Maintaining safe and healthy housing

Strategy overview

  • Balancing resident needs with inspector capacity: Initiatives focused on maintaining safe and healthy housing typically engage both property owners and tenants, and in many cases, housing inspectors. These programs intend to ensure that existing affordable homes remain safe, healthy, and high-quality. They typically address common home health hazards, which often fall into one of two major categories: physical injury/safety risks (i.e. unstable staircases or broken handrails) and illness-inducing hazards (such as lead paint, mold, pests, carbon monoxide, etc.).
  • Proactive inspections: The foundation of many effective programs is a more strategic deployment of a jurisdiction’s home inspection capacity. Oftentimes, this includes using data analysis to identify high-risk blocks or neighborhoods and then sending inspectors to walk those areas, conduct visual exterior assessments, speak to residents, and schedule proactive inspections.
  • Incentivizing housing rehabilitation: To ensure property owners have the financial capacity to address home hazards, some programs provide income-eligible property owners with grants and/or loans to assist with repair, rehabilitation, and/or reconstruction of homes. Funding is often tied to specific forms of home improvement, such insulation, plumbing, or mold removal.
  • Raising tenant and landlord awareness: Many successful programs include a robust education component — often run by inspectors — to help landlords and tenants identify home hazards and other threats to home safety. This can include written materials, videos, and public workshops (for instance, walking through a home to demonstrate an inspection). Such efforts also often include information on how to request a home inspection.
Target Population
Key Stakeholders
Mayor or County Executive's Office, Housing Department, Health Department, Environmental Protection Department, Program Evaluation Team

What evidence supports this strategy?


Multiple systematic reviews of rigorous evaluations demonstrated that interventions focused on maintaining safe and healthy housing can improve health outcomes for residents, especially children.

  • A 2009 comprehensive analysis of healthy housing initiatives concluded that up to 81% of studied neighborhood-level interventions improved health and/or environmental outcomes for residents.
  • A 2008 systematic review of home-based interventions seeking to reduce asthma triggers for children found that they decreased asthma symptom days, school days missed, and acute healthcare visits, all while generating significant savings from averted costs of asthma care.

How does maintaining safe and healthy housing impact economic mobility?

  • Remediating high-risk homes: Programs that maintain safe and healthy housing often prioritize remediation in the highest risk areas, in which the majority of residents are low-income. Research shows that children exposed to common home toxins have increased risks of learning disabilities, juvenile delinquency, and dropping out of high school.
  • Reducing risks for children: Maintaining safe and healthy housing can help ensure families are living in safe environments. Children with prolonged exposure to lead are far likelier to have poor health outcomes, which, research shows, can lead to lower earnings and more restrictive career paths. The reverse is also true: numerous studies show a positive correlation between good health and strong labor market outcomes.
  • Creating stable home environments: Children benefit significantly from staying stably housed in safe, healthy homes. Research shows that healthy home environments can be associated with improved academic and behavioral outcomes for children; unstable environments (often, moving multiple times in a short period as a result of low-quality housing) can lead to negative outcomes for children, like diminished reading and math skills and aggressive behavior.

Best practices in implementation

  • Roll out the program gradually: Many healthy homes and housing quality programs include significant overhauls to existing inspection and related processes. By rolling out a program in a single neighborhood (ideally one with a relatively high rate of unremediated hazards), program leaders can identify and resolve challenges before broader implementation.
  • Engage with tenants and landlords: Public education efforts should be a foundation of any healthy homes and housing quality program. Tenants and property owners must be provided the resources necessary to identify hazards and how to approach remediation (i.e. scheduling an inspection or applying for a rehabilitation loan). Education can be delivered in a range of ways, including printed materials in multiple languages, public information sessions in community centers, social media campaigns, and more.
  • Build public trust: A common challenge with proactive home inspection programs is hesitance in allowing government employees into a home voluntarily. To address this dynamic, encourage inspectors to participate in community events and regularly speak to residents. It is especially important for inspectors to demonstrate a solutions-oriented, rather than punitive, approach. This can include warnings instead of fines for good-faith efforts that are delayed, follow-up reminders on deadlines for loan programs, and more.
  • Cultivate buy-in among inspectors: Home inspectors often anchor healthy homes and housing quality programs; if a tenant attends an education session and then recognizes a hazard, the program relies on an inspector to conduct a home visit and follow-up to ensure remediation. Because such programs often involve significant changes to an inspector’s schedule and responsibilities, it is crucial to prioritize cultivating buy-in among them during the program design phase.
  • Leverage data to set priorities: Many programs focus on increasing inspector efficiency rather than increasing staff. To do so, jurisdictions invest in data management software that can help inform the home inspection process. For instance, data tools can be used to draw territories that balance inspector caseloads, rather than by an arbitrary geographic boundary; inspectors can use the analysis to plan and prioritize their inspection routes; and investment in technology (such as tablets) can allow for real-time data collection and analysis.

Evidence-based examples

Professional home inspections evaluating environmental health risks
Stable and healthy families Supportive neighborhoods Kindergarten readiness
Funding in the form of loans and/or grants to income-eligible owner-occupants to assist with repair, rehabilitation, and/or reconstruction of homes
Stable and healthy families Supportive neighborhoods
Programs focused on removing lead-based and contaminated surfaces from homes and other buildings
Stable and healthy families Supportive neighborhoods Kindergarten readiness