Healthy Homes Rating System Scoping Project

In 2011, the U.S. Department of Housing and Urban Development’s (HUD) Office of Lead Hazard Control and Healthy Homes (OLHCHH) began training its Healthy Homes program grantees to use the Healthy Homes Rating System (HHRS), a tool originally developed in the United Kingdom, to justify intervention decisions to correct identified residential health and safety hazards.

The British version of this tool assesses 29 housing hazards that pose risks to health or safety. The British created a formula to generate a numeric score for each hazard, that includes both the likelihood and the severity of potential harm. This allows all hazards to be compared across the same metric. HUD OLHCHH’s HHRS continues to use British data for its benchmarks; however, many of these housing and health outcome data differ from U.S. housing conditions. HUD OLHCHH tasked Solutions with determining if U.S. health and housing data can serve as HHRS benchmarks.

Solutions’ October 2014 preliminary scoping report highlighted readily available U.S. health and housing benchmark data, identified promising secondary research strategies, and offered suggestions for which of the 29 hazards in the HHRS merited further investigation. Sources reviewed by Solutions included the 2011 American Housing Survey; CDC’s online systems, such as WONDER (Wide-Ranging Online Data for Epidemiologic Research) and WISQARS (Web-based Injury Statistics Query and Reporting System); EPA and other publicly available federal data sources; and other published, peer-reviewed studies. The project also reviewed the Healthy People 2020 objectives that integrated data from a variety of health and demographic sources, notably the NHANES (National Health and Nutrition Examination Survey), the Behavioral Risk Factor Surveillance System (BRFSS), others surveys conducted through the U.S. Census, and multiple disease registries and surveillance systems.

As an adjunct to this scoping effort, Solutions prepared case studies on the use of the HHRS by Rebuilding Together affiliates in Columbus, OH; Nashville, TN; and Pittsburgh, PA. The goal of this effort was to examine how use of the HHRS by volunteer-based organizations impacted the scope of the repairs, the affiliate organization, and residents’ perceived health and safety.