners in influencing housing conditions has been challenging. Responsibility for social determinants of health is seen as lying primarily outside the scope of public health. The quality and accessibility of housing is, however, a particularly appropriate area for public health involvement. An evolving body of scientific evidence demonstrates solid relations between housing and health. The public health community is developing, testing, and implementing effective interventions that yield health benefits through improved housing quality. Public health agencies have valuable expertise and resources to contribute to a multisectoral approach to housing concerns. Public health has a long (albeit intermittent) history of involvement in the housing arena, and this involvement is generally accepted by other housing stakeholders (e.g., building departments, community housing advocates). Housingrelated health concerns such as lead exposure and asthma are highly visible. The public is also concerned about the quality and accessibility of housing as affordable housing becomes scarcer. 8 Elected officials and communities alike recognize that substandard housing is an important social justice issue that adversely influences health. In this article, we describe some of the evidence linking housing conditions to health, place public health's role in addressing housing issues in an historical context, provide examples of contemporary local public health activities in the housing arena, and conclude with suggestions for public health action in the next decade.
