Teaching Home Environmental Health to Resident Physicians

Abstract

Healthy Homes programs seek to integrate the evaluation and management of a multitude of health and safety risks in households. The education of physicians in the identification, evaluation, and management of these home health and safety issues continues to be deficient. Healthy Homes programs represent a unique opportunity to educate physicians in the home environment and stimulate ongoing, specific patient-physician discussions and more general learning about home environmental health. The Case Healthy Homes and Patients Program addresses these deficiencies in physician training while providing direct services to high-risk households. Pediatric and family practice resident physicians participate in healthy home inspections and interventions for their primary care patients and follow up on identified risks during health maintenance and acute illness visits.

Ensuring Healthy American Indian Generations for Tomorrow through Safe and Healthy Indoor Environments

“…Environmental exposures directly impact many health outcomes [ 1 ], and different strategies are necessary for reducing exposures specific to indoor environments [ 2 , 3 ]. Estimates predict that Americans spend roughly 90% of their time indoors, making indoor environments an important exposure site for various indoor allergens [ 4 ], chemicals, environmental tobacco smoke, volatile organic compounds (VOCs), heavy metals and unintended injuries [ 5 ]. Additionally, homes are a major predictor of health [ 3 ], with evidence showing a strong relationship between housing quality and health outcomes [ 5 ].…”

“…AI, defined by the United States (U.S.) Census as peoples having origins in any of the original peoples of North, Central and South America who maintain tribal affiliation and/or community attachment [ 11 ], have some of the poorest documented health outcomes of all racial/ethnic groups in the U.S. [ 11 , 12 ]. Additionally, AI have some of the highest rates of asthma (9.4%) compared to other racial/ethnic groups (multiracial 14.1%; Blacks, 11.2%; Whites, 7.7%; and Asians 5.2%) [ 12 ] and the highest rate of severe physical housing problems in the U.S. (3.9%), followed most closely by Blacks (2.8%) [ 4 ]. Additionally, 3% of AI live with moderate physical housing problems (malfunctioning plumbing, heating, or electrical systems, dilapidated public areas, or inadequate maintenance) [ 4 , 13 ].…”

“…Additionally, AI have some of the highest rates of asthma (9.4%) compared to other racial/ethnic groups (multiracial 14.1%; Blacks, 11.2%; Whites, 7.7%; and Asians 5.2%) [ 12 ] and the highest rate of severe physical housing problems in the U.S. (3.9%), followed most closely by Blacks (2.8%) [ 4 ]. Additionally, 3% of AI live with moderate physical housing problems (malfunctioning plumbing, heating, or electrical systems, dilapidated public areas, or inadequate maintenance) [ 4 , 13 ]. AI also have the highest rates of smoking of any racial/ethnic group in the U.S., with rates as high as 41%, compared to 21% to 24% for Whites and Blacks, meaning children are more likely to be exposed to environmental tobacco smoke [ 14 , 15 ].…”