National Tribal Healthy Homes
Assessment, Training &
Technical Assistance Support Center

In an effort to increase family and community wellness among our nation's tribes, MSU Extension Housing & Environmental Health Program and the Native American Housing Technical Assistance Institute proposed the creation of a National Tribal Healthy Homes Training & Technical Assistance Support Center which will integrate all elements of the existing National Center for Healthy Housing and the USDA/HUD Healthy Homes Partnership program.

Coordination with tribal housing and health professionals will enable the program to help community members and home occupants understand, measure, and control healthy home influences.

This Center will enable tribal communities to assess homes for common indoor health hazards such as mold and moisture, carbon monoxide, household chemicals, unsafe drinking water, lead, asbestos, pesticides, radon, dust and dust mites, common allergens, asthma triggers, and fire and safety hazards and septic systems. Training and technical assistance will be offered to all 562 federally-recognized tribes via national, state and local tribal partners (i.e., The National American Indian Housing Council, the National Congress of American Indians, the National Center for Healthy Housing, the national Healthy Homes Partnership program, etc.).

Training opportunities will be promoted to Indian Housing Authorities (or other Tribally Designated Housing Entities), Sanitarians, IHS Health Educators and IHS Community Health Representatives, USDA Tribal Colleges, other health professionals, as well as homeowners, and other interested community members. Program information and resources will be transferrable to other regularly-occupied buildings, especially those of children (i.e., schools, daycare centers, etc.).

Training and technical assistance will consist of regional, multi-day Healthy Homes trainings with significant time spent conducting hands-on home assessments in the field. The individuals receiving the training will be able to take the information and knowledge back to their communities and continue to build the capacity among their community members. Working closely with tribal partners, a tribal-specific/culturally appropriate curriculum will be developed. Other program materials and resources will be developed, such as pre- and post-occupancy Healthy Homes Assessment Guides; occupant and youth targeted educational material; and, Native American media campaign to raise awareness on a community level

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Environmental Health Risks
in Indian Country Housing

Background & Statistics

American Indians (AI) and Alaska Natives (AN) today face serious health issues such as higher prevalence rates of asthma, higher rates of smoking, unhealthy living conditions due to sub-standard housing in tribal areas, and increased risk of injuries compared to the rest of the country. Prevalence of current smoking in 2005 was highest among AI/AN (32.0%). (Smoking 101 Fact Sheet , May 2007, American Lung Association) Household injuries and accidents are the highest among this group when compared to any other ethnic population. A study conducted by the U.S. Dept. of HUD, Mold and Moisture Problems in Native American Housing on Tribal Lands: A Report to Congress revealed that black mold was found in 15% of tribal homes.

Sub-standard housing conditions are found on Reservations at an alarming rate. “In tribal areas, 14.7% of homes are overcrowded, compared to 5.7% of homes of the general U.S. population. On Native American lands, 11.7% of residents lack complete plumbing facilities, compared to 1.2% of the general U.S. population.” (Census Bureau, 2000) When looking at factors that contribute to increased asthma exacerbations seen among the AIs, the housing condition is very important. On the reservations, housing options are limited and residents may not have the information and tools needed to control the household environment adequately especially when limiting asthma trigger exposure. Mold and moisture - common accompaniments of poor housing – produce odors that can lead to increased asthma exacerbations and leads to weakening and degrading structures in a low-quality home. Low-income and overcrowded households also experience greater incidence of moisture problems.

The burden of asthma is increasing among all populations, but especially so in the AI population. According to the 2002 CDC Behavioral Risk Factor Surveillance System data, AI/AN asthma prevalence rate was 11.6% compared to the national prevalence rate of 7.5%. AI/AN pediatric asthma prevalence data is limited, but the data suggests that it may be much higher than the national average. A prevalence study conducted at the Fort Peck Indian Health Service Unit Northeast Montana in 1999 uncovered a 15.5% rate among children. Other studies have found prevalence rates to be twice the national average. Childhood asthma is the leading cause of missed school days (14 million per year). The quality of life of the asthmatic is diminished due to limitations in sleeping, playing sports, exercising, and other activities.

When sub-standard housing, lack of available health care and other health disparities, poverty and unemployment are taken into consideration, AIs face a multitude of challenges. Research indicates that a holistic approach when dealing with environmental health and building occupants is very effective in reducing indoor environmental health hazards. Organizations, such as the American Assoc. of Asthma Educators (AAAE), have recently included the indoor environment as one of the most significant factors when looking at why an asthmatic is having difficulties controlling their asthma. In addition, it is widely known that housing on the Reservations is considered sub-standard and may be contributing to health problems and negatively impacting overall well-being.