Creating a safe and healthy home for someone with asthma is challenging. The home can play host to many serious asthma triggers, including pests like cockroaches and dust mites, dampness, and ventilation problems that allow accumulation of particulate matter and other types of air pollution. People spend a significant portion of their time inside their home, and about 20% to 30% of asthma cases are linked to home environmental conditions.
While there are certainly steps that individual households can take to reduce these triggers in their home, renters often face unique barriers.
For example, while a household can take steps to remediate a pest problem in their apartment, the infestation may be present in the entire building. Mold and fungi due to leaks or dampness may be caused by structural problems outside of the renter’s control. Tenants may also be restricted in the changes they can make to their unit, like removing carpeting.
Given that over a third of U.S. households rent and one in four live in multiunit buildings, challenges like these warrant particular attention. Moreover, communities of color are both disproportionately burdened by asthma and more likely to live in rental housing.
Preventing and resolving housing issues is most successful when landlord and tenant work together. Multnomah County, Oregon’s Public Health Department, created a resource that highlights these opportunities: What Makes a Healthy Home: A Guide for Landlords and Tenants. The toolkit outlines the seven principles* of a healthy home (dry, clean, safe, ventilated, pest-free, maintained, and contaminant-free), and outlines how both tenants and landlords can play a role in maintaining the healthy status of a unit.
Regarding moisture, for example, the guide explains how landlords are responsible for ensuring all fans are in proper working order and are ventilated outside of the property, regularly inspecting the gutters and making sure all windows are well sealed. Tenants, on the other hand, are in charge of using the fans when showering or cooking, communicating water leaks to landlord immediately, and keeping their unit temperature around 68 degrees to both prevent mold and keep it well ventilated.
While in many case tenants and landlords can work together to solve these problems proactively, if a problem does arise that the landlord is not addressing, tenants have rights. When considering issues of tenants rights, it would be wise to seek legal assistance, especially before taking any action regarding the lease or payment. The U.S. Department of Housing and Urban Development (HUD) allows tenants to search for legal aid by state.
Most states have an implied warranty of habitability, which means that landlords must keep their properties “habitable” even if the upkeep isn’t specifically stipulated in the lease. Every state except Arkansas requires rental housing be kept in “livable condition,” which means that it must have safe electrical, plumbing, heating, and ventilation systems, as well as clean and safe hallways and stairs. These requirements also require garbage removal and vermin extermination. Beyond these baseline standards, the definition of “habitable” varies under state and local law. Households living in Section 8 or other federally-sponsored housing are covered under more strict federal standards.
If an issue goes unaddressed, tenants can contact the building manager with a written request about the situation. It is important to document the problem in detail including photos, a description of the issue, and the date and time of the issue. If the building manager is not responsive, however, tenants can request a city or county inspection for violations. Each state has slightly different processes for such complaints, but a call to the local health department is often a good place to start.
Finally, the U.S. Fair Housing Act (FHA) and the Americans with Disabilities Act (ADA) provide additional protections for individuals with disabilities who live in subsidized rental housing. Asthma is specifically classified as a disability under FHA and ADA. Tenants with asthma have “a legal right for reasonable accommodations to rules, policies, practices or services. They also are entitled to structural changes by the reasonable modification provision when a particular asthma trigger in the housing environment impacts their disability.” FHA and state fair housing laws provide similar protections for market-rate housing.
The process of submitting a formal complaint or request for accommodations can be challenging and new for tenants. Many tenants often don’t feel comfortable making complaints about their housing quality due to uncertainty as to how their landlord will respond or fear of retaliation. This is especially true for tenants living in high-demand rental markets where eviction rates are high. Many tenants also face other barriers to submitting complaints, including language access and work schedules. Local asthma coalitions, tenants rights organizations, and local public health departments can provide support to tenants through this process. While there is no comprehensive list of asthma coalitions, you can usually find resources by searching “asthma coalition city, state” or “public health department city, state.” Some of these groups even coordinate environmental assessments using the EPA environmental assessment checklist and are able to triage violations directly.
For households living in rental housing, the challenges to creating a healthy home environment can be significant. Ideally, tenants and landlords can work together to prevent asthma triggers and remediate any issues. However, while protections and processes are in place to support this collaboration, in practice resolving these problems can be time-consuming and discouraging for tenants. Understanding their rights as tenants and enlisting the support of local organizations can be critical to a tenant’s success.
*Note: At the time that What Makes a Healthy Home: A Guide for Landlords and Tenants was published, there were seven accepted principles of healthy housing. An eighth, "thermally-controlled," has since been adopted by the healthy homes community.
A version of this article was published in July 2013 as "How to Create an Asthma Safe Home Part II: Solutions for Tenants and Landlords" on the Propeller Health site. The author has modified portions of the article for publication here.
Justine Marcus is currently pursuing a dual degree, Masters in City Planning and Masters in Public Health, at the University of California Berkeley. Through her graduate studies, Justine is exploring how community infrastructure – from housing, to water, to governance – can be used to address health disparities and build community power. She is currently a graduate student researcher for the UC Berkeley Center for Community Innovation, where she is examining the health and material impacts of evictions on households. Justine is a proud Wisconsinite and lifelong public school alumna.