Environmental Racism at the Household Level

Housing quality and location influence how much of the outdoor pollutants discussed in  part II  of this series get inside the house. But what about exposures from inside the home? These include lead, pest problems, mold and moisture, fine particulate matter, and secondhand smoke. Paradoxically, better insulation (which keeps external pollutants out) can make indoor exposures worse.

While better insulation or tighter fitting windows might keep out air pollution from the street, these structural components might also keep the air pollution from a gas stove in. Further, indoor exposures are shaped by behaviors (cooking, smoking), household factors (multi-generational households), structural issues (building age, dwelling size) and neighborhood exposures that are all socially patterned.

For these reasons, studying exposures in the home is both complex and vitally necessary for understanding environmental racism and promoting environmental justice.

 Indoor air pollution  includes byproducts from combustion (gas stoves, smoking): carbon monoxide, nitrogen dioxide, and fine particulate matter (PM2.5) as well as volatile organic compounds (VOCs) from, among other things, the use of indoor air fresheners. The amount of exposure to indoor air pollution is determined by a complex relationship between indoor and outdoor air pollution sources, dwelling size and ventilation.

Exposure to indoor air pollutants can cause or worsen asthma and other respiratory issues including asthma. Long-term exposure to indoor air pollution can also increase the risk of cardiovascular disease and cancer.

One type of indoor air pollution that can be extremely harmful to health is secondhand smoke. Even though far fewer people smoke cigarettes indoors nowadays than 50 years ago, today there are  clear disparities  in who is exposed to secondhand smoke. Black and low-income children are far more likely to be exposed to secondhand smoke at home than White and high-income children.

High childhood BLL seem to cluster together in space. But are high blood levels also linked with demographics of an area?

To examine this question, use the slider below to compare high blood lead levels on the left with Massachusetts  Environmental Justice Communities  on the right. Based on the data from the 2015-2019 American Community Survey, a census block group is considered an Environmental Justice (EJ) community if it meets at least one of these criteria:

• the annual median household income is not more than 65 per cent of the statewide annual median household income,
• minorities comprise 40 per cent or more of the population,
• and/or 25 per cent or more of households lack English language proficiency.

The map on the right shows the number of EJ criteria met, with the darkest blue color indicating that a community met all three criteria.

Pest infestation can be harmful to health because infectious diseases are spread through some pest droppings and because of  pest-related allergens . These allergens are particularly harmful for  people with asthma.  Pesticides, chemicals used to kill pests in the home, can also release harmful toxins into the air. The presence of pests in the home is associated with worse  overall  and  mental  health, highlighting the importance of this issue.

Further, there are racial/ethnic and socioeconomic disparities in pest infestations. In an  analysis of Los Angeles households , researchers found that Hispanic and Asian households were nearly three times as likely to report cockroaches in their home compared to non-Hispanic Whites, and households with primary caregivers with at least a high school diploma were nearly five times less likely to report mice and cockroaches in the home compared to those without a high school degree.

On a local level, Boston ranked  #2 in the most rat-infested cities in America . Explore rodent complaints below in this map from RentHop (2019):  Is your city rat infested ? Note that the map below shows number of rodent complaints per unit area, not per person, meaning that more densely populated areas of the city (like the North End) are more likely to have a high density of rodent complaints than less densely populated areas (like West Roxbury).

Indoor exposure to mold and moisture is linked to  asthma, upper respiratory infections, coughing and wheezing . Mold and moisture are caused by insufficient ventilation, flooding, and/or poorly sealed walls and windows during rain. Residences without a ventilation fan in the bathroom are much more prone to mold and moisture, and associated health effects. Older buildings and those in need of renovation are  much more likely to have mold issues  than newer buildings.

Results from this study show that Whiter areas are less likely to file reports of household asthma triggers with the City of Boston, and that Whiter areas are more likely to get the reports they do file resolved. In light of these results, the authors of the study highlight the need for stronger tenant protections. They propose the following solutions:

• Stricter inspection and regulatory standards
• Proactive enforcement that does not rely on tenant reports to the city
  • There may be disparities in reporting in the first place, which takes time and resources to do.
• Expand public housing
  • Private landlords are incentivized to keep costs low, and one way to cut costs is to ignore important, but costly, repairs or services.

Read the full study in  Health Affairs .

• American Public Health Association,  Creating the Healthiest Nation: Health and Housing Equity  (2020).
• Ernie Hood,  Dwelling disparities: how poor housing leads to poor health  (2005). Environ Health Perspectives.
• Kleipes et al.,  The National Human Activity Pattern Survey (NHAPS): a resource for assessing exposure to environmental pollutants  (2011). Nature.
• EPA,  Indoor Air Quality 
• Teye, et al.,  Exploring persistent racial/ethnic disparities in lead exposure among American children aged 1-5 years: results from NHANES 1999-2016  (2021). Int Arch Occup Environ Health.
• Massachusetts Department of Public Health, Department of Environmental Health,  Data Brief: Childhood Lead Exposure in Massachusetts  (2019).
• National Institute on Drug Abuse,  Racial and socioeconomic disparities persist among U.S. children  (2019).
• Peters, et al.,  Determinants of allergen concentrations in apartments of asthmatic children living in public housing  (2007). J Urban Health.
• Chew, et al.,  Determinants of cockroach and mouse exposure and associations with asthma in families and elderly individuals living in New York City public housing  (2006). Ann Allergy Asthma Immunol.
• Camacho-Rivera, et al.,  Associations of neighborhood concentrated poverty, neighborhood racial/ethnic composition, and indoor allergen exposures: a cross-sectional analysis of Los Angeles households , 2006-2008 (2014). J Urban Health.
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• Shah, et al.,  Housing quality and mental health: the association between pest infestation and depressive symptoms in public housing residents  (2018). J Urban Health.
• Lemire, et al.,  Unequal Housing Conditions and Code Enforcement Contribute to Asthma Disparities in Boston, Massachusetts  (2022). Health Affairs.