The New York State Healthy Neighborhoods Program: Findings From an Evaluation of a Large-Scale, Multisite, State-Funded Healthy Homes Program.

CONTEXT A growing evidence base suggests that a comprehensive healthy homes approach may be an effective strategy for improving housing hazards that affect health, but questions remain about the feasibility of large-scale implementation. OBJECTIVE To evaluate the impact of a large-scale, multisite, state-funded healthy homes program. SETTING Homes in high-risk neighborhoods of 13 counties funded under the New York State Healthy Neighborhoods Program (NYS HNP) from 2008 to 2012. PARTICIPANTS A total of 28 491 homes received an initial visit and 6436 dwellings received a revisit (follow-up assessment 3 to 6 months after the intervention). A majority of residents are low-income renters living in buildings built prior to 1950. INTERVENTION The NYS HNP is a low-intensity healthy homes program. Participating homes undergo a visual assessment to identify potential environmental health and safety hazards, and interventions (education, referrals, and products) are provided to address any hazards identified during the visit. MAIN OUTCOME MEASURES The proportion of homes affected by several types of housing hazards, improvement in hazards among revisited homes, and the change in the overall number of hazards per home were assessed. RESULTS Among the homes that were revisited, there were significant improvements in the conditions assessed for tobacco control, fire safety, lead poisoning prevention, indoor air quality, and other hazards (including pests and mold). There was a significant reduction in the number of hazards per home (2.8 to 1.5; P < .001), but homes were not hazard-free at the revisit. CONCLUSION This evaluation suggests that a comprehensive, low-intensity healthy housing approach can produce short-term impacts with public health significance. This evaluation provides information about hazards that are common, easily assessed, and easily corrected or improved, which may be of use to a variety of programs that already provide in-home services and are seeking to expand the scope of their visits or to inform the development of new programs.