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National Healthy Housing Standard: 5 Things to Know

The APHA’s housing standards seek to improve health by improving housing.

Since the days when tuberculosis, typhoid, and dysentery were spreading through tenement buildings, we’ve understood that housing conditions and health are closely related. Unfortunately, even now, millions of people in the U.S. live in substandard conditions.1 What can we do about it? The American Public Health Association’s (APHA) National Center for Healthy Housing (NCHH) has a solution: the National Healthy Housing Standard (NHHS).

Developed by the APHA in 2014, the NHHS provides guidelines designed to help municipalities and housing occupants better ensure homes are safe and healthy.1 "The Standard is a living tool for property owners, elected officials, code agency staff, and all who are concerned about housing as a platform for health," the NCHH explains. "Individually and together, the Standard constitutes minimum performance standards for a safe and healthy home."2

National Healthy Housing Standard: 5 Things to Know

Here are the top five things you need to know about why these standards are needed and what they’re designed to achieve:

1. Substandard Housing Directly Impacts Health

The NHHS lists a number of health consequences of substandard housing. They include:3

  • About 20–30% of asthma cases are linked to home environmental conditions
  • 21,000 lung cancer deaths result from radon in homes
  • Over 24 million homes that have lead-based paint hazards put children at risk of the irreversible disease of childhood lead poisoning
  • Home injuries are the leading causes of death for young children and put 6 million adults over age 65 in hospitals and nursing homes due to preventable falls.

2. Recent Efforts to Improve Housing Have Fallen Short

Lowering the number of substandard housing units in the U.S. has proven to be difficult. According to the NCHH, approximately 6 million U.S. homes are substandard, "a statistic that has seen little change over the last two decades."1

The NHHS seeks to overcome the inherent challenges of improving existing housing by focusing on specific improvements. The practical, comprehensive provisions in the NHHS can be implemented in total or in part, allowing localities to address the healthy housing issues most urgent to them.

3. Building Codes Must Also Address Health Concerns

Most state and local building/housing codes seek to ensure a building’s structural integrity, while other codes mandate certain levels of energy efficiency and general occupant safety. Some areas even have codes regulating aesthetics. But building codes also must address health-related standards, and communities must enforce them, advise the authors of "up to Code: Code Enforcement Strategies for Healthy Housing," a guide funded by The Kresge Foundation.4

"Local code enforcement programs are the first line of defense in ensuring safe and healthy housing for residents," the guide says. "To be effective, these programs require strong housing codes, well-trained enforcement officers, cross-agency collaboration, partnerships with community agencies, programs to assist residents and property owners, and thoughtful data collection and evaluation."4

The guide advocates for "specific, science-based health standards" to be used in drafting housing codes. "In too many localities, housing codes contain ambiguous phrases in their standards, such as ‘clean,’ ‘sanitary,’ ‘safe,’ and ‘healthy,’ and the lack of details makes efficient and effective code enforcement difficult."4

Most codes do not address such issues as:

Noise levels
Indoor smoking
Presence of a fire extinguisher in the residence
Presence of carbon monoxide alarm
Lead paint in existing buildings
Asbestos in existing buildings
Radon levels
Identifying and eliminating methamphetamine exposure in multifamily housing
Use of pesticides

4. We Need to Focus on Seven Areas of Housing

The provisions of the NHHS are divided into the following seven areas of housing:3

  1. Duties of Owners and Occupants
    These provisions are designed to help ensure building owners provide occupants with the resources and information they need for healthy living, and that occupants take proper advantage of the resources and information they’re provided.
  2. Structure, Facilities, Plumbing, and Space Requirements
    These provisions seek to ensure the physical aspects of the home are safe and healthy. They cover overall structure, plumbing, kitchens, bathrooms, living space, flooring, and noise abatement.
  3. Safety and Personal Security
    These provisions are designed to ensure occupants are alerted to emergencies and can easily escape if needed. They also provide guidelines for reducing the causes of household accidents such as chemical exposure, falls, and drownings.
  4. Lighting and Electrical Systems
    These provisions seek to ensure all aspects of electrical systems are safe to use and not in danger of being overtaxed. Provisions also seek to ensure occupants have proper natural and artificial lighting.
  5. Thermal Comfort, Ventilation, and Energy Efficiency
    These provisions are designed to ensure heating and cooling doesn’t put the health of occupants at risk or cost more than necessary.
  6. Moisture Control, Solid Waste, and Pest Management
    These provisions seek to prevent the spread of disease by eliminating the risks associated with mold, improper waste removal, and pest infestations.
  7. Chemical and Radiological Agents
    These provisions seek to limit the possibility of human contamination by chemicals and other dangerous/toxic agents including lead paint, formaldehyde, asbestos, radon, and pesticides.

5. Public Awareness Is Key

Without public awareness, the provisions in the NHHS will go unnoticed and unused. Fortunately, there is a way you can help. With an MS in Health Education and Promotion, you can gain the skills you need to help ensure that policy makers and the public at large understand the ways improving our homes can improve our health.

If you’re currently working, you might think earning a health education and promotion degree isn’t feasible. However, thanks to online education, earning a master’s degree is more convenient than ever. That’s because online university programs give you advantages you can’t find at campus-based programs.

When you choose to earn a master’s in health education and promotion online, you can complete the majority of your coursework from home. Plus, an online master’s in health education and promotion program offers you a flexible schedule, allowing you to take classes and handle your studies at the time of day that works best for you and your job.

With a career in health education and promotion, you can help improve housing conditions for millions. And thanks to online learning, you can gain the skills you need to start that career sooner than you might think.

Walden University is an accredited institution offering an MS in Health Education and Promotion degree program online. Expand your career options and earn your degree in a convenient, flexible format that fits your busy life.


Walden University is accredited by The Higher Learning Commission,