Increased carbon monoxide levels in a public housing community

CASE STUDY 19.1: INCREASED CARBON MONOXIDE LEVELS IN A PUBLIC HOUSING COMMUNITY Situation McDougald Terrance is one of 14 public housing properties owned and maintained by the Durham Housing Authority (DHA) in Durham, North Carolina. Built in 1954, McDougald Terrace was heralded as the city’s first “Black project.” In 2019, McDougald Terrace had 360 units occupied primarily by African American, female-headed families (DHA, 2021). In 2018 and 2019, McDougald Terrace did not pass U.S. Department of Housing and Urban Development (HUD) health and safety inspections due to numerous noted deficiencies (Bridges, 2020). In late December 2019, Emergency Management Services (EMS) discovered an unusual cluster of carbon monoxide (CO) calls and developed a task force (Bridges, 2020). DHA launched an immediate response to protect their residents and ordered a full inspection of the property. Over 3 days, 296 apartments were inspected, and occupants’ CO levels were assessed (Bridges, 2020). Several adults and children had elevated CO levels, and some apartments had stoves and water heaters emitting higher-than-expected CO levels. After the inspections were completed, another call for unusual levels of CO prompted a voluntary evacuation of the property. Within the ensuing weeks, 270 families relocated to local hotels to allow property repairs (Bridges, 2020). Ultimately, an inspection of 346 units revealed 211 stoves, 38 furnaces, and 35 water heaters emitting high CO levels (Bridges, 2020). Appliances emitting high CO levels were repaired or replaced, and the original ventilation system was replaced to properly vent the gas appliances. Background The U.S. Housing Act of 1937 established government-funded permanent public housing under the U.S. Department of Housing and Urban Development (HUD, n.d.). The intent was to provide affordable and safe rental housing to eligible low-income families, older adults, and persons with disabilities. African Americans make up less than 15% of the population of the United States (U.S. Census Bureau, 2019) but account for 44% of people living in public housing (HUD, n.d.) in the United States. Public housing residents pay income-based rent, which is generally 30% of all adults’ combined earnings or $25 to $50 per month for households where no adults earn wages (HUD, n.d.). Over the years, a manifestation of structural racism and disinvestment in public housing has resulted in a $26 billion backlog of deferred maintenance to housing units across the nation (HUD, n.d.). The rental assistance demonstration (RAD) program is a policy solution that allows for private investment in public housing. RAD is being implemented in cities across the United States. Through RAD, private monies will help to offset critical public housing capital needs, which are estimated at over $70 billion nationwide (Schwartz & McClure, 2021). Findings The CO emergent situation at the McDougald Terrace apartments and the displacement of families into hotels, in some cases for up to 4 months, caused significant life disruptions. Regular routes for transportation and communication changed abruptly. A special bus route was established to provide transportation to school but this resulted in children being ostracized and bullied. Many hotels had no cooking facilities, and families had to eat take-out, prepared, and processed foods for all meals. Residents feared for their families’ health and safety and the security of their personal belongings, which remained in their apartments during renovation. The situation created an increased distrust of DHA and local government among some public housing residents. The McDougald Terrace property renovations, hotel room rentals, and necessities for the 270 displaced families cost millions. These monies were from the DHA budget intended to provide maintenance and upkeep to all their public and affordable housing properties. Conclusions Structural racism has resulted in disinvestment in public housing nationwide, jeopardizing the health and well-being of low-income families, older adults, and disabled persons. In Durham, substandard public housing caused the displacement of 270 families and more than 1,000 individuals and resulted in major life disruptions and stress. Public housing properties across the United States are undergoing RAD conversion and are receiving renovations, resulting in improved health outcomes. Case Study Questions 1. What implications for practice, research, and advocacy work stand out in this case study? Consider the following: Zoning laws governing housing, Green spaces and recreational sites, Neighborhood placement and affordability, Transportation, Access to nutritious food, and Access to healthcare. 2. In what ways does this case study illustrate inequity? Discuss the following: Systemic racism/redlining, and Social determinants/drivers of health. 3. Discuss the components of environmental risk assessments that you would focus on when assessing individuals living in public housing. 4. How does housing insecurity affect the health and well-being of individuals, families, and communities? 5. Discuss the psychosocial consequences of environmental hazards, including: structural violence, toxic stress, and social isolation. REQUIREMENTS 2 PAGES NO PLAGIO MORE THAN 5% CHECK GRAMMAR AND USE CORRECT APA FORMAT DUE DATE FEBRUARY 4, 2024 ADD CITATIONS AND SCHOLARLY REFERENCES NO OLDER THAN 5 YEARS.

Sample Solution

Case Study Analysis: McDougald Terrace CO Incident and Public Housing Inequities

Implications for Practice, Research, and Advocacy:

The McDougald Terrace case study highlights several crucial implications for practice, research, and advocacy efforts related to public housing:

Zoning Laws and Green Spaces: Zoning regulations often restrict the development of affordable housing in areas with access to green spaces and recreational facilities. Advocacy efforts should push for inclusive zoning policies that prioritize equitable access to these amenities. Research can explore the health benefits of green spaces for public housing residents and advocate for incorporating them into community designs.

Neighborhood Placement and Affordability: Public housing is often concentrated in disadvantaged neighborhoods with limited access to resources and opportunities. Practice efforts should focus on mixed-income housing developments that integrate public housing into thriving communities. Research can identify successful models of mixed-income housing and assess their impact on resident well-being.

Transportation: Limited access to reliable transportation hinders residents' ability to access jobs, education, and healthcare. Practices like subsidized public transportation passes and improved public transit infrastructure can address this challenge.

Full Answer Section

Research can explore the transportation needs of public housing residents and evaluate the effectiveness of different intervention strategies.

Access to Nutritious Food: Food deserts, characterized by limited access to affordable healthy food options, disproportionately impact public housing communities. Supporting community gardens, urban farms, and grocery store initiatives can improve access to healthy food. Research can assess the prevalence of food deserts in public housing areas and evaluate the impact of interventions aimed at increasing access to healthy food.

Access to Healthcare: Public housing residents often face barriers to accessing quality healthcare due to limited insurance coverage and transportation challenges. Advocating for expanded Medicaid access and establishing mobile health clinics within or near public housing communities can address these issues. Research can explore the healthcare needs of public housing residents and identify effective strategies to improve access to care.

Inequity Illustrated:

The McDougald Terrace case study exemplifies several forms of inequity:

Systemic Racism/Redlining: Historical practices of redlining denied Black communities access to mortgages and investments, leading to concentrated poverty and disinvestment in public housing. Advocacy efforts should focus on dismantling discriminatory housing policies and promoting reparations for communities harmed by redlining. Research can document the historical and ongoing impacts of redlining on public housing and advocate for policy changes to address these inequities.

Social Determinants/Drivers of Health: The substandard conditions in McDougald Terrace reflect the social determinants of health, such as poverty, lack of access to resources, and environmental hazards, which disproportionately impact low-income communities and communities of color. Advocacy efforts should address these social determinants through policies that promote income security, affordable housing, and equitable access to resources. Research can explore the links between social determinants and health outcomes in public housing communities and inform policy solutions.

Environmental Risk Assessments for Public Housing:

When assessing environmental risks in public housing, the following components should be prioritized:

Air quality: Indoor and outdoor air quality testing for pollutants like carbon monoxide, lead, and radon.
Water quality: Testing for contaminants in drinking water and potential exposure to lead pipes.
Mold and mildew: Assessment of moisture levels and potential mold growth, which can exacerbate respiratory problems.
Pest infestation: Evaluation of rodent and insect infestations, which can pose health risks and contribute to stress.
Structural integrity: Assessment of potential hazards like lead paint, asbestos, and structural deficiencies.

These assessments should be conducted regularly and involve resident participation to ensure their concerns are addressed effectively.

Impact of Housing Insecurity on Health and Well-being:

Housing insecurity, as experienced by the McDougald Terrace residents, negatively impacts individuals, families, and communities in various ways:

Physical health: Increased risk of chronic diseases like asthma, heart disease, and respiratory infections due to exposure to environmental hazards and stress.
Mental health: Increased risk of depression, anxiety, and post-traumatic stress disorder due to displacement, stress, and uncertainty.
Child development: Negative impacts on children's academic performance, social development, and emotional well-being due to disrupted routines and instability.
Community cohesion: Displacement can disrupt social networks and weaken community bonds, leading to feelings of isolation and decreased social support.

Psychosocial Consequences of Environmental Hazards:

Environmental hazards in public housing can have significant psychosocial consequences, including:

Structural violence: The systemic neglect and disinvestment in public housing represent a form of structural violence that perpetuates inequities and undermines residents' health and well-being.
Toxic stress: Chronic exposure to environmental hazards and the associated fear and anxiety can contribute to toxic stress, which can have lasting negative impacts on physical and mental health.
Social isolation: The stigma associated with living in public housing and the challenges of navigating displacement can lead to social isolation and feelings of disconnection.

Conclusion:

The McDougald Terrace case study reveals the stark realities of inadequate public housing and its detrimental impact

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