National Center for Healthy Housing

 


Local-level data combined with complementary federal sources provide the most robust health and housing assessment to drive healthy housing baseline data. From this baseline data, actors in many communities have designed and targeted healthy housing programs and resources, and developed dashboards for measuring progress. The resources below help to address these challenges.

While availability of data to evaluate the state and “health” of housing stock varies from community to community, there are several standard tools that almost any community can use to begin. Housing code violations and enforcement actions help to pinpoint substandard or poor quality housing, while health data may highlight issues, such as chronic respiratory illnesses, lead poisoning, falls, or even specific forms of death, which are often triggered by home health hazards. Overlaying the data together can often identify where community and housing health hot spots exist. Below is a list of potential data resources to assess housing “health” as well as examples of how a few communities have used and integrated health and housing data to promote healthier housing.

State Healthy Housing Profiles 
NCHH collected data from multiple sources to create healthy housing profiles for all 50 states, plus the District of Columbia, Puerto Rico, and the U.S. as a whole. Profiles examine the need for affordable housing, healthy housing funding, the level of childhood lead poisoning, the prevalence of asthma, and an assessment of the funding needed to adequately address healthy housing issues in the state. [url; NCHH]

City and County Profiles: Data Sources
There is a variety of data that communities can use to help with their community health and housing assessments. The following provide examples of the types of indicators that might be helpful to create a health profile of your community, along with examples of sources from which data could be collected. Although not every state or local jurisdiction has the same type of public health system, the resources provide examples of nationally available data, as well as the state/local agency that might be responsible for collecting the identified indicator at the local level.

• Healthy Homes Data
  This NCHH-developed presentation outlines the type of data useful for assessing housing and health conditions, a variety of ways to showcase the information, and where potentially to find the data (a federal, state, or local agency that collects and stores such data, for example). It also advises regarding mistakes to avoid making, consideration of appropriate geographic levels, and the benefit of pairing quantitative data with stories. [ppt; NCHH, 2014]

• Health Facts Profiles
  These sample profiles of health data, provided for each county and metropolitan statistical area (MSA) in Texas, provide data on demographics, socioeconomics, communicable diseases, births, and deaths with comparisons to statewide averages. [url; pdf; Texas Department of State Health Services, 2013]

• 2015 Dallas Map Book
  The Dallas Map Book is a comprehensive set of maps of housing quality indicators in Dallas, obtained through City of Dallas permit, tax assessment, code enforcement data, and census data. The maps include homes assessed as "very poor quality" or "unsound," liens, vacant properties, poverty data, and more.
  [url; pdf; Dallas Area Habitat]

Aggregated Data Sources

Although the data may not always be at the geographic level necessary, aggregated data sources can be useful when creating city- or countywide data profiles.

• Example: Data.gov
  This open federal government data site aggregates metadata from open data resources in one centralized location. Although the data is primarily federal-level, interested state and local governments can also collect and display metadata resources on the site. Participating states and localities vary, as do posted data sets. HUD has 174 data sets currently on the site, including the Housing Affordability Data System (HADS). Local data on crime, children's blood lead levels, and other issues directly related to health are available from a few cities and counties. Because the data source is linked directly to the site, metadata can be updated as often as every 24 hours, depending on the data and its original source. [url; Data.gov]

• Example: City-Data
  City-Data features interactive maps and a broad range of data at the city and neighborhood level, such as crime rates, cost of living, real estate sales and trends, cost of housing, and access to hospitals, schools, and libraries. [url; City-Data]

Data Mapping Technologies
Emerging technologies, such as those created by LocalData and SeeClickFix, provide applications that residents, volunteers, and surveyors can use to easily identify, report, and map community health hazards and other issues, such as vacant or dilapidated housing.

• Example: Layers of Data
  This resource addresses the collaboration between community groups, the Center for Housing and Community Studies (UNC, Greensboro), and the GIS mapping project that explored connections between neighborhoods and health in Greensboro and its surrounding county. Initially focused only on connections between asthma and housing quality, it was expanded to include other health conditions, such as infant mortality, low birth weight, falls, and cancers that may be related to housing and community. Community factors in the mapping project include vacant or abandoned homes, housing code violations, and other measured environmental conditions. [url; YesWeekly]
• Example: Loveland's Passion: Battle Blight
  Loveland's Passion highlights the use of technology to identify blighted areas and feed property data and information directly to a system that maps and catalogues it. The back-end system and app discussed in the article allowed the Detroit Blight Removal Task Force to map and catalogue 385,000 properties in under nine weeks. [url; Crain’s Detroit Business]

When available, local housing code violation, property assessment, permitting, lien, and land bank data are good sources of information on housing quality; however, this data may not always be available or complete. Alternatively, American Housing Survey (AHS) data includes measures such as an assessment of the overall quality of the unit, residents’ satisfaction with the unit, details on unit deficiencies (both inside and out, e.g., leaks, holes, crack, equipment breakdown) as well as deficiencies in common areas (e.g., nonworking light fixtures or loose railings); and general maintenance and repair information. However, AHS data is available only for metropolitan statistical areas and city cores, so does not provide neighborhood-level data often needed to design and drive programs. Generally, a combination of AHS data and local data provides the optimal mix for designing healthy housing interventions.

More specific local data can also be available through local healthy homes, health, and housing agencies; local nonprofit agencies; and universities. Many of these entities also often conduct studies and surveys of housing quality, blight, gentrification, and other factors impacting housing quality.

U.S. Census 
The U.S. Census is a primary source for population, income, housing, demographic, economic, and employment data. This resource offers a broad range of tools based on census data collected on a decennial basis, estimated data (five year rolling), and surveys. Interactive applications allow users access to statistics from multiple surveys and well as to integrate and visualize data with geographic information system (GIS) mapping tools. Geospatial levels vary according to indicator. American FactFinder provides access to every dataset maintained by the Census bureau. [url; U.S. Census]

American Housing Survey (AHS), 2013 Data
The AHS is the most comprehensive national housing survey in the U.S., conducted on a biennial basis by the U.S. Census for HUD. Data is available through both public use files, which feature individual household responses to survey questions, as well as summary tables. AHS provides data on indicators such as leaks, pest infestation, heating, electrical, plumbing, or roofing problems, and more. The ZADEQ variable, found in the public use file, provides an overall summary of housing quality. [url; U.S. Census, 2013]

• 2013 AHS Fact Sheets
  Two-page fact sheets created by the U.S. Census which provide snapshots of the national data and 25 metro areas covered by the 2013 survey [url; U.S. Census]

American Housing Survey: Basic Statistics for Healthy Housing
NCHH created this guide to using AHS data to assess healthy homes. NCHH reviewed the AHS to determine which data are directly related to health and safety issues, and developed a series of reports that summarize the national data, compares data from the 2009 and 2011 surveys, identifies trends found in 47 metropolitan statistical areas (MSAs), and compares the MSAs with nationally available data. To learn more about how to use AHS data, see NCHH's Key Definitions in the American Housing Survey Related to Healthy Housing. [pdf]

HUD Data Set Reference Guide
This matrix identifies publicly available data sets commonly used in housing research and rates them according to relevance and research usefulness. Short descriptions of each data set and information about its formats can be found in the Guide to HUD User Data Sets. [url; HUD]

State of Healthy Housing 
An NCHH report assessing the housing conditions in the 54 metropolitan communities sampled by the American Housing Survey. Learn more about the report and its definitions of housing hazards. [2013]

A Measure of (Poor) Housing Quality
This is an alternative measure of housing quality using the AHS. Rather than a measure of housing "adequacy," as found in the AHS, the authors developed a Poor Quality Index (PQI) using all of the AHS information available on housing deficiencies, which measures the level of physical deficiencies in sampled housing units. The broader range of deficiencies found in the PQI provides a more concrete assessment of quality between surveys.
[url, pdf; HUD, 2013]

Healthy Housing Reference Manual
Although not a "data" source, this manual, developed by HUD and HHS, provides healthy housing background and identifies specific housing and health criteria that should be used to assess and monitor housing quality. [url, pdf; CDC, 2012]

Hospitals and health agencies often have extensive data on areas of high prevalence of health problems such as lead poisoning, asthma, slips, trips, and falls frequently caused by home health hazards, and more. Healthy housing practitioners can work with health care providers to obtain and share data that identifies specific geographic areas of concern without violating HIPAA regulations.

General

Healthy People DATA2020
DATA2020 is an interactive data tool which allows users to explore housing data related to Healthy People 2020 objectives. The site provides clear descriptions of the objectives, its baseline data, and the HealthyPeople 2020 targets. Data sources are identified along with how to find more information. [url; Healthy People 2020]

Health Indicators Warehouse
This is a single source for many national, state, and community health indicators. Along with indicators, it provides a listing of geographic availability, data sources, most recent date collected/available, and related government initiatives using the data. [url; HHS]

EJScreen
This environmental justice (EJ) mapping and screening tool, developed by the EPA, utilizes standard and nationally consistent data to highlight environmental burdens in communities with vulnerable populations. It offers a variety of data and mapping capabilities that users can use to access environmental and demographic information, at high geographic resolution, displayed in color-coded maps and standard data reports. EJ Screen also combines environmental and demographic indicators to create EJ indexes. [url; EPA]

Healthcare Cost and Utilization Project (HCUP)
HCUP is a national information resource of encounter-level health care data compiled from State data organizations, hospital associations, private data organizations, and the Federal government. Databases can be used to identify, track, and analyze health care utilization, access, charges, quality, and outcomes. [url; AHRQ]

ICF Healthy Homes Data Toolkit
This matrix, developed by ICF International, outlines where to access specification and assessment guidelines, as well as data collection issues related to healthy housing. [pdf; NCHH]

Center on Society and Health, Virginia Commonwealth University
This academic research center works with the Robert Wood Johnson Foundation to study health implications of social factors on neighborhood and community environmental conditions. Data is available through research and reports on nationwide health conditions and the health of states, cities, communities, and neighborhoods. Projects of particular relevance include community mapping of life expectancy and relationship of income to health.
[url; VCU]

Lead Poisoning

Healthy Homes and Lead Poisoning Surveillance System (HHLPSS)
Data and long-term monitoring of childhood lead poisoning is available through a software program obtained from the CDC. The HHLPSS tracks lead-related data such as screenings and confirmed cases of childhood lead poisoning, as well as non-lead housing characteristics related to negative health outcomes. Software must be requested and obtained from the CDC. [url; CDC]

CDC’s National Surveillance Data
CDC's website provides background information on the blood lead level data collection and offers downloadable blood lead level charts. [url; CDC, 1997-2015]

• Blood Lead Levels
  Children tested and confirmed to have elevated blood lead levels by State and Year (Children < 72 Months Old, 1997-2014). [url; CDC]

CDC's State Surveillance Data
This CDC site contains links to blood lead level surveillance data, maps, and charts by state; includes county data. Because state blood lead testing policies and practices vary and local priorities determine which homes are assessed for housing hazards, data are not generalizable from state to state or local jurisdiction to jurisdiction. However, descriptive statistics can help users understand the approach used to assess housing units in a given location, allowing data to be used to make associations between the number of individuals in a given area and a specific housing hazard or health condition and geographic descriptors such as poverty, age of housing, tenancy, and health conditions. [url; CDC]

Asthma

Behavioral Risk Factor Surveillance System (BRFSS)  
The BRFSS is a system of health-related telephone surveys which collect data from U.S. residents regarding their health-related risk behaviors, chronic health conditions, and use of preventive services. Data is provided at the state level.
[url; CDC]

Asthma Call-Back Survey (ACBS)
This data covers lifetime and current asthma for children and adults (by region and race/ethnicity). The data includes asthma symptoms, healthcare utilization, asthma knowledge, self-management, medication usage, cost of care, use of complimentary/alternative medicine, and modifications to the environment. [url; CDC, 2013]

Safety and Injury

Web-Based Injury Statistics Query and Reporting System (WISQARS)
CDC's interactive, online database provides fatal and nonfatal injury, violent death, and injury-related costs. [url, CDC]

For individuals interested in taking a deeper dive to assess housing-related issues, HUD created a two-part guide to data sources to support housing research.

• Data Sources for U.S. Housing Research, Part 1: Public Sector Data Sources [pdf; HUD, 2014]

• Data Sources for U.S. Housing Research, Part 2: Private Sources, Administrative Records, and Future Directions [pdf; HUD, 2015]

HUD Data Sets
A full listing of the data sets available from HUD, the HUD Reference Guide and matrix rates each of the HUD data sets by its relevance to a variety of categories. A brief description of the data set and its available format is available from Guide to HUD User Data Sets. [url, pdf; HUD]